Insight in frontotemporal dementia and progressive supranuclear palsy

Area of Science:

• Neuroscience
• Clinical Neurology
• Cognitive Psychology

Background:

• Progressive supranuclear palsy (PSP) and behavioural variant frontotemporal dementia (bv-FTD) present overlapping neuropsychological symptoms.
• A key differentiator may be online monitoring awareness, a cognitive function assessing real-time self-awareness of performance.
• Investigating this difference could enhance diagnostic accuracy in clinical settings.

Purpose of the Study:

• To determine if online monitoring awareness can differentiate between bv-FTD and PSP.
• To assess the utility of online monitoring awareness in standard clinical practice for diagnosing these conditions.

Main Methods:

• Retrospective analysis of 93 participants: 27 bv-FTD, 25 PSP, and 42 healthy controls.
• Comprehensive neuropsychological and instrumental examinations were conducted for all subjects.
• Statistical analyses included ROC curves and logistic regression to identify predictive factors.

Main Results:

• bv-FTD patients exhibited significantly fewer self-corrections than PSP patients, despite similar total error counts.
• Receiver Operating Characteristic (ROC) curve analysis yielded an Area Under the Curve (AUC) of 0.79.
• Logistic regression identified the number of self-corrections as the sole significant predictor (p=0.004, β=1244).

Conclusions:

• Online monitoring awareness is demonstrably more impaired in bv-FTD compared to PSP.
• The number of self-corrections can serve as a valuable biomarker for differential diagnosis.
• Each additional self-correction increases the odds of having PSP by approximately 3.5 times (OR 3.47).