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Published on: April 18, 2011
A systematic review of behavioural changes in motor neuron disease
Joost Raaphorst1, Emma Beeldman, Marianne De Visser
1Department of Neurology, Academic Medical Centre, University of Amsterdam, The Netherlands. j.raaphorst@amc.uva.nl
Abstract:
Motor neuron disease (MND) and the behavioural variant of frontotemporal dementia (bvFTD) are thought to be part of a disease spectrum. There is uncertainty about the frequency and characteristics of behavioural changes in MND, and similarly, about a relation between bvFTD and the site of onset of MND. Our aim was to perform a systematic review of the publications on behavioural changes in MND. An extensive search for articles on behavioural changes in MND patients was performed. First, cohort studies of MND patients were reviewed to summarize the prevalence of bvFTD and mild behavioural changes. Secondly, data on bvFTD symptoms (mostly from case reports) of individual MND-bvFTD patients were used to analyse characteristics and pooled prevalences of bvFTD symptoms. In addition, site of onset, survival and demographic variables of MND-bvFTD patients were analysed. Results showed that in cohorts, 8.1% (95% CI 5.6 - 11.5%) of MND patients had bvFTD. In 170 individual patients with MND-bvFTD, perseveration (40%), apathy (29%) and disinhibition (26%) were the most frequently reported behavioural changes; 43% had memory disturbances and bulbar onset was found in 48%. In conclusion, 8% of MND patients have bvFTD, with perseveration being reported most frequently. MND-bvFTD is often accompanied by memory disturbances and is related to bulbar onset.
Insights
Motor neuron disease (MND) and behavioral variant frontotemporal dementia (bvFTD) share a spectrum. Approximately 8% of MND patients exhibit bvFTD, often with memory issues and bulbar onset.
Area of Science:
- Neurology
- Neuroscience
- Clinical Medicine
Background:
- Motor neuron disease (MND) and behavioral variant frontotemporal dementia (bvFTD) are increasingly recognized as part of a shared disease spectrum.
- Uncertainty exists regarding the prevalence and specific characteristics of behavioral changes in MND patients, as well as the association between bvFTD and MND onset location.
Purpose of the Study:
- To systematically review existing literature on behavioral changes in MND.
- To determine the prevalence of bvFTD and mild behavioral changes in MND cohorts.
- To analyze the characteristics, pooled prevalences, and demographic variables of MND-bvFTD patients, including onset site and survival.
Main Methods:
- Systematic literature search for articles detailing behavioral changes in MND patients.
- Review of cohort studies to summarize the prevalence of bvFTD and mild behavioral changes.
- Analysis of individual patient data (primarily from case reports) for MND-bvFTD patients to characterize symptoms and pooled prevalences.
Main Results:
- In cohort studies, 8.1% of MND patients were diagnosed with bvFTD (95% CI 5.6 - 11.5%).
- Among 170 individual MND-bvFTD patients, the most common behavioral changes were perseveration (40%), apathy (29%), and disinhibition (26%).
- Memory disturbances were reported in 43% of MND-bvFTD patients, and bulbar onset was observed in 48%.
Conclusions:
- Approximately 8% of individuals with MND meet criteria for bvFTD.
- Perseveration is the most frequently observed behavioral change in MND-bvFTD.
- MND-bvFTD is frequently associated with memory disturbances and a bulbar site of onset.
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