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We studied mood disorders (MD) and psychotic symptoms (PS) in patients with fronto -temporal dementia (FTD) and Alzheimer's disease (AD) by means of different diagnostic instruments. These were: a subjective scale (subsets of survey psychiatric assessment schedule: SPAS), an objective scale (subsets of neuropsychiatric inventory: NPI) and a projective task (Wartegg completion task: WCT). A general tendency of NPI to over estimate the presence of symptoms compared to SPAS was observed, but distribution and severity of symptoms were quite homogeneous in the two dementia-groups, independently of the diagnostic scales. At variance with the scales, the WCT showed a more severe impairment in FTD than in AD. The regression analysis selected neuropsychological models able to predict behavioral disorders only in FTD, in particular, a planning deficit predicted PS. These data confirm the hypothesis that a damage in the frontal areas constitutes the neurobiological basis of PS in degenerative brain diseases. Furthermore, they suggest that mostly in FTD, behavioral disorders, as well as cognitive deficits, should be considered a direct expression of neural damage.

Object and action naming and comprehension were tested in frontotemporal dementia (frontal variant, FTD), in Alzheimer's disease (AD) and in controls. Although lower scores were obtained by all groups, we can confirm that actions were proportionally more impaired in FTD. The correlation between action naming deficit and severity of dementia was stronger in this group than in AD. The correlation analysis also suggested that the naming disorder was different in nature in FTD (mostly a dysexecutive deficit) and in AD (mostly a linguistic disorder). Our explanation is that since verbs are supposed to be more demanding of executive resources than nouns, a higher sensitivity to verbs should be expected in any brain pathology, but mostly in FTD in which executive resources are typically reduced., (Copyright 2003 S. Karger AG, Basel)

Alzheimer’s disease (AD) is characterized by a significant reduction in AcetylCholinesterase and an increase in ButyrylCholinesterase (BuChE) activity. The existence of polymorphic regions on the BuChE gene has been previously described; the most frequently found polymorphism is the so-called K variant, which leads to a 30% decreased enzymatic activity. Different studies reported a positive association between K variant and AD, strongest among late-onset AD and Apolipoprotein E (APOE) e4 carriers. We analyzed APOE and BuChE polymorphisms in 167 AD and 59 fronto-temporal dementia (FTD) patients compared with 129 healthy controls (HC). We reported a significantly lower frequency of the BuChE K variant in AD compared with HC and FTD and a significant increased frequency of the K variant in FTD. These results are in agreement with the known increase of the BuChE activity in AD and support the evidence of different molecular pathways involved in the pathogenesis of AD and FTD. [ABSTRACT FROM AUTHOR]

Frontal variant-Frontotemporal dementia (fvFTD) and Alzheimer's disease (AD) patients matched for severity of dementia at the Clinical Dementia Rating (CDR) received neuropsychological testing in order to explore if the dysexecutive disorder might characterise fvFTD at early stage, when AD is dominated by the episodic memory defect. We also determined if the behavioural syndrome was more severe in fvFTD than AD, and if specific patterns of behavioural symptoms could differentiate the two types of dementia, using the Neuropsychiatry Inventory (NPI). AD patients performed worse than fvFTD not only in memory but also in executive tasks. Apathy and eating disorders proved to be more severe or frequent in fvFTD even if the two groups did not differ in the total NPI score. CDR score significantly correlated with the NPI score in fvFTD and with the MMSE in AD. Our data confirm that the memory disorders may differentiate the two types of dementia; however, the dysexecutive syndrome is as severe, and even more severe in AD. The severity of the behavioural syndrome is comparable in the two groups but the nature of the behavioural disorders may vary to some extent. We conclude that AD dementia at early stage is a behavioural-cognitive syndrome, while in fvFTD the behavioural disorders appear when the cognitive deficit is still relatively mild. [ABSTRACT FROM AUTHOR]

The definition of clinical criteria for differential diagnosis of Vascular Dementia (VaD) and Alzheimer's disease (AD) remains controversial. A large group of patients selected was affected by chronic cerebrovascular disease classified as VaD or not (VND), according to DSM IV criteria. Neuropsychological performances of VaD patients were compared with a group of patients affected by probable AD, matched for age, education, and severity of disease. The comparison of performances did not reach statistical significance in single neuropsychological tasks. The results suggest that neuropsychological examination might not clearly differentiate between VaD and AD patients; the similar pattern of cognitive impairment is probably indicative of several common pathogenetic mechanisms. [ABSTRACT FROM AUTHOR]