Clinical and neurocognitive correlates underlying the first symptoms in behavioral variant of frontotemporal dementia (bvFTD)

BAÉZ, SANDRA; SANTAMARIA GARCIA HERNANDO; AGUSTÍN IBAÑEZ; REYES, PABLO

Conferencia; XI International Conference of Frontotemporal Dementia; 2016

CLINICAL AND NEUROCOGNITIVE CORRELATES RELATED TO FIRST SYMPTOMS IN FRONTOTEMPORAL DEMENTIA. Previous works highlight the neurocognitive differences between apathetic and disinhibited clinical presentations of the behavioral variant frontotemporal dementia (bvFTD). However, little is known regarding how the early presentation (i.e., first symptom) is associated to the neurocognitive correlates of the disease?s clinical presentation at future stages of disease.METHODS: We evaluated the neuropsychological, clinical and neuroanatomical (3T structural images) correlates in a group of healthy controls (n=30) and two groups of bvFTD patients (presented with apathy [AbvFTD, n=18] or disinhibition [DbvFTD, n=16]). To differentiate groups according to first symptoms, we used multivariate analyses (factorial Discriminant Analysis (FDA) and Support Vector Machine (SVM)). RESULTS: The first symptom in patients was critical in describing the course and evolution of the disease. AbvFTD and DbvFTD patients showed increased brain atrophy (voxel based morphometry, VBM) and increased levels of disinhibition and apathy, respectively. Whole brain analyzes in AbvFTD revealed atrophy in the frontal, insular and temporal areas. DbvFTD, in turn, presented atrophy in the prefrontal regions, temporoparietal junction, insula and temporoparietal region. Increased atrophy in DbvFTD patients (compared to AbvFTD) was observed in frontotemporal regions. Multivariate analyses (FDA and SVM) confirmed that a set of brain areas including right orbitofrontal, right dorsolateral prefrontal and left caudate were enough to distinguish the patients? subgroups. CONCLUSION: First symptom in bvFTD patients is critical in describing the neuropsychological and neuroanatomical impairments profile after around three years of disease (mean of length duration of disease in each group), playing an important role in the early detection, disease tracking, and neuroanatomical specification of bvFTD, as well as in future research on potential disease-modifying treatments.