Late-life atypical reactivation of obsessive-compulsive disorder associated with frontotemporal dementia

Dondé, Clément; Lepetit, Alexis; Dorey, Jean‐Michel; Herrmann, Mathieu

doi:10.1016/j.neurol.2018.04.015

Cited by 4 publications

(2 citation statements)

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“…Unfortunately, many reports on late-life OCD do not state whether the compulsions were of recent onset or had been present since early adulthood or even before. The reports that provide this information indicate that the association of OCD and FTD may assume the form of (i) a rekindling or worsening of a lifelong OCD, as was the case of our patient and a few others reported in the literature [ 4 ] or (ii) a true onset of OC symptoms and kindred repetitive behaviors in patients without evidence of premorbid OCD [ 20 ].…”

Section: Discussionsupporting

confidence: 64%

“…Among the neurodegenerative diseases, an association between OCD and frontotemporal dementia (FTD) has been noted since the first attempts to differentiate FTD from Alzheimer’s disease on clinical and phenomenological grounds [ 2 ]. In such cases, OCD emerged as a late-onset disorder [ 3 ], as the reemergence [ 4 ] or aggravation [ 5 ] of a lifelong disorder. To date, the association between OCD and FTD cannot be reliably predicted from the behavioral or neuroimaging patterns of individual cases [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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A presumptive association between obsessive compulsions and asymmetric temporal lobe atrophy: a case report

et al. 2022

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Background The relatively isolated atrophy of the temporal lobes leads to a clinical radiological pattern, referred to as the temporal variant of frontotemporal dementia. While semantic dementia and behavioral variant frontotemporal dementia are classically related to this syndrome, the logopenic variant of primary progressive aphasia has been less commonly reported. This case report aims to give a pictorial description of a case in which a patient with asymmetric temporal lobe atrophy presented with the logopenic variant of primary progressive aphasia and complex rituals of cleanliness. Case presentation We report on the case of a 68-year-old, right-handed White woman with complex rituals and progressive speech impairment. The obsessive–compulsive rituals represented an exacerbation of lifelong preoccupations with cleanliness and orderliness that were praised by her relatives. Neuropsychological assessment revealed a striking impairment of language and memory, with relative sparing of tool-use praxis and visuospatial skills. Magnetic resonance imaging and 18fluorodeoxyglucose-positron emission tomography scans showed bilateral asymmetrical temporal lobe atrophy and hypometabolism. A year later, she was still able to entertain conversation for a short while, but her vocabulary and fluency had further declined. Praxis and visuospatial skills remained intact. She did not experience pathological elation, delusions, or hallucinations. The disease followed a relentless progression into a partial Klüver–Bucy syndrome, abulia, and terminal dementia. She died from acute myocardial infarction 8 years after the onset of aphasia. The symptoms and their temporal course supported a diagnosis of logopenic variant of primary progressive aphasia due to asymmetric temporal variant frontotemporal lobar degeneration. Conclusions This report gives a pictorial description of a temporal variant of frontotemporal dementia in a patient who presented with worsening of a lifelong obsessive–compulsive disorder and logopenic variant of primary progressive aphasia.

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Section: Discussionsupporting

confidence: 64%