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ALS and FTD Special Edition
Research paper
Social Cognition and Emotional Assessment differentiates frontotemporal dementia from depression
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  1. Maxime Bertoux1,2,3,4,
  2. Marine Delavest5,6,
  3. Leonardo Cruz de Souza1,2,3,4,
  4. Aurélie Funkiewiez3,4,
  5. Jean-Pierre Lépine5,6,
  6. Philippe Fossati7,
  7. Bruno Dubois1,2,3,4,
  8. Marie Sarazin1,2,3,4
  1. 1Université Pierre et Marie-Curie (UPMC) - Paris 6, Paris, France
  2. 2Institut du Cerveau et de la Moelle Epinière (ICM), INSERM UMRS 975, CNRS UMR 7225, Paris, France
  3. 3Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Paris, France
  4. 4Centre de Référence Démences Rares, Hôpital Pitié-Salpêtrière, Paris, France
  5. 5Service de Psychiatrie d'Adultes, Hôpital Fernand Widal - Lariboisière, Paris, France
  6. 6FondaMental Fondation, Créteil, France
  7. 7Service de Psychiatrie d'Adultes, Hôpital Pitié-Salpêtrière, Paris, France
  1. Correspondence to Dr M Bertoux, Institut de la Mémoire et de la Maladie d'Alzheimer - CHU Pitié-Salpêtrière, 47-83 boulevard de l'hôpital, 75013 Paris, France; maximel.bertoux{at}gmail.com

Abstract

Background Behavioural variant of frontotemporal dementia (bvFTD) is a neurodegenerative disease that is clinically characterised by progressive behavioural changes and social interpersonal dysfunctions. Its diagnosis remains a clinical challenge, and depression is one of the main causes of misdiagnoses due to the prevalence of apathy in bvFTD.

Objective To evaluate the sensitivity and specificity of the Social Cognition and Emotional Assessment (SEA) and the mini-SEA for differentiating bvFTD from major depressive disorder (MDD).

Methods Scores for the SEA and mini-SEA for 37 patients with bvFTD (divided into subgroups of 17 with early bvFTD and 20 with moderate bvFTD according to the normal range of the Mattis Dementia Rating Scale), 19 MDD patients and 30 control subjects were compared to define the discrimination power of these tools compared with other standard neuropsychological tests.

Results SEA and mini-SEA scores were significantly lower for both the early and moderate bvFTD groups compared with control subjects and the MDD group, and very few scores overlapped between patients in the bvFTD subgroups and patients in the MDD and control subgroups. SEA and mini-SEA scores distinguished early bvFTD from MDD with sensitivity and specificity rates above 94%.

Conclusion Unlike standard executive neuropsychological tests, SEA and the mini-SEA can differentiate MDD from bvFTD in the early stages of the disease. The mini-SEA is an easy tool that can be utilised in neurological or psychiatric departments.

https://doi.org/10.1136/jnnp-2011-301849

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    Footnotes

    • Funding MB was supported by the French Ministry of Defence and the National Centre for Scientific Research (CNRS) during his PhD.

    • Competing interests LCS received speaker honoraria from Lundbeck. J-PL received lecture honoraria from Servier, Sanofi, Pfizer-Wyeth and Pierre Fabre. PF received honoraria from Servier, Lundbeck, Eli Lilly and research grants from Servier. BD has consulted or served on advisory board for Bristol-Myers Squibb, Roche, Elan, Eli Lilly, Eisai and Janssen. His institution has received grants from Novartis and Sanofi-Aventis. MS received speaker honoraria from EISAI, Pfizer, Lundbeck, Janssen and Novartis; she belongs to a scientific advisory board for EISAI Company and serves as an associate editor for La Lettre du Neurologue.

    • Patient consent For patients, all clinical data were obtained during routine clinical work-up in the neurology and psychiatric departments and were extracted solely for the purpose of this study. Thus, according to French legislation, explicit informed consent was waived. However, the regulation concerning electronic filing was followed, and both patients and their relatives were informed that individual data may be used in retrospective clinical research studies. For healthy control subjects, the study was approved by the ethics committee for the protection of persons of the Pitié-Salpêtrière Hospital. All controls received oral and written information and we obtained a signed informed consent form before their participation.

    • Ethics approval The study was approved by the ethics committee of Pitié-Salpêtrière Hospital, France.

    • Provenance and peer review Not commissioned; externally peer reviewed.