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Clinical Manifestations.

Grace J Goodwin1, Sebastian Mehrzad2, Samantha E John3

  • 1University of Nevada, Las Vegas, Las Vegas, NV, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 26, 2025
PubMed
Summary
This summary is machine-generated.

Neuropsychiatric symptoms (NPS) in behavioral variant frontotemporal dementia (bvFTD) are interconnected. Targeting irritability and agitation may reduce symptom spread and improve management of bvFTD.

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Area of Science:

  • Neuroscience
  • Geriatric Medicine
  • Psychiatry

Background:

  • Behavioral variant frontotemporal dementia (bvFTD) presents with neuropsychiatric symptoms (NPS) leading to functional decline.
  • Current treatments for NPS in bvFTD lack efficacy, necessitating a deeper understanding for personalized interventions.
  • Network analysis is employed to model NPS in bvFTD at the initial clinical visit.

Purpose of the Study:

  • To model the network structure of neuropsychiatric symptoms (NPS) in behavioral variant frontotemporal dementia (bvFTD).
  • To identify key symptoms and symptom clusters within the NPS network of bvFTD patients.
  • To inform potential therapeutic targets for managing NPS in bvFTD.

Main Methods:

  • Utilized data from 1066 bvFTD patients from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set (UDS).
  • Employed network analysis with the eLasso method to estimate pairwise dependencies between 12 Neuropsychiatric Inventory Questionnaire (NPI-Q) items.
  • Calculated node strength to determine the relative importance of each NPI-Q item in the overall network.

Main Results:

  • Apathy/indifference (79.01%) and disinhibition (67.70%) were the most frequent symptoms.
  • The NPS network revealed interconnected symptom clusters, including hallucinations/delusions and agitation/irritability.
  • Irritability/lability and agitation/aggression showed high node strength, though centrality values require cautious interpretation due to instability.

Conclusions:

  • Neuropsychiatric symptoms in bvFTD are highly interconnected, suggesting that one symptom increases the likelihood of others.
  • Interventions targeting irritability and agitation may reduce symptom connectivity and "contagion" in bvFTD.
  • Larger sample sizes are recommended to confirm network features and ensure stable centrality values for clinical application.