TY - JOUR
T1 - Disease trajectories in behavioural variant frontotemporal dementia, primary psychiatric and other neurodegenerative disorders presenting with behavioural change
AU - Reus, Lianne M.
AU - Vijverberg, Everard G. B.
AU - Tijms, Betty M.
AU - ten Kate, Mara
AU - Gossink, Flora
AU - Krudop, Welmoed A.
AU - del Campo, Marta
AU - Teunissen, Charlotte E.
AU - Barkhof, Frederik
AU - van der Flier, Wiesje M.
AU - Visser, Pieter Jelle
AU - Dols, Annemiek
AU - Al Pijnenburg, Yolande
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Behavioural variant frontotemporal dementia (bvFTD) is characterized by behavioural and social cognitive disturbances, while various psychiatric and neurodegenerative disorders may have similar clinical symptoms. Since neurodegenerative disorders are eventually progressive, whereas primary psychiatric disorders are not, this study aimed to investigate whether the change in clinical symptoms over time differed between groups and which biomarkers predicted rate of decline. Disease trajectories (median follow-up = 3 years) of frontal and stereotyped behaviour, general and frontal cognitive functioning, and social cognition were examined in bvFTD (n = 34), other neurodegenerative (n = 28) and primary psychiatric disorders (n = 43), all presenting with late-onset frontal lobe syndrome (45-75 years), using linear mixed models. To gain more insight in underlying pathological processes driving disease progression, we studied the association of baseline cerebrospinal fluid (CSF) (neurofilament light (NfL) and YKL-40 levels, phosphotau(181) to total tau ratio) and neuroimaging markers with disease trajectories. Frontal behavioural symptoms (e.g., disinhibition, apathy) worsened over time in bvFTD, whereas they improved in psychiatric disorders and remained stable in other neurodegenerative disorders. General and frontal cognitive decline was observed in bvFTD and other neurodegenerative disorders, but not in psychiatric disorders. None of the groups showed change in stereotypy and social cognition. For all diagnostic groups, higher CSF NfL levels were associated with faster frontal cognitive decline. A modest association was observed between caudate volume and stereotyped behaviour. Tracking frontal behavioural symptoms and cognition has potential to distinguish bvFTD from other disorders. CSF NfL levels seem to be associated with decline in frontal cognitive functioning.
AB - Behavioural variant frontotemporal dementia (bvFTD) is characterized by behavioural and social cognitive disturbances, while various psychiatric and neurodegenerative disorders may have similar clinical symptoms. Since neurodegenerative disorders are eventually progressive, whereas primary psychiatric disorders are not, this study aimed to investigate whether the change in clinical symptoms over time differed between groups and which biomarkers predicted rate of decline. Disease trajectories (median follow-up = 3 years) of frontal and stereotyped behaviour, general and frontal cognitive functioning, and social cognition were examined in bvFTD (n = 34), other neurodegenerative (n = 28) and primary psychiatric disorders (n = 43), all presenting with late-onset frontal lobe syndrome (45-75 years), using linear mixed models. To gain more insight in underlying pathological processes driving disease progression, we studied the association of baseline cerebrospinal fluid (CSF) (neurofilament light (NfL) and YKL-40 levels, phosphotau(181) to total tau ratio) and neuroimaging markers with disease trajectories. Frontal behavioural symptoms (e.g., disinhibition, apathy) worsened over time in bvFTD, whereas they improved in psychiatric disorders and remained stable in other neurodegenerative disorders. General and frontal cognitive decline was observed in bvFTD and other neurodegenerative disorders, but not in psychiatric disorders. None of the groups showed change in stereotypy and social cognition. For all diagnostic groups, higher CSF NfL levels were associated with faster frontal cognitive decline. A modest association was observed between caudate volume and stereotyped behaviour. Tracking frontal behavioural symptoms and cognition has potential to distinguish bvFTD from other disorders. CSF NfL levels seem to be associated with decline in frontal cognitive functioning.
KW - Behavioural variant frontotemporal dementia (bvFTD)
KW - Disease trajectories
KW - Cerebrospinal fluid
KW - Magnetic resonance imaging (MRI)
KW - Subcortical volumes
KW - Cortical thickness
KW - HUMAN CEREBRAL-CORTEX
KW - FRONTAL-LOBE SYNDROME
KW - DIAGNOSTIC-CRITERIA
KW - ALZHEIMERS-DISEASE
KW - BIPOLAR DISORDER
KW - DEGENERATION
KW - SYMPTOMS
KW - RECOGNITION
KW - DECLINE
KW - MRI
U2 - 10.1016/j.jpsychires.2018.07.014
DO - 10.1016/j.jpsychires.2018.07.014
M3 - Article
C2 - 30103065
SN - 0022-3956
VL - 104
SP - 183
EP - 191
JO - Journal of Psychiatric Research
JF - Journal of Psychiatric Research
ER -