1. Disease trajectories in behavioural variant frontotemporal dementia, primary psychiatric and other neurodegenerative disorders presenting with behavioural change
- Author
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Mara ten Kate, Frederik Barkhof, Annemiek Dols, Betty M. Tijms, Everard G. B. Vijverberg, Charlotte E. Teunissen, Wiesje M. van der Flier, Marta Del Campo, Lianne M. Reus, Yolande A.L. Pijnenburg, Pieter Jelle Visser, Welmoed A. Krudop, Flora Gossink, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Psychiatrie & Neuropsychologie, Neurology, Amsterdam Neuroscience - Neurodegeneration, Radiology and nuclear medicine, NCA - Neurobiology of mental health, Clinical chemistry, Epidemiology and Data Science, APH - Mental Health, Psychiatry, Divisions, APH - Personalized Medicine, and APH - Methodology
- Subjects
Male ,SYMPTOMS ,FRONTAL-LOBE SYNDROME ,Neuropsychological Tests ,0302 clinical medicine ,Image Processing, Computer-Assisted ,Medicine ,Apathy ,Longitudinal Studies ,Cognitive decline ,Mental Disorders ,BIPOLAR DISORDER ,Cognition ,Neurodegenerative Diseases ,DEGENERATION ,Middle Aged ,Magnetic Resonance Imaging ,ALZHEIMERS-DISEASE ,Psychiatry and Mental health ,Cerebrospinal fluid ,Frontal lobe ,Frontotemporal Dementia ,Disease Progression ,Female ,medicine.symptom ,MRI ,Frontotemporal dementia ,medicine.medical_specialty ,DIAGNOSTIC-CRITERIA ,Cortical thickness ,Disease trajectories ,03 medical and health sciences ,Social cognition ,Behavioural variant frontotemporal dementia (bvFTD) ,Humans ,Magnetic resonance imaging (MRI) ,Bipolar disorder ,Psychiatry ,Biological Psychiatry ,Aged ,Psychiatric Status Rating Scales ,DECLINE ,030214 geriatrics ,business.industry ,RECOGNITION ,medicine.disease ,Subcortical volumes ,Disinhibition ,Stereotyped Behavior ,HUMAN CEREBRAL-CORTEX ,business ,Cognition Disorders ,030217 neurology & neurosurgery - Abstract
Behavioural variant frontotemporal dementia (bvFTD) is characterized by behavioural and social cognitive disturbances, while various psychiatric and neurodegenerative disorders may have similar clinical symptoms. Since neurodegenerative disorders are eventually progressive, whereas primary psychiatric disorders are not, this study aimed to investigate whether the change in clinical symptoms over time differed between groups and which biomarkers predicted rate of decline. Disease trajectories (median follow-up = 3 years) of frontal and stereotyped behaviour, general and frontal cognitive functioning, and social cognition were examined in bvFTD (n = 34), other neurodegenerative (n = 28) and primary psychiatric disorders (n = 43), all presenting with late-onset frontal lobe syndrome (45-75 years), using linear mixed models. To gain more insight in underlying pathological processes driving disease progression, we studied the association of baseline cerebrospinal fluid (CSF) (neurofilament light (NfL) and YKL-40 levels, phosphotau181 to total tau ratio) and neuroimaging markers with disease trajectories. Frontal behavioural symptoms (e.g., disinhibition, apathy) worsened over time in bvFTD, whereas they improved in psychiatric disorders and remained stable in other neurodegenerative disorders. General and frontal cognitive decline was observed in bvFTD and other neurodegenerative disorders, but not in psychiatric disorders. None of the groups showed change in stereotypy and social cognition. For all diagnostic groups, higher CSF NfL levels were associated with faster frontal cognitive decline. A modest association was observed between caudate volume and stereotyped behaviour. Tracking frontal behavioural symptoms and cognition has potential to distinguish bvFTD from other disorders. CSF NfL levels seem to be associated with decline in frontal cognitive functioning.
- Published
- 2018
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