Utility of behavioral versus cognitive measures in differentiating between subtypes of frontotemporal lobar degeneration and Alzheimer's disease.

Full Abstract

We hypothesized that a modified version of the Frontal Behavioral Inventory (FBI-mod), along with a few cognitive tests, would be clinically useful in distinguishing between clinically defined Alzheimer's disease (AD) and subtypes of frontotemporal lobar degeneration (FTLD):
frontotemporal dementia (dysexecutive type), progressive nonfluent aphasia, and semantic dementia. We studied 80 patients who were diagnosed with AD (n = 30) or FTLD (n = 50), on the basis of a comprehensive neuropsychological battery, imaging, neurological examination, and history. We found significant between-group differences on the FBI-mod, two subtests of the Rey Auditory Verbal Learning Test (verbal learning and delayed recall), and the Trail Making Test Part B (one measure of 'executive functioning'). AD was characterized by relatively severe impairment in verbal learning, delayed recall, and executive functioning, with relatively normal scores on the FBI-mod. Frontotemporal dementia was characterized by relatively severe impairment on the FBI-mod and executive functioning in the absence of severe impairment in verbal learning and recall. Progressive nonfluent aphasia was characterized by severe impairment in executive functioning with relatively normal scores on verbal learning and recall and FBI-mod. Finally, semantic dementia was characterized by relatively severe deficits in delayed recall, but relatively normal performance on new learning, executive functioning, and on FBI-mod. Discriminant function analysis confirmed that the FBI-mod, in conjunction with the Rey Auditory Verbal Learning Test, and the Trail Making Test Part B categorized the majority of patients as subtypes of FTLD or AD in the same way as a full neuropsychological battery, neurological examination, complete history, and imaging. These tests may be useful for efficient clinical diagnosis, although progressive nonfluent aphasia and semantic dementia are likely to be best distinguished by language tests not included in standard neuropsychological test batteries.

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Author information

Author/s: Heidler-Gary, Jennifer (J); Gottesman, Rebecca (R); Newhart, Melissa (M); Chang, Shannon (S); Ken, Lynda (L); Hillis, Argye E (AE);

Affiliation: Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. jheidle1(-atsign-)jhmi.edu

Journal and publication information

Publication Type: Comparative Study; Journal Article; Validation Studies

Journal: Dementia and geriatric cognitive disorders (Dement Geriatr Cogn Disord), published in Switzerland. (Language: eng)

Reference: 2007-; vol 23 (issue 3) : pp 184-93

Dates: Created 2007/02/22; Completed 2007/04/26; Revised 2008/03/24;

PMID: 17220629, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Aged, 80 and over
Alzheimer Disease - complications; diagnosis
Analysis of Variance
Behavioral Symptoms - diagnosis
Cognition Disorders - complications; diagnosis
Dementia - classification; complications; diagnosis
Diagnosis, Differential

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