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Executive dysfunction in frontotemporal dementia and corticobasal syndrome
E D Huey1, E N Goveia, S Paviol
1Cognitive Neuroscience Section, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD 20892-1440, USA.
Neurology
|February 4, 2009
Summary
Frontotemporal dementia (FTD) and corticobasal syndrome (CBS) patients exhibit distinct executive dysfunction patterns. The Twenty Questions test effectively differentiates these conditions, highlighting specific brain regions involved.
Area of Science:
- Neuroscience
- Neurology
- Cognitive Psychology
Background:
- Frontotemporal dementia (FTD) and corticobasal syndrome (CBS) are neurodegenerative conditions often presenting with executive dysfunction.
- Understanding the specific patterns of executive dysfunction and their neural correlates is crucial for accurate diagnosis and management.
Purpose of the Study:
- To delineate the characteristic executive dysfunction profiles in FTD and CBS.
- To identify the specific brain regions associated with executive dysfunction in FTD and CBS.
- To determine which executive function tests best differentiate between FTD and CBS.
Main Methods:
- Administered the Delis-Kaplan Executive Function System (D-KEFS) to 51 FTD and 50 CBS patients.
- Utilized discriminant analysis on D-KEFS results to identify distinguishing tests.
- Employed voxel-based morphometry (VBM) to correlate gray matter volume loss with executive dysfunction.
Main Results:
- Both FTD and CBS patients demonstrated greater executive than memory dysfunction.
- Executive function was generally better preserved in CBS patients, except on tasks involving motor or visuospatial skills.
- Specific D-KEFS tests, particularly the Twenty Questions task, effectively distinguished between FTD and CBS.
- VBM revealed distinct patterns of regional gray matter loss associated with executive dysfunction in FTD and CBS patients, implicating dorsal frontal, parietal, temporal-parietal, and left perisylvian/prefrontal/anterior frontal cortices.
Conclusions:
- Neuroanatomic findings in FTD align with existing literature.
- FTD and CBS patients exhibit differential performance on higher-order executive functions, notably the Twenty Questions test.
- Distinguishing executive function from motor and visuospatial abilities in CBS can be challenging with tests like Trail Making.
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