title: Correlated patterns of neuropsychological and behavioral symptoms in frontal variant of Alzheimer disease and behavioral variant frontotemporal dementia: a comparative case study.
abstract: Although the neuropathologic changes and diagnostic criteria for the neurodegenerative disorder Alzheimer's disease (AD) are well-established, the clinical symptoms vary largely. Symptomatically, frontal variant of AD (fv-AD) presents very similarly to behavioral variant frontotemporal dementia (bvFTD), which creates major challenges for differential diagnosis. Here, we report two patients who present with progressive cognitive impairment, early and prominent behavioral features, and significant frontotemporal lobe atrophy on magnetic resonance imaging, consistent with an initial diagnosis of probable bvFTD. However, multimodal functional neuroimaging revealed neuropathological data consistent with a diagnosis of probable AD for one patient (pathology distributed in the frontal lobes) and a diagnosis of probable bvFTD for the other patient (hypometabolism in the bilateral frontal lobes). In addition, the fv-AD patient presented with greater executive impairment and milder behavioral symptoms relative to the bvFTD patient. These cases highlight that recognition of these atypical syndromes using detailed neuropsychological tests, biomarkers, and multimodal neuroimaging will lead to greater accuracy in diagnosis and patient management.
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, 122, Qi-Xiang-Tai Road, Hexi District, Tianjin, 300060, People's Republic of China.|Key Laboratory of Cerebral Vascular and Neurodegenerative Disease, Tianjin, People's Republic of China.
authors.forename: Pan
authors.initials: P
authors.lastname: Li
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, 122, Qi-Xiang-Tai Road, Hexi District, Tianjin, 300060, People's Republic of China. qiying789@sina.cn.|Key Laboratory of Cerebral Vascular and Neurodegenerative Disease, Tianjin, People's Republic of China. qiying789@sina.cn.
authors.forename: Yu-Ying
authors.initials: YY
authors.lastname: Zhou
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, 122, Qi-Xiang-Tai Road, Hexi District, Tianjin, 300060, People's Republic of China.|Key Laboratory of Cerebral Vascular and Neurodegenerative Disease, Tianjin, People's Republic of China.
authors.forename: Da
authors.initials: D
authors.lastname: Lu
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, 122, Qi-Xiang-Tai Road, Hexi District, Tianjin, 300060, People's Republic of China.|Key Laboratory of Cerebral Vascular and Neurodegenerative Disease, Tianjin, People's Republic of China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, 122, Qi-Xiang-Tai Road, Hexi District, Tianjin, 300060, People's Republic of China.|Key Laboratory of Cerebral Vascular and Neurodegenerative Disease, Tianjin, People's Republic of China.
authors.forename: Hui-Hong
authors.initials: HH
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000150:complications*; D001526:Behavioral Symptoms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000473:pathology*; D057180:Frontotemporal Dementia / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008875:Middle Aged; D059906:Neuroimaging; D009483:Neuropsychological Tests; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D020280:Sertraline / Q000627:therapeutic use
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline
keywords: Alzheimer disease; Behavioral disturbance; Behavioral variant frontotemporal dementia; Executive dysfunction; Frontal variant Alzheimer disease; Multimodal neuroimaging