TY - JOUR
T1 - Different patterns of gray matter atrophy in behavioral variant frontotemporal dementia with and without episodic memory impairment
AU - Resende, Elisa de Paula França
AU - Hornberger, Michael
AU - Guimarães, Henrique Cerqueira
AU - Gambogi, Leandro Boson
AU - Mariano, Luciano Inácio
AU - Teixeira, Antônio Lúcio
AU - Caramelli, Paulo
AU - de Souza, Leonardo Cruz
PY - 2021/12
Y1 - 2021/12
N2 - Background: Differentiating patients with behavioral variant frontotemporal dementia (bvFTD) from Alzheimer's disease (AD) is important as these two conditions have distinct treatment and prognosis. Using episodic impairment and medial temporal lobe atrophy as a tool to make this distinction has been debatable in the recent literature, as some patients with bvFTD can also have episodic memory impairment and medial temporal lobe atrophy early in the disease. Objectives: To compare brain atrophy patterns of patients with bvFTD with and without episodic memory impairment to that of patients with AD. Methods: We analyzed 19 patients with bvFTD, 21 with AD and 21 controls, matched by age, sex, and years of education. They underwent brain MRI and the memory test from the Brief Cognitive Battery (BCB) to assess episodic memory. We then categorized the bvFTD group into amnestic (BCB delayed recall score <7) and non-amnestic. Results: The amnestic bvFTD group (n = 8) had significant gray matter atrophy in the left parahippocampal gyrus, right cingulate and precuneus regions compared with the nonamnestic group. Compared with AD, amnestic bvFTD had more atrophy in the left fusiform cortex, left insula, left inferior temporal gyrus and right temporal pole, whereas patients with AD had more atrophy in the left hippocampus, left frontal pole and left angular gyrus. Conclusions: There is a group of amnestic bvFTD patients with episodic memory dysfunction and significant atrophy in medial temporal structures, which poses a challenge in considering only these features when differentiating bvFTD from AD clinically.
AB - Background: Differentiating patients with behavioral variant frontotemporal dementia (bvFTD) from Alzheimer's disease (AD) is important as these two conditions have distinct treatment and prognosis. Using episodic impairment and medial temporal lobe atrophy as a tool to make this distinction has been debatable in the recent literature, as some patients with bvFTD can also have episodic memory impairment and medial temporal lobe atrophy early in the disease. Objectives: To compare brain atrophy patterns of patients with bvFTD with and without episodic memory impairment to that of patients with AD. Methods: We analyzed 19 patients with bvFTD, 21 with AD and 21 controls, matched by age, sex, and years of education. They underwent brain MRI and the memory test from the Brief Cognitive Battery (BCB) to assess episodic memory. We then categorized the bvFTD group into amnestic (BCB delayed recall score <7) and non-amnestic. Results: The amnestic bvFTD group (n = 8) had significant gray matter atrophy in the left parahippocampal gyrus, right cingulate and precuneus regions compared with the nonamnestic group. Compared with AD, amnestic bvFTD had more atrophy in the left fusiform cortex, left insula, left inferior temporal gyrus and right temporal pole, whereas patients with AD had more atrophy in the left hippocampus, left frontal pole and left angular gyrus. Conclusions: There is a group of amnestic bvFTD patients with episodic memory dysfunction and significant atrophy in medial temporal structures, which poses a challenge in considering only these features when differentiating bvFTD from AD clinically.
KW - Alzheimer's disease
KW - episodic memory
KW - frontotemporal dementia
KW - gray matter
KW - neuroimaging
UR - http://www.scopus.com/inward/record.url?scp=85101136278&partnerID=8YFLogxK
U2 - 10.1002/gps.5503
DO - 10.1002/gps.5503
M3 - Article
C2 - 33527441
SN - 0885-6230
VL - 36
SP - 1848
EP - 1857
JO - International Journal of Geriatric Psychiatry
JF - International Journal of Geriatric Psychiatry
IS - 12
ER -