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Self-appraisal in behavioural variant frontotemporal degeneration
Lauren Massimo1, David J Libon, Keerthi Chandrasekaran
1Department of Neurology, University of Pennsylvania, 3400 Spruce Street, Gates Building, Philadelphia, PA 19104, USA. mgrossma@mail.med.upenn.edu
Journal of Neurology, Neurosurgery, and Psychiatry
|September 7, 2012
Summary
Self-appraisal deficits in behavioural-variant frontotemporal degeneration (bvFTD) impact multiple cognitive domains, unlike Alzheimer's disease (AD). This multi-domain impairment is linked to reduced grey matter density in the subgenual cingulate region.
Area of Science:
- Neuroscience
- Cognitive Neurology
- Neuropsychology
Background:
- Previous research on behavioural-variant frontotemporal degeneration (bvFTD) self-appraisal deficits focused on social/behavioral domains.
- The extent to which self-appraisal is impaired across multiple cognitive domains in bvFTD remains unclear.
Purpose of the Study:
- To determine if a domain-specific or multi-domain model best explains impaired self-appraisal in bvFTD.
- To compare self-appraisal deficits in bvFTD with those in Alzheimer's disease (AD).
Main Methods:
- 49 bvFTD patients and 73 AD patients completed cognitive tests (episodic memory, naming, comprehension).
- Self-appraisal was measured by patient ratings of performance post-testing, with discrepancy scores calculated.
- Voxel-based morphometry analyzed the relationship between self-appraisal and grey matter density.
Main Results:
- bvFTD patients showed poor self-appraisal across all tested cognitive domains.
- In contrast, AD patients' poor self-appraisal was limited to episodic memory.
- Reduced grey matter density in ventral and rostral medial prefrontal regions correlated with poor self-appraisal in both groups.
- Specifically, reduced grey matter in the subgenual cingulate (BA 25) was linked to multi-domain self-appraisal deficits in bvFTD.
Conclusions:
- Self-appraisal deficits in bvFTD are multi-domain, not domain-specific.
- This widespread impairment pattern is associated with frontal lobe degeneration, particularly in the subgenual cingulate cortex.
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