title: Social Cognition Deficits: The Key to Discriminate Behavioral Variant Frontotemporal Dementia from Alzheimer's Disease Regardless of Amnesia?
abstract: Relative sparing of episodic memory is a diagnostic criterion of behavioral variant frontotemporal dementia (bvFTD). However, increasing evidence suggests that bvFTD patients can show episodic memory deficits at a similar level as Alzheimer's disease (AD). Social cognition tasks have been proposed to distinguish bvFTD, but no study to date has explored the utility of such tasks for the diagnosis of amnestic bvFTD. Here, we contrasted social cognition performance of amnestic and non-amnestic bvFTD from AD, with a subgroup having confirmed in vivo pathology markers. Ninety-six participants (38 bvFTD and 28 AD patients as well as 30 controls) performed the short Social-cognition and Emotional Assessment (mini-SEA). BvFTD patients were divided into amnestic versus non-amnestic presentation using the validated Free and Cued Selective Reminding Test (FCSRT) assessing episodic memory. As expected, the accuracy of the FCSRT to distinguish the overall bvFTD group from AD was low (69.7% ) with ∼50% of bvFTD patients being amnestic. By contrast, the diagnostic accuracy of the mini-SEA was high (87.9% ). When bvFTD patients were split on the level of amnesia, mini-SEA diagnostic accuracy remained high (85.1% ) for amnestic bvFTD versus AD and increased to very high (93.9% ) for non-amnestic bvFTD versus AD. Social cognition deficits can distinguish bvFTD and AD regardless of amnesia to a high degree and provide a simple way to distinguish both diseases at presentation. These findings have clear implications for the diagnostic criteria of bvFTD. They suggest that the emphasis should be on social cognition deficits with episodic memory deficits not being a helpful diagnostic criterion in bvFTD.
authors.affiliation: Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.|Institut de la Mémoire et de la Maladie d'Alzheimer, Pitié-Salpêtrière Hospital, Paris, France.|Institut du Cerveau et de la Moelle Epinière, UMRS 975 INSERM, Paris, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Bertoux
authors.affiliation: Institut de la Mémoire et de la Maladie d'Alzheimer, Pitié-Salpêtrière Hospital, Paris, France.|Universidade Federal de Minas Gerais, Belo-Horizonte, Brazil.
authors.forename: Leonardo Cruz
authors.initials: LC
authors.lastname: de Souza
authors.affiliation: Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: O'Callaghan
authors.affiliation: MRC Cognition & Brain Sciences Unit, University of Cambridge, Cambridge, UK.
authors.forename: Andrea
authors.initials: A
authors.lastname: Greve
authors.affiliation: Institut de la Mémoire et de la Maladie d'Alzheimer, Pitié-Salpêtrière Hospital, Paris, France.|Neurologie de la Mémoire et du Langage, Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR S894, Centre Hospitalier Sainte Anne, Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Sarazin
authors.affiliation: Institut de la Mémoire et de la Maladie d'Alzheimer, Pitié-Salpêtrière Hospital, Paris, France.|Institut du Cerveau et de la Moelle Epinière, UMRS 975 INSERM, Paris, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Dubois
authors.affiliation: Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Hornberger
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000523:psychology; D000647:Amnesia / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000523:psychology; D003071:Cognition; D003937:Diagnosis, Differential; D004644:Emotions; D005260:Female; D057180:Frontotemporal Dementia / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D008297:Male; D061212:Memory, Episodic; D009483:Neuropsychological Tests; D012938:Social Perception
keywords: Alzheimer’s disease; amnesia; differential diagnosis; episodic memory; frontotemporal dementia; neuropsychology; social-cognition