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.

Enhancing theory of mind in behavioural variant frontotemporal dementia with transcranial direct current stimulation

“…Our findings corroborate previous studies of marked impairment in the domain of social cognition in patients with bvFTD (Adenzato, Cavallo, & Enrici, 2010;Baez et al, 2017;Cavallo, Enrici, & Adenzato, 2011;Dermody et al, 2016;Eslinger et al, 2007;Gregory et al, 2002;Irish, Hodges, & Piguet, 2014;Lough, Gregory, & Hodges, 2001;Lough & Hodges, 2002;Lough et al, 2006;Snowden et al, 2003;Torralva et al, 2007) and suggest that communicative intentions are disproportionately affected in bvFTD.…”

Behavioral variant frontotemporal dementia in patients with previous severe mental illness: a systematic and critical review

“…On LILACS, none of the nine retrieved met the requirements. Therefore, 42 articles were selected, of which 10 were cohort studies 15,16,17,18,19,20,21,22,23,24 , three were case-control studies 25,26,27 , 12 were case repo rts 28,29,30,31,32,33,34,35,36,37,38,39 and 17 other studies were cross-sectional surveys 6,7,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54 .…”

“…Nevertheless, they found that specific CSF biomarkers-total tau, phosphorylated tau, amyloid-β 1-42 peptide and neurofilament light chain concentrations-may aid clinicians in the diagnostic workup (64). Also, in an attempt to contribute to the distinction between primary psychiatric disorders and bvFTD, Metin and colleagues used quantitative electroencephalography for differentiating bvFTD from late-life BD with 76% overall accuracy 41 .…”

INECO Frontal Screening (IFS): una herramienta psicométrica para evaluar la disfunción ejecutiva en policonsumidores

“…En nuestro estudio, el IFS ha demostrado ser una buena herramienta clínica con propiedades psicométricas que muestran buena consistencia interna y validez discriminante para determinar el funcionamiento ejecutivo en adicciones; previamente, Torralva y colaboradores habían confirmado las cualidades psicométricas de la prueba en la demencia tipo alzhéimer y demencia frontotemporal (Torralva, Roca, Gleichgerrcht, Bekinschtein et al, 2009;Torralva, Roca, Gleichgerrcht, López et al, 2009), y Báez e Ibáñez reportaron las ventajas del instrumento para identificar la disfunción ejecutiva en el trastorno afectivo bipolar (Báez et al, 2014(Báez et al, , 2017. Si bien, evaluar el funcionamiento ejecutivo en su totalidad es complejo y el uso de una sola batería neurocognitiva no permitiría sensibilizar con exactitud todos los dominios ejecutivos, el uso del IFS resulta ser una excelente herramienta clínica para el diagnóstico del funcionamiento ejecutivo, privilegiando, además, los tiempos de aplicación y la sencillez del protocolo.…”