title: Eating behavior in frontotemporal dementia: Peripheral hormones vs hypothalamic pathology.
abstract: OBJECTIVE
  To contrast the relationships of hormonal eating peptides and hypothalamic volumes to eating behavior and metabolic changes (body mass index [BMI]) in behavioral variant frontotemporal dementia (bvFTD) and semantic variant primary progressive aphasia (svPPA).
  
  
  METHODS
  Seventy-five patients with dementia (19 bvFTD, 26 svPPA, and 30 Alzheimer disease dementia) and 23 controls underwent fasting blood analyses of leptin, ghrelin, cholecystokinin, peptide tyrosine tyrosine (PYY), and agouti-related peptide (AgRP) levels. On brain MRI anterior, posterior, and total hypothalamic volumes were measured. Relationships between endocrine measures, hypothalamic volumes, eating behaviors, and BMI were investigated.
  
  
  RESULTS
  Levels of AgRP were higher in patients with bvFTD (69 ± 89 pg/mL) and svPPA (62 ± 81 pg/mL) compared with controls (23 ± 19 pg/mL, p < 0.01). No differences were found for leptin, oxytocin, cholecystokinin, ghrelin, and PYY levels. Patients with bvFTD and svPPA had higher scores on questionnaires measuring eating behaviors. Atrophy of the posterior and total hypothalamus was observed in the bvFTD group only. Linear regression modeling revealed that leptin and AgRP levels predicted BMI.
  
  
  CONCLUSIONS
  Eating abnormalities are multifactorial in FTD. In bvFTD, they are in part related to hypothalamic degeneration, with potential disintegration of the network connections between the hypothalamus and orbitofrontal cortex/reward pathways. In svPPA, although hypothalamic volumes are preserved, this group experiences elevated AgRP levels similar to bvFTD, which predicts BMI in both groups. This finding highlights the potential key role of AgRP in eating and metabolic changes and provides a potential target for treatment to modify disease progression.
authors.affiliation: From Neuroscience Research Australia (R.M.A., S.L., L.B., M.I., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A.), School of Medical Sciences (G.M.H., J.R.H., O.P.), School of Psychology (M.I.), and ARC Centre of Excellence in Cognition and Its Disorders (R.M.A., M.I., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Centre, University of Sydney, Australia. r.ahmed@neura.edu.au o.piguet@neura.edu.au.
authors.forename: Rebekah M
authors.initials: RM
authors.lastname: Ahmed
authors.affiliation: From Neuroscience Research Australia (R.M.A., S.L., L.B., M.I., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A.), School of Medical Sciences (G.M.H., J.R.H., O.P.), School of Psychology (M.I.), and ARC Centre of Excellence in Cognition and Its Disorders (R.M.A., M.I., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Centre, University of Sydney, Australia.
authors.forename: Sahar
authors.initials: S
authors.lastname: Latheef
authors.affiliation: From Neuroscience Research Australia (R.M.A., S.L., L.B., M.I., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A.), School of Medical Sciences (G.M.H., J.R.H., O.P.), School of Psychology (M.I.), and ARC Centre of Excellence in Cognition and Its Disorders (R.M.A., M.I., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Centre, University of Sydney, Australia.
authors.forename: Lauren
authors.initials: L
authors.lastname: Bartley
authors.affiliation: From Neuroscience Research Australia (R.M.A., S.L., L.B., M.I., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A.), School of Medical Sciences (G.M.H., J.R.H., O.P.), School of Psychology (M.I.), and ARC Centre of Excellence in Cognition and Its Disorders (R.M.A., M.I., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Centre, University of Sydney, Australia.
authors.forename: Muireann
authors.initials: M
authors.lastname: Irish
authors.affiliation: From Neuroscience Research Australia (R.M.A., S.L., L.B., M.I., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A.), School of Medical Sciences (G.M.H., J.R.H., O.P.), School of Psychology (M.I.), and ARC Centre of Excellence in Cognition and Its Disorders (R.M.A., M.I., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Centre, University of Sydney, Australia.
authors.forename: Glenda M
authors.initials: GM
authors.lastname: Halliday
authors.affiliation: From Neuroscience Research Australia (R.M.A., S.L., L.B., M.I., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A.), School of Medical Sciences (G.M.H., J.R.H., O.P.), School of Psychology (M.I.), and ARC Centre of Excellence in Cognition and Its Disorders (R.M.A., M.I., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Centre, University of Sydney, Australia.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Kiernan
authors.affiliation: From Neuroscience Research Australia (R.M.A., S.L., L.B., M.I., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A.), School of Medical Sciences (G.M.H., J.R.H., O.P.), School of Psychology (M.I.), and ARC Centre of Excellence in Cognition and Its Disorders (R.M.A., M.I., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Centre, University of Sydney, Australia.
authors.forename: John R
authors.initials: JR
authors.lastname: Hodges
authors.affiliation: From Neuroscience Research Australia (R.M.A., S.L., L.B., M.I., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A.), School of Medical Sciences (G.M.H., J.R.H., O.P.), School of Psychology (M.I.), and ARC Centre of Excellence in Cognition and Its Disorders (R.M.A., M.I., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Centre, University of Sydney, Australia. r.ahmed@neura.edu.au o.piguet@neura.edu.au.
authors.forename: Olivier
authors.initials: O
authors.lastname: Piguet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000097:blood / Q000473:pathology; D018888:Aphasia, Primary Progressive / Q000473:pathology; D005215:Fasting / Q000502:physiology; D005247:Feeding Behavior; D005260:Female; D057180:Frontotemporal Dementia / Q000097:blood / Q000473:pathology* / Q000503:physiopathology; D006728:Hormones / Q000097:blood; D006801:Humans; D007031:Hypothalamus / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020774:Pick Disease of the Brain / Q000097:blood / Q000473:pathology*
chemical_list: D006728:Hormones