title: Brain structural correlates of executive and social cognition profiles in behavioral variant frontotemporal dementia and elderly bipolar disorder.
abstract: An early stage of behavioral variant frontotemporal dementia (bvFTD) often displays a mix of behavioral disturbances and personality changes hindering a differential diagnosis from elderly bipolar disorder (BD), making this process a big challenge. However, no studies have compared these pathologies from neuropsychological and neuroanatomical perspectives. The aim of the present study was to compare the executive functions (EF) and social cognition profiles as well as the structural neuroimaging of bvFTD and elderly patients with BD. First, we compared the executive and social cognition performances of 16 bvFTD patients, 13 BD patients and 22 healthy controls. Second, we compared grey matter volumes in both groups of patients and controls using voxel-based morphometry. Lastly, we examined the brain regions where atrophy might be associated with specific impairments in bvFTD and BD patients. Compared to controls, bvFTD patients showed deficits in working memory, abstraction capacity, inhibitory control, cognitive flexibility, verbal fluency and theory of mind (ToM). Patients with BD showed lower performance than controls in terms of abstraction capacity and verbal inhibitory control. In bvFTD patients, atrophy of frontal, temporal and insular cortices was related to EF deficits. Atrophy of the amygdala, the hippocampus, the parahippocampal gyrus, the putamen, the insula, the precuneus, the right temporo-parietal junction and superior temporal pole was associated to ToM impairments. No significant associations between atrophy and EF performance were observed in BD patients. BvFTD patients showed greater EF and ToM deficits than BD patients. Moreover, compared to BD, bvFTD patients exhibited a significant decrease in GM volume in frontal, temporal and parietal regions. Our results provide the first comparison of EF, social cognition and neuroanatomical profiles of bvFTD and elderly BD patients. These findings shed light on differential diagnosis of these disorders and may have important clinical implications.
authors.affiliation: Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina; Departamento de Psicología. Universidad de los Andes, Bogotá, Colombia.
authors.forename: Sandra
authors.initials: S
authors.lastname: Baez
authors.affiliation: Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.
authors.forename: Clara
authors.initials: C
authors.lastname: Pinasco
authors.affiliation: Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina.
authors.forename: María
authors.initials: M
authors.lastname: Roca
authors.affiliation: Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.
authors.forename: Jesica
authors.initials: J
authors.lastname: Ferrari
authors.affiliation: Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.
authors.forename: Blas
authors.initials: B
authors.lastname: Couto
authors.affiliation: Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.
authors.forename: Indira
authors.initials: I
authors.lastname: García-Cordero
authors.affiliation: Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile; Universidad Autónoma del Caribe, Colombia; Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, Australia.
authors.forename: Agustín
authors.initials: A
authors.lastname: Ibañez
authors.affiliation: Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: Francy
authors.initials: F
authors.lastname: Cruz
authors.affiliation: Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia; Departamento de Radiología, Hospital Universitario San Ignacio, Bogotá, Colombia.
authors.forename: Pablo
authors.initials: P
authors.lastname: Reyes
authors.affiliation: Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: Diana
authors.initials: D
authors.lastname: Matallana
authors.affiliation: Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina; Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, Australia.
authors.forename: Facundo
authors.initials: F
authors.lastname: Manes
authors.affiliation: Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Cetcovich
authors.affiliation: Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina. Electronic address: ttorralva@ineco.org.ar.
authors.forename: Teresa
authors.initials: T
authors.lastname: Torralva
mesh_terms: D017668:Age of Onset; D000368:Aged; D001284:Atrophy / Q000473:pathology; D001714:Bipolar Disorder / Q000473:pathology* / Q000503:physiopathology*; D002540:Cerebral Cortex / Q000473:pathology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D057180:Frontotemporal Dementia / Q000473:pathology* / Q000503:physiopathology*; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012938:Social Perception; D056345:Theory of Mind / Q000502:physiology*
keywords: Behavioral variant frontotemporal dementia; Executive functions; Late-life bipolar disorder; Structural neuroimaging; Theory of mind