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Vol. 21, No. 2, 2006
Issue release date: January 2006
Dement Geriatr Cogn Disord 2006;21:74–80
(DOI:10.1159/000090139)

Initial Symptoms in Frontotemporal Dementia and Semantic Dementia Compared with Alzheimer’s Disease

Shinagawa S. · Ikeda M. · Fukuhara R. · Tanabe H.
aDepartment of Neuropsychiatry, Ehime University School of Medicine, Ehime, and bDepartment of Psychiatry, Jikei University School of Medicine, Tokyo, Japan

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Abstract

Background: Despite many reports about cognitive decline and behavioral changes in patients with frontotemporal lobar degeneration (FTLD), there have been very few systematic studies of initial symptoms of frontotemporal dementia (FTD) and semantic dementia (SD). Objective: It was the aim of this study to investigate FTD and SD and to establish whether they are characterized by different initial symptoms. Methods: Three groups of patients were studied: FTD (n = 36), SD (n = 17) and age-matched Alzheimer’s disease (AD) patients (n = 52). Information on initial symptoms was obtained from caregivers. Symptoms were classified into 22 distinct categories from the following domains, based on previous studies of symptoms of FTLD: (1) change in social behavior, affection, and daily activities, (2) cognitive decline, (3) language impairments, and (4) other abnormal symptoms. Results: Change in social behavior, affection, and daily activities was significantly more common in patients with FTD; on the other hand, language impairments were significantly more common in patients with SD as initial symptoms. Apathy and stereotypic behaviors were the most common initial symptoms among patients with FTD, while anomia, paraphasia, and impairment in word comprehension were the most common initial symptoms among patients with SD. Memory disturbance was the most common initial symptom among patients with AD. Conclusions: Behavioral and psychiatric symptoms are predominant initial symptoms in FTD, while language symptoms are predominant initial symptoms in SD. In addition to the assessment of current symptoms, the assessment of initial symptoms is useful for differential diagnosis in patients with FTD, SD and AD.



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References

  1. Kertesz A, Nadkarni N, Davidson W, Thomas AW: The Frontal Behavioral Inventory in the differential diagnosis of frontotemporal dementia. J Int Neuropsychol Soc 2000;6:460–468.
  2. Mathuranath PS, Nestor PJ, Berrios GE, Rakowicz W, Hodges JR: A brief cognitive test battery to differentiate Alzheimer’s disease and frontotemporal dementia. Neurology 2000;55:1613–1620.
  3. Gregory CA, Serra-Mestres J, Hodges JR: Early diagnosis of the frontal variant of frontotemporal dementia: how sensitive are standard neuroimaging and neuropsychologic tests? Neuropsychiatry Neuropsychol Behav Neurol 1999;12:128–135.
  4. Oppenheim G: The earliest signs of Alzheimer’s disease. J Geriatr Psychiatry Neurol 1994;7:116–120.
  5. McKhann GM, Albert MS, Grossman M, Miller B, Dickson D, Trojanowski JQ: Clinical and pathological diagnosis of frontotemporal dementia: report of the Work Group on Frontotemporal Dementia and Pick’s Disease. Arch Neurol 2001;58:1803–1809.
  6. Hodges JR, Davies RR, Xuereb JH, Casey B, Broe M, Bak TH, Kril JJ, Halliday GM: Clinicopathological correlates in frontotemporal dementia. Ann Neurol 2004;56:399–406.
  7. Cummings JL: Frontal-subcortical circuits and human behavior. Arch Neurol 1993;50:873–880.
  8. Loewenstein DA, Barker WW, Harwood DG, Luis C, Acevedo A, Rodriguez I, Duara R: Utility of a modified Mini-Mental State Examination with extended delayed recall in screening for mild cognitive impairment and dementia among community dwelling elders. Int J Geriatr Psychiatry 2000;15:434–440.
  9. Galasko D, Klauber MR, Hofstetter CR, Salmon DP, Lasker B, Thal LJ: The Mini-Mental State Examination in the early diagnosis of Alzheimer’s disease. Arch Neurol 1990;47:49–52.
  10. Lindau M, Almkvist O, Kushi J, Boone K, Johansson SE, Wahlund LO, Cummings JL, Miller BL: First symptoms – Frontotemporal dementia versus Alzheimer’s disease. Dement Geriatr Cogn Disord 2000;11:286–293.
  11. Gregory CA, Orrell M, Sahakian B, Hodges JR: Can frontotemporal dementia and Alzheimer’s disease be differentiated using a brief battery of tests? Int J Geriatr Psychiatry 1997;12:375–383.
  12. Welsh KA, Butters N, Hughes JP, Mohs RC, Heyman A: Detection and staging of dementia in Alzheimer’s disease. Use of the neuropsychological measures developed for the Consortium to Establish a Registry for Alzheimer’s Disease. Arch Neurol 1992;49:448–452.
  13. Cummings JL, Benson DF: Dementia of the Alzheimer type. An inventory of diagnostic clinical features. J Am Geriatr Soc 1986;34:12–19.
  14. The Lund and Manchester Groups: Clinical and neuropathological criteria for frontotemporal dementia. J Neurol Neurosurg Psychiatry 1994;57:416–418.
  15. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM: Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984;34:939–944.
  16. Galton CJ, Patterson K, Graham K, Lambon-Ralph MA, Williams G, Antoun N, Sahakian BJ, Hodges JR: Differing patterns of temporal atrophy in Alzheimer’s disease and semantic dementia. Neurology 2001;57:216–225.
  17. Chan D, Fox NC, Scahill RI, Crum WR, Whitwell JL, Leschziner G, Rossor AM, Stevens JM, Cipolotti L, Rossor MN: Patterns of temporal lobe atrophy in semantic dementia and Alzheimer’s disease. Ann Neurol 2001;49:433–442.
  18. Miller BL, Gearhart R: Neuroimaging in the diagnosis of frontotemporal dementia. Dement Geriatr Cogn Disord 1999;10(suppl 1):71–74.
  19. SLTA Committe: Standard Language Test of Aphasia Manual. Tokyo, Shinkou Igaku Shuppan-sha, 1997.
  20. Hirono N, Mori E, Ikejiri Y, Imamura T, Shimomura T, Hashimoto M, Yamashita H, Ikeda M: Japanese version of the Neuropsychiatric Inventory – A scoring system for neuro psychiatric disturbance in dementia patients. No To Shinkei 1997;49:266–271.
  21. Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J: The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994;44:2308–2314.
  22. Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL: A new clinical scale for the staging of dementia. Br J Psychiatry 1982;140:566–572.
  23. Raven JC, Court JH, Raven J: Manual for Raven’s Coloured Progressive Matrices. Oxford, Oxfords Psychologists Press, 1990.
  24. Folstein MF, Folstein SE, McHugh PR: Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
  25. Ikeda M, Tanabe H: Reducing the burden of care in dementia through the amelioration of BPSD by drug therapy. Expert Rev Neurother 2004;4:921–922.

    External Resources

  26. Cummings JL: Cholinesterase inhibitors: a new class of psychotropic compounds. Am J Psychiatry 2000;157:4–15.
  27. Shigenobu K, Ikeda M, Fukuhara R, Maki N, Hokoishi K, Nebu A, Yasuoka T, Komori K, Tanabe H: The Stereotypy Rating Inventory for frontotemporal lobar degeneration. Psychiatry Res 2002;110:175–187.
  28. Edwards-Lee T, Miller BL, Benson DF, Cummings JL, Russell GL, Boone K, Mena I: The temporal lobe variant of frontotemporal dementia. Neurology 1996;46:2023.
  29. Snowden JS: Semantic dysfunction in frontotemporal lobar degeneration. Dement Geriatr Cogn Disord 1999;10(suppl 1):33–36.
  30. Hodges JR, Patterson K, Oxbury S, Funnell E: Semantic dementia. Progressive fluent aphasia with temporal lobe atrophy. Brain 1992;115:1783–1806.
  31. Snowden JS, Goulding PJ, Neary D: Semantic dementia: a form of circumscribed cerebral atrophy. Behav Neurol 1989;2:167–182.
  32. Ikeda M, Brown J, Holland AJ, Fukuhara R, Hodges JR: Changes in appetite, food preference, and eating habits in frontotemporal dementia and Alzheimer’s disease. J Neurol Neurosurg Psychiatry 2002;73:371–376.
  33. Snowden JS, Bathgate D, Varma A, Blackshaw A, Gibbons ZC, Neary D: Distinct behavioural profiles in frontotemporal dementia and semantic dementia. J Neurol Neurosurg Psychiatry 2001;70:323–332.
  34. Bozeat S, Gregory CA, Ralph MA, Hodges JR: Which neuropsychiatric and behavioural features distinguish frontal and temporal variants of frontotemporal dementia from Alzheimer’s disease? J Neurol Neurosurg Psychiatry 2000;69:178–186.
  35. Gregory CA, Hodges JR: Frontotemporal dementia: use of consensus criteria and prevalence of psychiatric features. Neuropsychiatry Neuropsychol Behav Neurol 1996;9:145–153.

    External Resources

  36. Ikeda M, Ishikawa T, Tanabe H: Epidemiology of frontotemporal lobar degeneration. Dement Geriatr Cogn Disord 2004;17:265–268.
  37. Neary D, Snowden JS, Gustafson L, Passant U, Stuss D, Black S, Freedman M, Kertesz A, Robert PH, Albert M, Boone K, Miller BL, Cummings J, Benson DF: Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology 1998;51:1546–1554.
  38. Snowden JS, Neary D, Mann DMA: Fronto-Temporal Lobar Degeneration: Fronto-Temporal Dementia, Progressive Aphasia, Semantic Dementia. New York, Churchill Living stone, 1996.


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