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Predicting functional decline in behavioural variant frontotemporal dementia.

Keith A Josephs1, Jennifer L Whitwell, Stephen D Weigand

  • 1Department of Neurology (Behavioural Neurology), Mayo Clinic, Rochester, Minnesota 55905, USA. josephs.keith@mayo.edu

Brain : a Journal of Neurology
|January 22, 2011
PubMed
Summary
This summary is machine-generated.

Predicting functional decline in behavioural variant frontotemporal dementia (bvFTD) is crucial. This study found that anatomical atrophy patterns, age at onset, and baseline neuropsychiatric symptoms significantly predict the rate of decline in bvFTD patients.

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Area of Science:

  • Neuroscience
  • Neurology
  • Gerontology

Background:

  • Behavioural variant frontotemporal dementia (bvFTD) presents with significant functional decline, but the rate varies greatly among patients.
  • Predictors for the rate of functional decline in bvFTD are not well understood.
  • Identifying baseline features that predict decline is essential for patient management and therapeutic development.

Purpose of the Study:

  • To investigate the impact of baseline clinical, neuropsychological, neuropsychiatric, genetic, and anatomical features on the rate of functional decline in bvFTD.
  • To identify specific predictors that can forecast the speed of functional deterioration in bvFTD.
  • To explore whether anatomical subtypes influence the rate of decline and the predictive power of other variables.

Main Methods:

  • Studied 86 bvFTD subjects with serial Clinical Dementia Rating Sum of Boxes (CDR-SB) assessments.
  • Utilized atlas-based parcellation for baseline regional brain volumes and cluster analysis for anatomical subtypes.
  • Employed linear mixed-effects regression modeling to assess predictors of functional decline rate.

Main Results:

  • Rates of functional decline varied significantly across anatomical subtypes, with faster progression in frontal dominant and frontotemporal subtypes.
  • Poorer executive, language, and visuospatial function, less disinhibition, agitation/aggression, and night-time behaviors, along with smaller frontal lobe volumes, predicted faster decline.
  • Age at onset became a highly significant predictor after adjusting for anatomical subtype; some predictors improved prediction beyond subtype alone.

Conclusions:

  • The rate of functional decline in bvFTD is significantly influenced by the pattern of brain atrophy, age at onset, and baseline neuropsychiatric characteristics.
  • Anatomical subtypes of bvFTD are associated with different rates of functional decline.
  • These findings provide a more nuanced understanding of bvFTD progression, aiding in prognostication and personalized care strategies.