CAN FRONTOTEMPORAL DEMENTIA AND ALZHEIMER'S DISEASE BE DIFFERENTIATED USING A BRIEF BATTERY OF TESTS?
✍ Scribed by CAROL A. GREGORY; MARTIN ORRELL; BARBARA SAHAKIAN; JOHN R. HODGES
- Publisher
- John Wiley and Sons
- Year
- 1997
- Tongue
- English
- Weight
- 135 KB
- Volume
- 12
- Category
- Article
- ISSN
- 0885-6230
No coin nor oath required. For personal study only.
✦ Synopsis
Objective. To compare the performance of patients with frontotemporal dementia (FTD) and Alzheimer's disease (AD) on a range of simple neuropsychological tests.
Design. A battery of neuropsychological tests easily applied at the bedside, consisting of traditional tests of memory, attention and executive function, were given together with tests of motor sequencing and examination of frontal release signs. In addition, we devised a theoretically motivated test of dual attentionÐa story with distraction which also contained a `social dilemma'.
Setting. Specialist memory and cognitive disorders clinic.
Patients. 12 patients with FTD and 12 patients with AD, matched for overall level of dementia on the Mini-Mental State Examination, were selected.
Results. In general, the dierence in results between FTD and AD patients was small. However, a composite score derived from the presence of a grasp and pout re¯ex, the number of perseverations during category ¯uency for animals and response to the social dilemma within the two stories produced a sensitivity of 83.3% and speci®city of 91.6%. There was also a highly signi®cant dierence between patients with FTD and AD in scores achieved on the Clinical Dementia Rating Scale re¯ecting the marked change in behaviour that patients with FTD suer, even at a stage when memory functions are well preserved.
Conclusion. Traditional neuropsychological tests were poor at dierentiating cases of FTD and AD; however, a composite (SIFTD) score appears potentially useful but requires prospective validation. Better methods of assessing the changes in comportment that characterize the early stages of FTD are required. (# 1997 by John Wiley & Sons, Ltd.) KEY WORDSÐAlzheimer's disease; dementia; Pick's disease; dementia of frontal type; frontotemporal dementia Frontotemporal dementia (FTD) has been recognized since the turn of the century, although its terminology has changed over the years. In 1906, Arnold Pick (Pick, 1906) reported the clinical features of a patient with frontal lobe degeneration. A few years later Alzheimer (Alzheimer, 1910±1911) described the histological abnormal-ities associated with `Pick's disease', and in the 1930s and 1940s large numbers of cases were reported (Hodges, 1994b;Tissot et al., 1985).
Subsequently, however, it became apparent that only a minority of cases of frontal lobe degeneration were, in fact, accompanied by Pick cells and