Hyperorality in Frontotemporal Dementia: How Psychiatric and Neural Correlates Change During the Disease Course

Area of Science:

• Neuroscience
• Behavioral Neurology
• Psychiatry

Background:

• Hyperorality is a hallmark of behavioral variant frontotemporal dementia (bvFTD).
• The cognitive, psychiatric, and neuroanatomical underpinnings of hyperorality across bvFTD progression are not fully understood.
• Understanding these factors is crucial for managing bvFTD.

Purpose of the Study:

• To investigate the cognitive, psychiatric, and neuroanatomical correlates of hyperorality in early- and advanced-stage bvFTD.
• To explore the relationship between hyperorality and disease severity.
• To identify potential early markers and therapeutic targets for bvFTD.

Main Methods:

• Participants with bvFTD were stratified by disease severity (early vs. advanced).
• Cognitive and psychiatric symptoms were compared between hyperoral and non-hyperoral groups.
• Regional gray matter volume (GMV) was analyzed using linear regression, focusing on preselected brain regions.

Main Results:

• Hyperorality was present in 50% of early-stage and 63% of advanced-stage bvFTD participants.
• Early-stage hyperorality was associated with ritualistic behavior and impaired social-emotional detection.
• Advanced-stage hyperorality correlated with apathy, ritualistic behavior, socially aberrant behavior, and reduced right striatal GMV.

Conclusions:

• Hyperorality is an early feature of bvFTD, preceding significant gray matter loss.
• It is linked to social cognition deficits and complex ritualistic behaviors.
• Early identification and management of hyperorality may improve bvFTD outcomes.