Clinical Manifestations

Area of Science:

• Neurology
• Neuroscience
• Psychiatry

Background:

• Behavioral variant frontotemporal dementia (bvFTD) is a major cause of early-onset dementia characterized by significant personality and behavioral changes.
• Accurate diagnosis of bvFTD is challenging due to symptom overlap with psychiatric disorders and other neurodegenerative conditions.
• Diagnostic delays and misdiagnosis rates in bvFTD are significant clinical concerns.

Purpose of the Study:

• To review recent literature on diagnostic accuracy and challenges in behavioral variant frontotemporal dementia (bvFTD).
• To identify factors influencing diagnostic delays and misdiagnosis in bvFTD.
• To explore the role of emerging technologies and clinical expertise in improving bvFTD diagnosis.

Main Methods:

• A comprehensive literature review was performed using PubMed, Scopus, and Web of Science.
• Studies published between 2020 and 2025 focusing on bvFTD diagnostic pathways, misdiagnosis, and longitudinal assessments were included.
• Emphasis was placed on clinical presentation timelines, diagnostic reclassification, and accuracy predictors like neuroimaging and neuropsychological tests.

Main Results:

• A significant diagnostic delay of 2–5 years is common, with initial misdiagnoses including depression, bipolar disorder, or Alzheimer's disease.
• Subtle early behavioral symptoms (disinhibition, apathy) are often misinterpreted.
• Neuroimaging, neuropsychological evaluations, AI algorithms, and clinician expertise improve diagnostic accuracy.

Conclusions:

• bvFTD is frequently misdiagnosed initially due to overlapping symptoms with other conditions.
• Standardized frameworks and ongoing assessments improve diagnostic accuracy, but delays persist.
• Early recognition of subtle signs, clinician awareness, longitudinal evaluation, and AI are key to overcoming diagnostic challenges in bvFTD.