Differences in Discriminability and Response Bias on Rey Auditory Verbal Learning Test Delayed Recognition in Behavioral Variant Frontotemporal Dementia and Alzheimer’s Disease

Abstract

Objective: Episodic memory is impaired in Alzheimer’s disease (AD) dementia but thought to be relatively spared in behavioral variant frontotemporal dementia (bvFTD). This view is challenged by evidence of memory impairment in bvFTD. This study investigated differences in recognition memory performance between bvFTD and AD. Method: We performed a retrospective analysis on the recognition trial of the Rey Auditory Verbal Learning Test in patients with bvFTD (n = 85), AD (n = 55), and control participants (n = 59). Age- and education-adjusted between-group analysis was performed on the total score and indices of discriminative ability and response bias. Correlations between recognition and measures of memory, language, executive functioning, and construction were examined. Results: Patients with AD had a significantly lower total recognition score than patients with bvFTD (control 28.8 ± 1.5; bvFTD 24.8 ± 4.5; AD 23.4 ± 3.6, p < .01). Both bvFTD and AD had worse discriminative ability than controls (A’ control 0.96 ± 0.03; bvFTD 0.87 ± 0.03; AD 0.84 ± 0.10, p < .01), but there was no difference in response bias (B” control 0.9 ± 0.2; bvFTD 1.6 ± 1.47; AD 1.4± 1.4, p < .01). AD had worse discriminability than bvFTD (p < .05). Discriminability was associated with memory for both patient groups (median correlation coefficient r = .34) and additionally associated with language (r = .31), but not executive functioning (r = −.03) in bvFTD. Response bias was unrelated to other cognitive functions (r = −.02). Conclusions: Discriminability, but not response bias, differentiated patients with bvFTD from AD. The presence of an impaired discrimination index suggests a “pure” (recognition) memory deficit in bvFTD.

Process approach as a cognitive biomarker related to gray matter volume in mild cognitive impairment and Alzheimer’s disease

“…Response bias is another index calculated in recognition. We found that the AD group exhibited significantly lower (more liberal) response bias than the MCI and HC groups which was consistent with previous studies [ 21 , 22 ]. However, the results of MCI remain unclear.…”

“…Previous research has indicated that the process approach played an important role in diagnosing and tracking the progression of cognitive impairment. Most researchers found that AD subjects had impaired discriminability and more liberal response bias [ 21 , 22 ]. Discriminability was helpful in predicting conversion from MCI to AD, and adding discriminability to the delay recall created a better predictive tool [ 23 , 24 ].…”

Short-term memory conjunctive binding in Alzheimer’s disease: A systematic review and meta-analysis.

“…In another poster, Cecchini et al (2017c) showed that the free recall version of the STM binding test could differentiate AD from amnestic bvFTD. That is important because AD and amnestic bvFTD showed the same pattern of episodic memory deficits on the RAVLT test, thus the free recall binding task could be used to differentiate AD from bvFTD even when the latter show episodic memory deficits, which is not unusual (Hornberger et al, 2010; van den Berg et al, 2020). Therefore, free recall and change detection tasks could assess binding through different brain networks.…”

The Free and Cued Selective Reminding Test: Discriminative Values in a Naturalistic Cohort

“…Regarding RP and IW, instead, the AD group performed similarly to the other groups, except for DEP and SCD. Visual recognition deficit has been reported in a part of AD and MCI patients [26], but it can be observed, even if to a lesser extent, also in other dementia, such as bvFTD [27] and DLB [28]. The possible reasons why we did not find significant differences in RP between groups are the slight impairment of RP in the other dementia groups as well, along with the very mild global cognitive impairment (average MMSE = 25.8) of The AUC value and the cut-off scores (lower part of the cell) of the index used to compare group pairs with 95% confidence level (CL) computed with a bootstrap method, are showed.…”