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Predicting progression in the late onset frontal lobe syndrome

Published online by Cambridge University Press:  26 October 2018

Flora T. Gossink ,
Everard Vijverberg ,
Welmoed Krudop ,
Philip Scheltens ,
Max L. Stek ,
Yolande A. L. Pijnenburg  and
Annemiek Dols
Flora T. Gossink*
Affiliation:
Department of Old Age Psychiatry, GGZinGeest/VU University Medical Center, Amsterdam, the Netherlands Alzheimer Centre & Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
Everard Vijverberg
Affiliation:
Alzheimer Centre & Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
Welmoed Krudop
Affiliation:
Alzheimer Centre & Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
Philip Scheltens
Affiliation:
Alzheimer Centre & Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
Max L. Stek
Affiliation:
Department of Old Age Psychiatry, GGZinGeest/VU University Medical Center, Amsterdam, the Netherlands
Yolande A. L. Pijnenburg
Affiliation:
Department of Old Age Psychiatry, GGZinGeest/VU University Medical Center, Amsterdam, the Netherlands Alzheimer Centre & Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
Annemiek Dols
Affiliation:
Department of Old Age Psychiatry, GGZinGeest/VU University Medical Center, Amsterdam, the Netherlands Alzheimer Centre & Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
*
Correspondence should be addressed to: Flora Gossink, Old Age Psychiatry DNV, Alzheimer Center VUmc, Amsterdam, Amstelveenseweg 589 1081 JC Amsterdam, The Netherlands. Phone: 31-614028518; Fax: 31-204448529. Email: [email protected]; [email protected]
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Abstract

A late onset frontal lobe syndrome (LOF) refers to a clinical syndrome with apathy, disinhibition, or stereotypical behavior arising in middle or late adulthood. Diagnostics are challenging, and both clinicians and patients need reliable predictors of progression to improve clinical guidance. In this longitudinal multicenter and genetically screened prospective study, 137 LOF patients with frontal behavior (FBI score≥11) and/or stereotypical behavior (SRI≥10) were included. Progression was defined as institutionalization, death, or progression of frontal or temporal atrophy at magnetic resonance imaging (MRI) after two years of follow up. Absence of progression at MRI in addition to stable or improved Mini Mental State Examination and Frontal Assessment Battery scores after two years was indicative for non-progression. The presence of stereotypy and a neuropsychological profile with executive deficits at baseline were found to be predictive for progression, while a history and family history with psychiatric disorders were predictors for non-progression. The combination of these clinical markers had a predictive value of 80.4% (p < 0.05). In patients presenting with late onset behavioral symptoms, an appraisal of the rate of deterioration can be made by detailed mapping of clinical symptoms. Distinction of progressive discourses from non-progressive or treatable conditions is to be gained.

Keywords

progressiondementiafrontotemporal dementialate onset frontal lobe syndromeprognosispsychiatric disorders
Type
Brief Report
Information
International Psychogeriatrics , Volume 31 , Issue 5: Issue Theme: Well-Being in Dementia , May 2019 , pp. 743 - 748
Copyright
© International Psychogeriatric Association 2018 

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References

Alloy, L. B. et al. (2012). Progression along the bipolar spectrum: a longitudinal study of predictors of conversion from bipolar spectrum conditions to bipolar I and II disorders. Journal of Abnormal Psychology, 121, 16–27. doi: 10.1037/a0023973.CrossRefGoogle ScholarPubMed
Devenney, E. et al. (2015). Progression in behavioral variant frontotemporal dementia: a longitudinal study. JAMA Neurology, 72, 1501–1509. doi: 10.1001/jamaneurol.2015.2061.CrossRefGoogle ScholarPubMed
Diehl-Schmid, J. et al. (2013). Caregiver burden and needs in frontotemporal dementia. Journal of Geriatric Psychiatry and Neurology, 26, 221–229. doi: 10.1177/0891988713498467.CrossRefGoogle ScholarPubMed
Dols, A. et al. (2016). Identifying specific clinical symptoms of behavioral variant frontotemporal dementia versus differential psychiatric disorders in patients presenting with a late-onset frontal lobe syndrome. The Journal of Clinical Psychiatry, 77, 1391–1395. doi: 10.4088/JCP.15m09844.CrossRefGoogle ScholarPubMed
Dubois, B. Slachevsky, A., Litvan, I. and Pillon, B. (2000). The FAB: a frontal assessment battery at bedside. Neurology, 55, 1621–1626. doi: 10.1212/WNL.55.11.1621.CrossRefGoogle ScholarPubMed
Galea, M. and Woodward, M. (2005). Mini-mental state examination (MMSE). Australian Journal of Physiotherapy, 51, 198. doi: 10.1016/S0004-9514(05)70034-9.CrossRefGoogle Scholar
Haller, S. et al. (2011). Combined analysis of grey matter voxel-based morphometry and white matter tract-based spatial statistics in late-life bipolar disorder. Journal of Psychiatry and Neuroscience, 36, 391–401. doi: 10.1503/jpn.100140.CrossRefGoogle ScholarPubMed
Harper, L., Barkhof, F., Fox, N. C. and Schott, J. M. (2015). Using visual rating to diagnose dementia: a critical evaluation of MRI atrophy scales. Journal of Neurology, Neurosurgery, and Psychiatry, 86, 1225–1233. doi: 10.1136/jnnp-2014-310090.CrossRefGoogle ScholarPubMed
Kipps, C. M., Hodges, J. R. and Hornberger, M. (2010). Nonprogressive behavioural frontotemporal dementia: recent developments and clinical implications of the “bvFTD phenocopy syndrome”. Current Opinion in Neurology, 23, 628–632. doi: 10.1097/WCO.0b013e3283404309.CrossRefGoogle Scholar
Krudop, W. et al. (2014). Building a new paradigm for the early recognition of behavioral variant frontotemporal dementia: late onset frontal lobe syndrome study. The American Journal of Geriatric Psychiatry, 22, 735–740. doi: 10.1016/j.jagp.2013.02.002.CrossRefGoogle ScholarPubMed
Li, J.-Q. et al. (2016). Risk factors for predicting progression from mild cognitive impairment to Alzheimer’s disease: a systematic review and meta-analysis of cohort studies. Journal of Neurology, Neurosurgery & Psychiatry, 6, 1–9. doi: 10.1136/jnnp-2014-310095.Google Scholar
Moylan, S., Maes, M., Wray, N. R. and Berk, M. (2012). The neuroprogressive nature of major depressive disorder: pathways to disease evolution and resistance, and therapeutic implications. Molecular Psychiatry, 18, 595–606. doi: 10.1038/mp.2012.33.CrossRefGoogle ScholarPubMed
Rascovsky, K. et al. (2011). Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain, 134, 2456–2477. doi: 10.1093/brain/awr179.CrossRefGoogle ScholarPubMed
Scheltens, P. et al. (1992). Atrophy of medial temporal lobes on MRI in “probable” Alzheimer’s disease and normal ageing: diagnostic value and neuropsychological correlates. Journal of Neurology, Neurosurgery, and Psychiatry, 55, 967–972. doi: 10.1136/jnnp.55.10.967.CrossRefGoogle ScholarPubMed
Solje, E. et al. (2015). The phenotype of the C9ORF72 expansion carriers according to revised criteria for bvFTD. PLoS ONE, 10. doi: 10.1371/journal.pone.0131817.Google ScholarPubMed
Tifratene, K. Robert, P., Metelkina, A., Pradier, C. and Dartigues, J. F. (2015). Progression of mild cognitive impairment to dementia due to AD in clinical settings. Neurology, 85, 331–338. doi: 10.1212/WNL.0000000000001788.CrossRefGoogle ScholarPubMed
Wald, C. Fahy, M., Walker, Z. and Livingston, G. (2003). What to tell dementia caregivers - The rule of threes. International Journal of Geriatric Psychiatry, 18, 313–317. doi: 10.1002/gps.828.CrossRefGoogle ScholarPubMed
Woolley, J. D., Khan, B. K., Murthy, N. K., Miller, B. L. and Rankin, K. P. (2011). The diagnostic challenge of psychiatric symptoms in neurodegenerative disease: rates of and risk factors for prior psychiatric diagnosis in patients with early neurodegenerative disease. Journal of Clinical Psychiatry, 72, 126–133. doi: 10.4088/JCP.10m06382oli.CrossRefGoogle ScholarPubMed