Two Distinct Amnesic Profiles in Behavioral Variant Frontotemporal Dementia

doi:10.1016/j.biopsych.2013.08.017

Biological Psychiatry

Volume 75, Issue 7, 1 April 2014, Pages 582-588

https://doi.org/10.1016/j.biopsych.2013.08.017 Get rights and content

Background

Whether or not episodic memory deficit is a characteristic of behavioral variant frontotemporal dementia (bvFTD) is a crucial question for its diagnosis and management.

Methods

We compared the episodic memory performance profile of bvFTD patients with healthy control subjects and patients with Alzheimer’s disease (AD) as defined by clinical and biological criteria. Episodic memory was assessed with the Free and Cued Selective Reminding Test, which controls for effective encoding and identifies memory storage ability resulting from consolidation processing. One hundred thirty-four participants were evaluated: 56 patients with typical clinical presentation of AD and pathophysiological evidence as defined by cerebrospinal fluid AD biomarker profile and/or significant amyloid retention on Pittsburgh Compound B positron emission tomography; 56 patients diagnosed with bvFTD with no evidence of AD-cerebrospinal fluid biomarkers when a profile was available (28/56), including 44 progressive (bvFTD) and 12 nonprogressive (phenocopies) patients; and 22 control subjects with negative amyloid imaging.

Results

Memory scores could not differentiate bvFTD from AD patients (sensitivity and specificity <50%). Taking into account the individual distribution of Free and Cued Selective Reminding Test scores, half of bvFTD patients had a deficit of free recall, total (free + cued) recall, and delayed recall as severe as AD patients. The other half had subnormal scores similar to phenocopies and a delayed recall score similar to control subjects.

Conclusions

We observed two distinct amnesic profiles in bvFTD patients that could reflect two types of hippocampal structure and Papez circuit involvement. These findings on episodic memory profiles could contribute to discussions on the recent international consensus criteria for bvFTD.

Section snippets

Participants

One hundred thirty-four participants were selected from the database of the Memory and Alzheimer Institute of the Pitié-Salpêtrière Hospital from May 2007 to June 2012, including the Biomage (ANR-07-LVIE-002-01) and Imabio3 studies (Programme Hospitalier de Recherche Clinique 2010). Fifty-six AD patients were selected according to the following criteria: 1) typical clinical presentation of AD with an amnestic presentation; and 2) biological evidence of the AD pathophysiological process as

Demographic and Neuropsychological Characteristics

The four groups (control subjects, AD, bvFTD, and phenocopy) were not significantly different with regard to age and educational level. Not surprisingly, MMSE scores were significantly lower in the bvFTD and AD groups compared with control subjects (p < .005) and phenocopies (p < .005). No difference in MMSE score was observed between bvFTD and AD or between control subjects and phenocopies. As expected, the FAB and verbal fluency scores were lower (p < .005) in the bvFTD and phenocopy groups

Discussion

This study analyzed the profile of episodic memory function in bvFTD patients compared with control subjects and AD patients. All control and AD patients and over half of the FTD patients were selected according to clinical and biological criteria. We chose the FCSRT (19), which assesses the four main components of verbal episodic memory (encoding, free recall, total [free + cued] recall, and free and total delayed [free + cued] recall) to test memory storage capacity, which is believed to be

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: Authors MB and LCdS contributed equally to this work.

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Priority CommunicationTwo Distinct Amnesic Profiles in Behavioral Variant Frontotemporal Dementia

Background

Methods

Results

Conclusions

Section snippets

Participants

Demographic and Neuropsychological Characteristics

Discussion

J Psychiatr Res

Cortex

Neuroimage

Biol Psychiatry

Lancet Neurol

Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia

Brain

Frontotemporal lobar degeneration: A consensus on clinical diagnostic criteria

Neurology

Pathologically proven frontotemporal dementia presenting with severe amnesia

Brain

Histopathological changes underlying frontotemporal lobar degeneration with clinicopathological correlation

Acta Neuropathol

How preserved is episodic memory in behavioral variant frontotemporal dementia?

Neurology

Neural correlates of episodic memory in behavioral variant frontotemporal dementia

J Alzheimers Dis

Measuring progression in frontotemporal dementia: Implications for therapeutic interventions

Neurology

Episodic memory in frontotemporal dementia: A critical review

Brain

In vivo and post-mortem memory circuit integrity in frontotemporal dementia and Alzheimer’s disease

Brain

Is hippocampal volume a good marker to differentiate Alzheimer’s disease from frontotemporal dementia?

J Alzheimers Dis

Measurements of the amygdala and hippocampus in pathologically confirmed Alzheimer disease and frontotemporal lobar degeneration

Arch Neurol

Memory impairment differs in frontotemporal dementia and Alzheimer’s disease

Neurocase

Differential mechanisms of impairment of remote memory in Alzheimer’s and frontotemporal dementia

Dement Geriatr Cogn Disord

Priority Communication
Two Distinct Amnesic Profiles in Behavioral Variant Frontotemporal Dementia