Decision Making in patients with Primary Progressive Aphasia

EZEQUIEL GLEICHGERRCHT; TERESA TORRALVA; FLORENCIA SCHILDER; DANIELA SZENKMAN; MARÍA ÁNGELES POSE; MARÍA ROCA; FACUNDO MANES

Honolulu

Encuentro; 63rd AAN 2011 Annual Meeting; 2011

American Academy of Neurology

OBJECTIVE: To investigate the decision-making (DM) profile of patients with early Primary Progressive Aphasia (PPA). BACKGROUND: Frontotemporal Dementia (FTD) is considered an umbrella term that includes multiple syndromes of varied nature, each one of them associated with different patterns of neural degeneration. While many research studies have focused on cognitive and behavioral changes of the behavioral variant of FTD (bvFTD), as these are central to patients' symptomatic profile, little is known about the way higher cognitive processes are affected in patients presenting the temporal variants of FTD. These are grouped under the term PPA, which includes at least two distinct patient populations: those presenting Progressive Non-Fluent Aphasia (PNFA) and those presenting with Semantic Dementia (SD). DESIGN/METHODS: A complete neurospsychological battery as well as a widely used decision-making task (the Iowa Gambling Task, IGT) were administered on ten PPA patients (five with PNFA and five with SD), 35 patients with bvFTD and 14 controls matched by age, gender, and years of education. RESULTS: PPA patients performed significantly worse (p < 0.001) than controls but significantly better (p < 0.001) than bvFTD patients on the IGT. The decision-making profile of PPA patients was characterized by random selections of risky and safe decks. No significant differences were found between PNFA and SD subtypes (p > 0.5). Within the PPA group, no significant correlations were found between DM performance and performance on language tasks. CONCLUSIONS: The decision-making profile of PPA patients differs from that of bvFTD patients and seems to be independent of language deficits. These results have important clinical and theoretical implications for the differential diagnosis and treatment of FTD subvariants.