Functional neuroimaging and presenting psychiatric features in frontotemporal dementia

Area of Science:

• Neuroscience
• Neurology
• Psychiatry

Background:

• Frontotemporal dementia (FTD) is a neurodegenerative disorder affecting frontal and temporal lobes, leading to behavioral changes.
• Psychiatric features are common in FTD, but their presentation varies based on the initial brain regions affected.

Purpose of the Study:

• To identify psychiatric changes in FTD that are not part of its diagnostic criteria.
• To correlate these psychiatric features with hemispheric asymmetry and hypoperfusion in frontal and temporal lobes using SPECT imaging.

Main Methods:

• Evaluated 74 patients meeting FTD consensus criteria with a two-year follow-up.
• Utilized brain single photon emission computed tomography (SPECT) imaging at initial presentation.
• Contrasted FTD psychiatric checklist results with regional hypoperfusion ratings.

Main Results:

• No correlation found between hypoperfusion regions and FTD demographic variables.
• Dysthymia and anxiety were linked to right temporal hypoperfusion.
• Frivolous behavior ('moria') associated with temporal lobe changes, particularly on the right.
• Right frontal hypoperfusion correlated with peculiar physical bearing.

Conclusions:

• FTD patients can exhibit psychiatric changes beyond standard diagnostic criteria.
• Early temporal lobe involvement, especially the right side, is associated with emotional disturbances and frivolous behavior.
• Right frontal lobe disease may manifest as alterations in non-verbal behavior.