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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/S1980-57642013DN70100012 

ORIGINAL ARTICLES

Fronto-striatal atrophy correlates of neuropsychiatric dysfunction in frontotemporal dementia (FTD) and Alzheimer's disease (AD)

Correlatos de atrofia fronto-estriatal e disfunção neuropsiquiátrica em demência frontotemporal (DFT) e Doença de Alzheimer (DA)

Dong Seok Yi1 

Maxime Bertoux2 

Eneida Mioshi3 

John R. Hodges4 

Michael Hornberger4 

1Neuroscience Research Australia, Sydney, Australia.

2University Pierre and Marie Curie - Paris VI, Sorbonne Universités, Paris, France.

3Neuroscience Research Australia, Sydney, Australia. School of Medical Sciences, University of New South Wales, Sydney, Australia.

4Neuroscience Research Australia, Sydney, Australia. ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia. School of Medical Sciences, University of New South Wales, Sydney, Australia.

ABSTRACT

Behavioural disturbances in frontotemporal dementia (FTD) are thought to reflect mainly atrophy of cortical regions. Recent studies suggest that subcortical brain regions, in particular the striatum, are also significantly affected and this pathology might play a role in the generation of behavioural symptoms.

Objective:

To investigate prefrontal cortical and striatal atrophy contributions to behavioural symptoms in FTD.

Methods:

One hundred and eighty-two participants (87 FTD patients, 39 AD patients and 56 controls) were included. Behavioural profiles were established using the Cambridge Behavioural Inventory Revised (CBI-R) and Frontal System Behaviour Scale (FrSBe). Atrophy in prefrontal (VMPFC, DLPFC) and striatal (caudate, putamen) regions was established via a 5-point visual rating scale of the MRI scans. Behavioural scores were correlated with atrophy rating scores.

Results:

Behavioural and atrophy ratings demonstrated that patients were significantly impaired compared to controls, with bvFTD being most severely affected. Behavioural-anatomical correlations revealed that VMPFC atrophy was closely related to abnormal behaviour and motivation disturbances. Stereotypical behaviours were associated with both VMPFC and striatal atrophy. By contrast, disturbance of eating was found to be related to striatal atrophy only.

Conclusion:

Frontal and striatal atrophy contributed to the behavioural disturbances seen in FTD, with some behaviours related to frontal, striatal or combined fronto-striatal pathology. Consideration of striatal contributions to the generation of behavioural disturbances should be taken into account when assessing patients with potential FTD.

Key words: frontotemporal dementia; Alzheimer's disease; neuropsychiatric symptoms; striatum

RESUMO

Distúrbios de comportamento na demência frontotemporal (DFT) parecem refletir principalmente atrofia de regiões corticais. Estudos recentes sugerem que regiões cerebrais subcorticais, em particilar o estriado, são também são significativamente afetados e esta patologia pode ter um papel na geração dos sintomas comportamentais.

Investigar a contribuição da atrofia cortical prefrontal e estriatal para os sintomas da DFT.

Métodos:

182 participantes (87 pacienjtes com DFT, 39 pacientes com DA e 56 controles) foram incluídos. Os perfis cognitivos foram estabelecidos usando o Cambridge Behavioural Inventory Revised (CBI-R) e Frontal System Behaviour Scale (FrSBe). Atrofia nas regiões prefrontal (VMPFC, DLPFC) e estriatal (caudado e putamen) foi estabelecida através de uma escala visual de 5 pontos nas imagens de ressonância magnética. Os escores de comportamento foram correlacionados aos escores de atrfoia.

Resultados:

Os resultados comportamentais e de atrofia demonstraram que os pacientes estavam significativamente mais comprometidos do que os controles, com os pacientes com DFT mais gravemente afetados. As correlações anátomo-comportamentais revelaram que a atrofia do VMPFC foi intimamente relacionada ao comportamento anormal e distúrbios de motivação. Comportamentos estereotipados estiveram associados com atrofia do VMPFC e estriatal. Em contraste, distúrbios da alimentação foram relacionados somente a atrofia estriatal.

Conclusão:

A atrofia frontal e estriatal contribuíram para os distúrbios vistos na DFT, com alguns comportamentos relacionados a patologia frontal, estriatal ou combinadas. Considerações quanto à contribuição estriatal na gênese dos distúrbios de comportamento devem ser levados em conta quando se avalia pacientes com DFT em potencial.

Palavras-chave: demência fronto-temporal; doença de Alzheimer; sintomas neuropsiquiátricos; estriado

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Received: December 16, 2012; Accepted: February 20, 2013

Michael Hornberger. Neuroscience Research Australia, Cnr Barker & Easy Street, Randwick, NSW 2031, Sydney, Australia. E-mail: m.hornberger@neura.edu.au

Disclosure: The authors report no conflicts of interest.

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