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Behavioural variant frontotemporal dementia (bvFTD) is a neurodegenerative disease, the symptoms of which are changes in character, behavioural changes and socio-cognitive changes occurring predominantly at an age between 40 and 70 years. Frontotemporal atrophy is apparent on diagnostic imaging in 70% of patients with bvFTD; a diagnostic dilemma arises if this is not clearly obvious. Validated questionnaires for stereotypical behaviour, depressive symptoms and apathy, and neuropsychological examination can be very helpful in differentiating between bvFTD and psychiatric and other neurological conditions. A brain MRI is always indicated in patients displaying behavioural changes; frontal or temporal atrophy on brain MRI provide sufficient support for the diagnosis 'probable bvFTD'. When in doubt, a supplementary 18F-FDG-PET scan can be performed, but hypometabolism on an 18F-FDG-PET scan can give a false-positive result. If bvFTD is suspected, a multidisciplinary approach, clinical follow-up for 2 years and referral to an FTD centre of excellence are recommended. Conflict of interest and financial support: none declared.

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease caused by repetitive head injuries like those seen in sports such as boxing, American football and soccer. The clinical features of CTE are a range of cognitive, psychiatric and motor symptoms, and histopathology involves deposits of hyperphosphorylated tau protein and the presence of TAR DNA-binding protein (TDP-43) with relatively little beta-Amyloid. CTE is difficult to differentiate clinically from Alzheimer's disease, frontotemporal dementia and psychiatric disorders because of the major symptom overlap between these conditions. The most important risk factors for developing CTE are the cumulative effect of repetitive head injuries, with or without clinical symptoms, and the duration of exposure to the repetitive injuries (the sporting career). There is no treatment for CTE at present and the strategy must be primarily geared to prevention. In view of the large number of people, including those in the Netherlands, who take part in sports in which head injuries may occur, research into CTE is of major societal importance.