Behavioral disturbances and frontotemporal dementia

Background

Frontotemporal dementia (FTD) is the most frequent cause of presenile dementia next to Alzheimer's disease (AD) and it has great impact on family members as it produces profound changes in personality, behavior, and social interaction.

In fact, FTD is usually diagnosed clinically as AD. It is widely appreciated that FTD cases may differ significantly in clinical picture.

An open label non-randomized prospective study of patients with AD and FTD, 1–2 years after disease onset.

Materials and methods

A total of 22 out and inpatients, under 59 years of age, who met ICD-10 criteria for dementia in Alzheimer's or Pick's disease, were included in the study. The clinical diagnostic features dementia and Behavioral and neuropsychiatric features that distinguish FTD from AD (Jeffrey L Cummings, 2003); Cognitive tests and structural neuroimages (CT or MRI); Mini-Mental State Examination (MMSE); Hutchinski score; The questionnaire the Frontal Behavioral Inventory (Kertesz et al.1997) (FBI), were used in a two year follow up period.

Results

MMSE scores were considerably lower in patients with AD compared with the patients with FTD, Hatchinski score lower of 4 in all patients. The patients in this study who had FTD scored significantly higher than did those with AD in the Frontal Behavior Inventory.

A total score on the questionnaire the FBI above 30 is suggestive of FTD. In lower- scoring groups, patients with AD can be discriminated.

Discussion

The patients who had FTD scored significantly higher on "the questionnaire the Frontal Behavioral Inventory" than did those with AD, for loss of emotions and insight, apathy, indifference, aspontaneity, logopenia, selfishness, disinhibition, personal neglect, irritability, impulsivity, restlessness, aggression, hyperorality and special food preference, motor and verbal stereotypies. FTD begins with personality and behavioral changes, in contrast to Alzheimer's disease, which begins with memory deficits.