Original Research Article
Neural Correlates of Caregiver Burden in Cortical Basal Syndrome and Frontotemporal DementiaKnutson K.M.a · Zamboni G.a, b · Tierney M.C.a · Grafman J.a
aCognitive Neuroscience Section, National Institutes of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md., USA; bDipartimento di Neuroscienze, Università di Modena e Reggio Emilia, Modena, Italy
Jordan Grafman, PhD, Cognitive Neuroscience Section
National Institutes of Neurological Disorders and Stroke National Institutes of Health, Building 10, Room 7D43, MSC 1440
10 Center Drive, Bethesda, MD 20892-1440 (USA)
Tel. +1 301 496 0220, Fax +1 301 480 2909, E-Mail firstname.lastname@example.org
Do you have an account?
Aims: To determine areas of atrophy in patients that are associated with caregiver burden. Methods: We measured caregiver burden, dementia and neuropsychiatric scores in 22 patients with corticobasal syndrome (CBS) and 25 with frontotemporal dementia (FTD), and in 14 healthy controls. We used voxel-based morphometry to correlate caregiver burden with gray matter loss. Results: Increased dementia and behavioral disturbances contributed to higher burden scores in CBS patients, while behavioral disturbances alone significantly affected burden scores in frontal-variant FTD (FTD-fv) patients. In CBS patients, caregiver burden scores correlated with atrophy in left inferior and middle temporal gyri. Conclusions: Caregivers of FTD-fv patients had significantly higher burden scores than caregivers of CBS patients. Damage to areas important in semantic knowledge appears critical in increased burden for CBS caregivers.
© 2008 S. Karger AG, Basel
- Josephs KA, Whitwell JL, Dickson DW, et al: Voxel-based morphometry in autopsy proven PSP and CBD. Neurobiol Aging 2008;29:280–289.
- Rosen HJ, Gorno-Tempini ML, Goldman WP, et al: Patterns of brain atrophy in frontotemporal dementia and semantic dementia. Neurology 2002;58:198–208.
- De Vugt M, Stevens F, Aalten P, et al: Behavioural disturbances in dementia patients and quality of the marital relationship. Int J Geriatr Psychiatry 2003;18:149–154.
- De Vugt M, Nicolson N, Aalten P, et al: Behavioral problems in dementia patients and salivary cortisol patterns in caregivers. J Neuropsychiatry Clin Neurosci 2005;17:201–207.
- Riedijk S, De Vugt M, Duivenvoorden H, et al: Caregiver burden, health-related quality of life and coping in dementia caregivers: a comparison of frontotemporal dementia and Alzheimer’s disease. Dement Geriatr Cogn Disord 2006;22:405–412.
- Rinne JO, Lee MS, Thompson PD, Marsden CD: Corticobasal degeneration. Brain 1994;117:1183–1196.
- Josephs KA, Petersen RC, Knopman DS, et al: Clinicopathologic analysis of frontotemporal and corticobasal degenerations and PSP. Neurology 2006;66:41–48.
- McKhann GM, Albert MS, Grossman M, et al: Clinical and pathological diagnosis of frontotemporal dementia. Arch Neurol 2001;58:1803–1809.
- Neary D, Snowden JS, Gustafson L, et al: Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology 1998;51:1546–1554.
- Rebeiz J, Kolodny E, Richardson E: Corticodentatonigral degeneration with neuronal achromasia. Arch Neurol 1968;18:20–33.
- Josephs KA, Tang-Wai DF, Edland SD, et al: Correlation between antemortem magnetic resonance imaging findings and pathologically confirmed corticobasal degeneration. Arch Neurol 2004;61:1881–1884.
- Grimes DA, Lang AE, Bergeron CB: Dementia as the most common presentation of cortical-basal ganglionic degeneration. Neurology 1999;53:1969–1974.
- Bergeron C, Davis A, Lang AE: Corticobasal ganglionic degeneration and progressive supranuclear palsy presenting with cognitive decline. Brain Pathol 1998;8:355–365.
- Pillon B, Dubois B: Memory and executive processes in corticobasal degeneration. Adv Neurol 2000;82:91–101.
- Mourik JC, Rosso SM, Niermeijer MF, et al: Frontotemporal dementia: behavioral symptoms and caregiver distress. Dementia Geriatr Cogn Disord 2004;18:299–306.
- Liu W, Miller BL, Kramer JH, et al: Behavioral disorders in the frontal and temporal variants of frontotemporal dementia. Neurology 2004;62:742–748.
- De Vugt M, Riedijk S, Aalten P, et al: Impact of behavioural problems on spousal caregivers: a comparison between Alzheimer’s disease and frontotemporal dementia. Dement Geriatr Cogn Disord 2006;22:35–41.
Seeley WW, Miller BL: Disorders of the self in dementia; in Feinberg TE, Keenan JP (eds): The Lost Self. New York, Oxford University Press, 2005, pp 147–165.
Zarit SH, Orr NK, Zarit JM: The Hidden Victims of Alzheimer’s Disease: Families under Stress. New York, New York University Press, 1985.
- Zarit SH, Reever KE, Bach-Peterson J: Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 1980;20:649–655.
- Seltzer B, Vasterling JJ, Yoder J, Thompson KA: Awareness of deficit in Alzheimer’s disease: relation of caregiver burden. Gerontologist 1997;37:20–24.
- Zarit SH, Todd PA, Zarit JM: Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist 1986;26:260–266.
- Rosen HJ, Allison SC, Schauer GF, et al: Neuroanatomical correlates of behavioural disorders in dementia. Brain 2005;128:2612–2625.
- Zamboni G, Huey ED, Krueger F, Nichelli PF, Grafman J: Apathy and disinhibition in frontotemporal dementia: insights into their neural correlates. Neurology 2008;71:736–742.
Boeve BF: Corticobasal degeneration: the syndrome and the disease; in Litvan I (ed): Atypical Parkinsonian Disorders: Clinical and Research Aspects. Totowa, Humana Press, 2005, pp 309–334.
- Schreiner AS, Morimoto T, Aria Y, Zarit SH: Assessing family caregiver’s mental health using a statistically derived cut-off score for the Zarit Burden Interview. Aging Ment Health 2006;10:107–111.
Jurica PJ, Leitten CL, Mattis S: Dementia Ratings Scale-2. Lutz, Psychological Assessment Resources, 2001.
- Cummings JL, Mega MS, Gray JA, et al: The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994;44:2308–2314.
- Ashburner J, Friston KJ: Unified segmentation. Neuroimage 2005;26:839–851.
- Ridgway GR, Henley SM, Rohrer JD, et al: Ten simple rules for reporting voxel-based morphometry studies. Neuroimage 2008;40:1429–1435.
- Boutoleau-Bretonniere C, Vercelletto M, Volteau C, Renou P, Lamy E: Zarit Burden Inventory and Activities of Daily Living in the behavioral variant of frontotemporal dementia. Dement Geriatr Cogn Disord 2008;25:272–277.
- Leinonen E, Korpisammal L, Pulkkinen LM, Pukuri T: The comparison of burden between caregiving spouses of depressive and demented patients. Int J Geriatr Psychiatry 2001;16:387–393.
- Ricci PT, Zelkowicz BJ, Nebes RD, et al: Functional neuroanatomy of semantic memory: recognition of semantic associations. Neuroimage 1999;9:88–96.
- Bookheimer S: Functional MRI of language: new approaches to understanding the cortical organization of semantic processing. Annu Rev Neurosci 2002;25:151–188.
- Vandenberghe R, Price C, Wise R, Josephs O, Frackowiak RS: Functional anatomy of a common semantic system for words and pictures. Nature 1996;383:254–256.
- Reilly J, Peelle JE: Effects of semantic impairment on language processing in semantic dementia. Semin Speech Lang 2008;29:32–43.
- Harvey PO, Pruessner J, Czechowska Y, Lepage M: Individual differences in trait anhedonia: a structural and functional magnetic resonance imaging study in non-clinical subjects. Mol Psychiatry 2007;12:767–775.
- Yatham LN, Lyoo IK, Liddle P, et al: A magnetic resonance imaging study of mood stabilizer- and neuroleptic-naive first-episode mania. Bipolar Disord 2007;9:693–697.
- Grafman J, Schwab K, Warden D, et al: Frontal lobe injuries, violence, and aggression: a report of the Vietnam Head Injury Study. Neurology 1996;46:1231–1238.
- Grafman J, Vance SC, Weingartner H, Salazar AM, Amin D: The effects of lateralized frontal lesions on mood regulation. Brain 1986;109:1127–1148.
- O’Doherty J, Kringelbach ML, Rolls ET, Hornak J, Andrews C: Abstract reward and punishment representations in the human orbitofrontal cortex. Nat Neurosci 2001;4:95–102.
- Bechara A, Damasio AR, Damasio H, Anderson SW: Insensitivity to future consequences following damage to human prefrontal cortex. Cognition 1994;50:7–15.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.