Frontotemporal dementia: A review

Abstract

This review summarizes the clinical, imaging, and pathological features of frontotemporal dementia (FTD). Clinicians have become increasingly sensitive to FTD in the differential diagnosis of Alzheimer's disease. Clinical subgroups of FTD patients have been recognized, including patients with progressive non-fluent aphasia, semantic dementia, and behavioral disorder with executive difficulty. The clinical, neuroimaging and neuropathological profiles associated with these clinically defined subgroups are examined. (JINS, 2002, 8, 566–583.)

Metacognitive deficits in frontotemporal dementia

“…This profile of statistically significant differences from healthy controls suggests that impaired self-awareness and self-knowledge are pervasive deficits affecting the metacognitive capacities of FTD patients with prominent social and dysexecutive impairments. These data are consistent not only with clinical characterisations of this subgroup [25][26][27] but also suggest that metacognitive impairments may be important contributing factors to their social behavioural impairments of disinhibition, erratic judgement, poor self-monitoring, and declining adjustment to progressive deficits. In contrast, the other FTD clinical subgroups and the AD sample showed metacognitive loss in only a few, select behavioural domains, suggesting a minimal deficit.…”

Metacognitive deficits in frontotemporal dementia

“…This profile of statistically significant differences from healthy controls suggests that impaired self-awareness and self-knowledge are pervasive deficits affecting the metacognitive capacities of FTD patients with prominent social and dysexecutive impairments. These data are consistent not only with clinical characterisations of this subgroup [25][26][27] but also suggest that metacognitive impairments may be important contributing factors to their social behavioural impairments of disinhibition, erratic judgement, poor self-monitoring, and declining adjustment to progressive deficits. In contrast, the other FTD clinical subgroups and the AD sample showed metacognitive loss in only a few, select behavioural domains, suggesting a minimal deficit.…”

Clinical comparison of progressive aphasia associated with Alzheimer versus FTD-spectrum pathology

“…The AD pathology group was older than the FTD-spectrum group, consistent with the recognised consensus that FTD, on average, has an earlier onset than AD 20 21. Although ‘early-onset’ dementia is typically defined as before 65 years, and FTD is considered a major cause of early-onset dementia,21 22 the present study indicated that this age was not a discriminatory cut-off.…”

“…Although ‘early-onset’ dementia is typically defined as before 65 years, and FTD is considered a major cause of early-onset dementia,21 22 the present study indicated that this age was not a discriminatory cut-off. About half of the patients in both groups had onset before 65 years.…”

Executive functions in frontotemporal dementia and Lewy body dementia.

“…There was a significant group difference for age, F(2, 49) ϭ 4.33, p ϭ .019. FTD patients were significantly younger than LBD patients but not controls ( p ϭ .021 and p ϭ .108, respectively), which is consistent with the earlier age of onset typical for this patient group (Grossman, 2002). However, age was not significantly correlated with any of the variables in this study and, therefore, was not used as a covariate in any of the group comparisons.…”

Metacognitive deficits in frontotemporal dementia

“…This profile of statistically significant differences from healthy controls suggests that impaired self-awareness and self-knowledge are pervasive deficits affecting the metacognitive capacities of FTD patients with prominent social and dysexecutive impairments. These data are consistent not only with clinical characterisations of this subgroup [25][26][27] but also suggest that metacognitive impairments may be important contributing factors to their social behavioural impairments of disinhibition, erratic judgement, poor self-monitoring, and declining adjustment to progressive deficits. In contrast, the other FTD clinical subgroups and the AD sample showed metacognitive loss in only a few, select behavioural domains, suggesting a minimal deficit.…”

Clinical comparison of progressive aphasia associated with Alzheimer versus FTD-spectrum pathology

“…The AD pathology group was older than the FTD-spectrum group, consistent with the recognised consensus that FTD, on average, has an earlier onset than AD 20 21. Although ‘early-onset’ dementia is typically defined as before 65 years, and FTD is considered a major cause of early-onset dementia,21 22 the present study indicated that this age was not a discriminatory cut-off.…”

“…Although ‘early-onset’ dementia is typically defined as before 65 years, and FTD is considered a major cause of early-onset dementia,21 22 the present study indicated that this age was not a discriminatory cut-off. About half of the patients in both groups had onset before 65 years.…”

Executive functions in frontotemporal dementia and Lewy body dementia.

“…There was a significant group difference for age, F(2, 49) ϭ 4.33, p ϭ .019. FTD patients were significantly younger than LBD patients but not controls ( p ϭ .021 and p ϭ .108, respectively), which is consistent with the earlier age of onset typical for this patient group (Grossman, 2002). However, age was not significantly correlated with any of the variables in this study and, therefore, was not used as a covariate in any of the group comparisons.…”

Metacognitive deficits in frontotemporal dementia

“…This profile of statistically significant differences from healthy controls suggests that impaired self-awareness and self-knowledge are pervasive deficits affecting the metacognitive capacities of FTD patients with prominent social and dysexecutive impairments. These data are consistent not only with clinical characterisations of this subgroup [25][26][27] but also suggest that metacognitive impairments may be important contributing factors to their social behavioural impairments of disinhibition, erratic judgement, poor self-monitoring, and declining adjustment to progressive deficits. In contrast, the other FTD clinical subgroups and the AD sample showed metacognitive loss in only a few, select behavioural domains, suggesting a minimal deficit.…”

Clinical comparison of progressive aphasia associated with Alzheimer versus FTD-spectrum pathology

“…The AD pathology group was older than the FTD-spectrum group, consistent with the recognised consensus that FTD, on average, has an earlier onset than AD 20 21. Although ‘early-onset’ dementia is typically defined as before 65 years, and FTD is considered a major cause of early-onset dementia,21 22 the present study indicated that this age was not a discriminatory cut-off.…”

“…Although ‘early-onset’ dementia is typically defined as before 65 years, and FTD is considered a major cause of early-onset dementia,21 22 the present study indicated that this age was not a discriminatory cut-off. About half of the patients in both groups had onset before 65 years.…”

Executive functions in frontotemporal dementia and Lewy body dementia.

“…There was a significant group difference for age, F(2, 49) ϭ 4.33, p ϭ .019. FTD patients were significantly younger than LBD patients but not controls ( p ϭ .021 and p ϭ .108, respectively), which is consistent with the earlier age of onset typical for this patient group (Grossman, 2002). However, age was not significantly correlated with any of the variables in this study and, therefore, was not used as a covariate in any of the group comparisons.…”