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Early anhedonia distinguishes behavioral variant frontotemporal dementia from Alzheimer's disease
Siobhán Shaw1,2, Samuel L Warren1,2, Claris Teng1,2
1Brain and Mind Centre The University of Sydney Sydney New South Wales Australia.
Introduction:
Differentiating behavioral variant frontotemporal dementia (bvFTD) from Alzheimer's disease (AD) remains challenging due to overlapping early behavioral and cognitive features. Anhedonia has emerged as a promising clinical marker, yet its multidimensional nature and temporal emergence across dementia syndromes remain unclear.
Methods:
Anticipatory and consummatory components of anhedonia were assessed in bvFTD and AD using the Temporal Experience of Pleasure Scale. Event-based modeling was applied in each group to stage the probabilistic emergence of anticipatory and consummatory anhedonia dimensions relative to apathy and cognitive symptoms.
Results:
Relative to controls, bvFTD showed marked loss of pleasure across anticipatory and consummatory components, whereas AD showed selective anticipatory anhedonia in the context of preserved consummatory pleasure. Event-based modeling placed consummatory and anticipatory anhedonia dimensions as early features of bvFTD occurring prior to overt cognitive changes. In contrast, for AD, anhedonia was probabilistically more likely to arise at later stages of the disease sequence, subsequent to cognitive decline.
Discussion:
These findings highlight consummatory anhedonia as an early, clinically informative marker of bvFTD and support the value of multidimensional hedonic assessment for improving dementia differentiation.