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Dementia & Neuropsychologia

Print version ISSN 1980-5764

Dement. neuropsychol. vol.7 no.1 São Paulo Jan./Mar. 2013

http://dx.doi.org/10.1590/S1980-57642013DN70100006 

ORIGINAL ARTICLES

The INECO Frontal Screening tool differentiates behavioral variant - frontotemporal dementia (bv-FTD) from major depression

Rastreio frontal INECO diferencia a variante comportamental da demência frontotemporal de depressão maior

Natalia Fiorentino1 

Ezequiel Gleichgerrcht2 

María Roca2 

Marcelo Cetkovich2 

Facundo Manes2 

Teresa Torralva3 

1Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina.

2Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina. Institute of Neurosciences, Buenos Aires, Argentina.

3Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina. Institute of Neurosciences, Buenos Aires, Argentina. Laboratory of Neuroscience, University of Diego Portales, Chile.

ABSTRACT

Executive dysfunction may result from prefrontal circuitry involvement occurring in both neurodegenerative diseases and psychiatric disorders. Moreover, multiple neuropsychiatric conditions, may present with overlapping behavioral and cognitive symptoms, making differential diagnosis challenging, especially during earlier stages. In this sense, cognitive assessment may contribute to the differential diagnosis by providing an objective and quantifiable set of measures that has the potential to distinguish clinical conditions otherwise perceived in everyday clinical settings as quite similar.

Objective:

The goal of this study was to investigate the utility of the INECO Frontal Screening (IFS) for differentiating bv-FTD patients from patients with Major Depression.

Methods:

We studied 49 patients with bv-FTD diagnosis and 30 patients diagnosed with unipolar depression compared to a control group of 26 healthy controls using the INECO Frontal Screening (IFS), the Mini Mental State Examination (MMSE) and the Addenbrooke's Cognitive Examination-Revised (ACE-R).

Results:

Patient groups differed significantly on the motor inhibitory control (U=437.0, p<0.01), verbal working memory (U=298.0, p<0.001), spatial working memory (U=300.5, p<0.001), proverbs (U=341.5, p<0.001) and verbal inhibitory control (U=316.0, p<0.001) subtests, with bv-FTD patients scoring significantly lower than patients with depression.

Conclusion:

Our results suggest the IFS can be considered a useful tool for detecting executive dysfunction in both depression and bv-FTD patients and, perhaps more importantly, that it has the potential to help differentiate these two conditions.

Key words: frontotemporal dementia; major depression and executive dysfunction

RESUMO

A disfunção executiva pode resultar de envolvimento do circuito pré-frontal que ocorre em doenças neurodegenerativas e distúrbios psiquiátricos. Além disso, várias condições neuropsiquiátricas, podem apresentar sobreposição de sintomas comportamentais e cognitivos, tornando o diagnóstico diferencial um desafio, especialmente durante as fases iniciais. Neste sentido, a avaliação cognitiva pode contribuir para o diagnóstico diferencial, fornecendo um conjunto de medidas objetivas e quantificáveis com potencial para distinguir as condições clínicas percebidas em ambientes clínicos comuns como bastante similar.

Objetivo:

O objetivo deste estudo foi o de investigar a utilidade do Rastreio Frontal INECO (IFS) em diferenciar pacientes bv-FTD de pacientes com depressão maior.

Métodos:

Foram estudados 49 pacientes com diagnóstico de bv-FTD e 30 pacientes com diagnóstico de depressão unipolar, que foram comparados com um grupo controle de 26 controles saudáveis usando o IFS, o Mini Exame do Estado Mental (MMSE) e Exame Cognitivo de Addenbrooke-revisado (ACE-I).

Resultados:

Os grupos de pacientes diferiram significativamente no controle inibitório motor (U=437,0, p<0,01), memória de trabalho verbal (U=298,0, p<0,001), a memória de trabalho espacial (U=300,5, p<0,001), provérbios (U=341,5, p<0,001) e no controle inibitório verbal (U=316,0, p<0,001), com pacientes com bv-FTD tendo pontuação significativamente menor do que os pacientes com depressão.

Conclusão:

Nossos resultados sugerem que o IFS pode ser considerado uma ferramenta útil para detectar a disfunção executiva em depressão e pacientes bv-FTD e, talvez mais importante, que tem o potencial de ajudar na diferenciação dessas duas condições.

Palavras-chave: demência frontotemporal; depressão; disfunção executiva

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Received: December 04, 2012; Accepted: February 06, 2013

Teresa Torralva. Institute of Cognitive Neurology - Castex 3293 (C1425), Buenos Aires - Argentina. E-mail: ttorralva@ineco.org.ar

Disclosure: The authors report no conflicts of interest.

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