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Bradycardia in frontotemporal dementia
A Robles Bayón1, F Gude Sampedro2, J M Torregrosa Quesada3
1Unidad de Neurología cognitiva, Hospital La Rosaleda, Santiago de Compostela, España.
Insights
Patients with frontotemporal dementia (FTD) experienced significantly more bradycardia (slow heart rate) than other cognitive impairment groups. This suggests a potential link between FTD and autonomic dysfunction, warranting further investigation.
Area of Science:
- Neuroscience
- Cardiology
- Neurology
Background:
- Brain regions controlling heart rate, including the medial frontal cortex and amygdala, are affected by frontotemporal dementia (FTD).
- Degeneration in these areas may lead to autonomic nervous system dysfunction and cardiovascular symptoms like bradycardia.
- Autonomic dysfunction, specifically non-cardiogenic bradycardia, is explored as a potential indicator in FTD.
Purpose of the Study:
- To determine if non-cardiogenic bradycardia is more prevalent in patients with frontotemporal dementia (FTD) compared to other cognitive impairment groups.
- To investigate the association between FTD and cardiovascular autonomic dysfunction.
Main Methods:
- Heart rates were recorded for 258 patients with cognitive symptoms, including 36 with FTD.
- Patients with primary cardiac arrhythmias were excluded from the study.
- Participants included those with Alzheimer disease, vascular dementia, other dementias, and non-dementia cognitive impairment.
Main Results:
- Bradycardia (<60 beats/minute) was significantly more frequent in patients with frontotemporal dementia (FTD).
- This finding persisted even after excluding individuals on bradycardia-inducing medications.
- FTD patients also exhibited lower mean systolic blood pressure and a higher prevalence of hypotension.
Conclusions:
- Bradycardia is more common in patients with frontotemporal dementia (FTD) than in other cognitive impairment cohorts.
- The results suggest a potential role for bradycardia as a diagnostic marker for FTD, particularly its behavioral variant.
- Further research is needed to confirm bradycardia as a supportive diagnostic sign for FTD.
Introduction:
Numerous regions of the brain, such as the medial frontal cortex, orbitofrontal cortex, insula, and amygdala, participate in the autonomic control of cardiovascular functions such as heart rate. The degenerative process in frontotemporal dementia (FTD) involves the listed anatomical structures and may therefore produce dysautonomic cardiovascular symptoms.
Aim:
To observe whether or not non-cardiogenic bradycardia was more frequent in a group of patients with FTD than in subjects with mild cognitive impairment or dementia of a different aetiology.
Patients And Method:
Once patients with primary cardiac arrhythmia were excluded, we registered the heart rates of 258 patients with cognitive symptoms (36 with FTD, 22 with Alzheimer disease, 23 with vascular dementia, 10 with other dementias, and 167 with non-dementia cognitive impairment).
Results:
Bradycardia (<60 beats/minute) was significantly more frequent in patients with FTD. This difference remained significant after excluding subjects undergoing treatment with a potentially bradycardic effect. Bradycardia was more prevalent in behavioural FTD cases than in cases of the aphasic variant, and we detected a trend toward higher frequency among patients with more pronounced right hemisphere atrophy. Moreover, mean systolic blood pressure in FTD patients was lower than in other participants, and systolic hypotension (<120 and <100mm Hg) was more prevalent.
Conclusion:
Bradycardia was more frequent in the FTD sample than in other patients with cognitive symptoms. Further investigations will be necessary before we may consider bradycardia to be a sign supporting diagnosis of FTD or its behavioural variant.
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