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Behavioural changes in frontotemporal dementia and their cognitive and neuroanatomical correlates

Title: Behavioural changes in frontotemporal dementia and their cognitive and neuroanatomical correlates
Authors: Rouse, MA; Husain, M; Garrard, P; Patterson, K; Rowe, JB; Lambon Ralph, MA
Publisher Information: Oxford University Press
Publication Year: 2025
Collection: Oxford University Research Archive (ORA)
Description: Behavioural changes are a central feature of frontotemporal dementia (FTD); they occur in both behavioural-variant (bvFTD) and semantic dementia (SD)/semantic-variant primary progressive aphasia subtypes. In this study, we addressed two current clinical knowledge gaps: (i) are there qualitative or clear distinctions between behavioural profiles in bvFTD and SD; and (ii) what are the precise roles of the prefrontal cortex and anterior temporal lobes in supporting social behaviour? Resolving these conundrums is crucial for improving diagnostic accuracy and for the development of targeted interventions to treat challenging behaviours in FTD. Informant questionnaires to assess behavioural changes included the Cambridge Behavioural Inventory-Revised and two targeted measures of apathy and impulsivity. Participants completed a detailed neuropsychological battery to permit investigation of the relationship between cognitive status (including social-semantic knowledge, general semantic knowledge and executive function) with behaviour change in FTD. To explore changes in regional grey matter volume, a subset of patients had structural MRI. Diagnosis-based group comparisons were supplemented by a transdiagnostic approach that encompassed the spectrum of bvFTD, SD and ‘mixed’ or intermediate cases. Such an approach is sensitive to the systematic graded variation in FTD and allows the neurobiological underpinnings of behaviour change to be explored across an FTD spectrum. We found a wide range of behavioural changes across FTD. Although quantitatively more severe on average in bvFTD, as expected, the item-level analyses found no evidence for qualitative differences in behavioural profiles or ‘behavioural double dissociations’ between bvFTD and SD. Comparisons of self and informant ratings revealed strong discrepancies in the perspective of the caregiver versus the patient. Logistic regression revealed that neuropsychological measures had better discriminative accuracy for bvFTD versus SD than caregiver-reported behavioural ...
Document Type: article in journal/newspaper
Language: English
Relation: https://doi.org/10.1093/brain/awaf061
DOI: 10.1093/brain/awaf061
Availability: https://doi.org/10.1093/brain/awaf061; https://ora.ox.ac.uk/objects/uuid:a167ed94-dbf0-4832-aae6-75a9c2397153
Rights: info:eu-repo/semantics/openAccess ; CC Attribution (CC BY)
Accession Number: edsbas.D0B9FB39
Database: BASE