Conflict monitoring in early frontotemporal dementia.

Full Abstract

BACKGROUND: Despite the extensive frontal atrophy and behavioral disinhibition that characterizes behavioral variant frontotemporal dementia (bvFTD), many studies of early bvFTD suggest normal executive functioning (EF). The current study examined cognitive control in patients with bvFTD who otherwise seemed cognitively normal. METHODS: Subjects included 7 patients with bvFTD with normal neuropsychological test scores, 7 patients with bvFTD matched for Mini-Mental State Examination score but with impaired neuropsychological test scores, and 14 normal controls. A flanker paradigm and other measures of EF were administered to participants. A semiautomated parcellation program was used to analyze structural MRI scans. RESULTS: On the flanker task, multivariate analysis of variance revealed a significant condition X diagnosis interaction. Both bvFTD groups showed a larger congruency effect than normal controls, i.e., they displayed disproportionately reduced speed and accuracy on incongruent trials relative to congruent trials. Imaging data illustrated significant orbitofrontal atrophy in patients with early bvFTD as compared with controls. CONCLUSIONS: Patients with behavioral variant frontotemporal dementia (bvFTD) who performed within normal limits on clinical tests of executive functioning demonstrated a select impairment on an experimental test of cognitive control, suggesting a subtle impairment in inhibiting attention or response to the irrelevant stimuli. Measures of neuropsychological functioning sensitive to the ventromedial prefrontal cortex may be useful in early diagnosis of patients with bvFTD. Our understanding of this syndrome may be increased by considering the efficiency of selective inhibition, a fundamental component of executive cognitive control.

Author information

Author/s: Krueger, C E (CE); Bird, A C (AC); Growdon, M E (ME); Jang, J Y (JY); Miller, B L (BL); Kramer, J H (JH);

Affiliation: Memory and Aging Center, UCSF Department of Neurology, San Francisco, CA, USA. ckrueger(-atsign-)memory.ucsf.edu

Grants: 01-154-20 (Agency:PHS HHS) ; AG22983 (Agency:NIA NIH HHS) ; P41 RR013642 (Agency:NCRR NIH HHS) ; P50-AG05142 (Agency:NIA NIH HHS) ; R01 MH71940 (Agency:NIMH NIH HHS) ; U54 RR021813 (Agency:NCRR NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: Neurology (Neurology), published in United States. (Language: eng)

Reference: 2009-Aug; vol 73 (issue 5) : pp 349-55

Dates: Created 2009/08/04; Completed 2009/09/02;

PMID: 19652138, status: MEDLINE (last retrieval date: 9/4/2009, IMS Date: )

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