scholarly journals 433 - A possible link between Bipolar Disease and Frontotemporal Dementia

2021 ◽  
Vol 33 (S1) ◽  
pp. 52-53
Author(s):  
B. Jorge ◽  
C. Pedro ◽  
J. Carvalho ◽  
S. Carneiro ◽  
M. Mangas
Keyword(s):  
Frontotemporal Dementia ◽  
Neurodegenerative Disorder ◽  
Psychiatric Symptoms ◽  
Early Stage ◽  
Synaptic Proteins ◽  
Behavioral Disturbances ◽  
Behavioral Variant Frontotemporal Dementia ◽  
Bipolar Disease ◽  
Personality Changes ◽  
Relationship Of

Background:Both neurological and psychiatric symptoms are observed among mental disorders and represent a challenge for the differential diagnosis, specially in old adults presenting behavioral changes. Investigations have documented manic/hypomanic symptoms from behavioral variant frontotemporal dementia(bvFTD), suggesting a relationship of bipolar disease (BD) with bvFTD.Research objective:This work aims to determine the relationship between patients with bipolar disease and behavioral variant frontotemporal dementia.Method:A non-systematic review of the literature is presented. Bibliographic selection was carried out through keyword research in MEDLINE and Google Scholar.Results:An early stage of bvFTD often displays a mix of behavioral disturbances and personality changes. Also, BP is associated with a higher risk of dementia in older adults and with cognitive impairment, where a subset of patients presents a neuroprogressive pattern during the disease course. It was shown a specific type of post-BD dementia with clinical features of bvFTD and cases of patients with marked manic symptoms for the first time in their life had subsequent diagnosis of FTD. Mutations in the progranulin gene (GRN) were the most frequent causes of autosomal dominant FTD and have also been reported in sporadic FTD. Genetic polymorphisms in this gene are also associated with schizophrenia and BD. An hypothetical model of shared mechanisms between bvFTD and BD was proposed, including specific mendelian mutations associated with genetic predisposition (e.g. brain-derived neurotrophic factor-BDNF gene) and environmental factors with an effect on cellular homeostasis (e.g. increased cell deaths, decreased synthesis of synaptic proteins) and an influence over behavioural and cognitive symptoms. Nevertheless, comparison of the executive functions, social cognition profiles and structural neuroimaging of bvFTD and elderly patients with BD showed difference in patterns.Discussion:Although BD is principally considered a neurodevelopment disorder, while FTD is a neurodegenerative disorder, follow-up studies of cognitive deficits, imaging, and genetics in BD patients could elucidate the possible correlation between these major diseases and may have implications for pathogenesis, as well as for treatment.

scholarly journals Anosognosia in People with Cognitive Impairment: Association with Cognitive Deficits and Behavioral Disturbances

2015 ◽  
Vol 5 (1) ◽  
pp. 42-50 ◽  
Author(s):  
Antonella De Carolis ◽  
Virginia Cipollini ◽  
Valentina Corigliano ◽  
Anna Comparelli ◽  
Micaela Sepe-Monti ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Rating Scale ◽  
Motor Behavior ◽  
Psychiatric Symptoms ◽  
Early Stage ◽  
Functional Anatomy ◽  
Night Time ◽  
Behavioral Disturbances ◽  
The Relationship

Aims: To investigate, in a group of subjects at an early stage of cognitive impairment, the relationship between anosognosia and both cognitive and behavioral symptoms by exploring the various domains of insight. Methods: One hundred and eight subjects affected by cognitive impairment were consecutively enrolled. The level of awareness was evaluated by means of the Clinical Insight Rating Scale (CIRS). Psychiatric symptoms were evaluated using the Italian version of the Neuropsychiatric Inventory (NPI), whereas memory (memory index, MI) and executive (executive index, EI) functions were explored using a battery of neuropsychological tests and qualified by means of a single composite cognitive index score for each function. Results: A significant positive correlation between the total NPI score and global anosognosia score was found. Furthermore, both the MI and EI scores were lower in subjects with anosognosia than in those without anosognosia (p < 0.001 and p < 0.007, respectively). When the single domains of the CIRS were considered, anosognosia of reason of visit correlated with the EI score (r = -0.327, p = 0.01) and night-time behavioral disturbances (r = 0.225; p = 0.021); anosognosia of cognitive deficit correlated with depression (r = -0.193; p = 0.049) and the MI score (r = -0.201; p = 0.040); anosognosia of functional deficit correlated with the MI score (r = -0.257; p = 0.008), delusions (r = 0.232; p = 0.015) and aberrant motor behavior (r = 0.289; p = 0.003); anosognosia of disease progression correlated with the MI score (r = -0.236; p = 0.015), agitation (r = 0.247; p = 0.011), aberrant motor behavior (r = 0.351; p = 0.001) and night-time behavioral disturbances (r = 0.216; p = 0.027). Conclusions: Our study suggests that, in the early stage of cognitive impairment, anosognosia is associated with both cognitive deficits and behavioral disorders according to the specific functional anatomy of the symptoms.

Early stage of behavioral variant frontotemporal dementia: clinical and neuroimaging correlates

2015 ◽  
Vol 36 (11) ◽  
pp. 3108-3115 ◽  
Author(s):  
Barbara Borroni ◽  
Maura Cosseddu ◽  
Andrea Pilotto ◽  
Enrico Premi ◽  
Silvana Archetti ◽  
...  
Keyword(s):  
Frontotemporal Dementia ◽  
Early Stage ◽  
Behavioral Variant Frontotemporal Dementia

scholarly journals Behavioral Variant Frontotemporal Dementia: Diagnosis and Treatment Interventions

2021 ◽  
Author(s):  
Silpa Balachandran ◽  
Elizabeth L. Matlock ◽  
Michelle L. Conroy ◽  
Chadrick E. Lane
Keyword(s):  
Frontotemporal Dementia ◽  
Neurodegenerative Disorder ◽  
Diagnosis And Treatment ◽  
Behavioral Variant Frontotemporal Dementia ◽  
Caregiver Support ◽  
Psychiatric Illnesses ◽  
Heritable Disorder ◽  
Pharmacologic Management ◽  
Gradual Accumulation ◽  
Disease Modifying Agents

Abstract Purpose of Review The diagnosis and treatment of behavioral variant frontotemporal dementia is challenging and often delayed because of overlapping symptoms with more common dementia syndromes or primary psychiatric illnesses. The purpose of this paper is to explore the relevant presentation, diagnostic workup, pathophysiology, and both pharmacologic and non-pharmacologic management. Recent Findings Behavioral variant frontotemporal dementia is a highly heritable disorder. The gradual accumulation of diseased protein culminates in the destruction of those brain circuits responsible for much of one’s emotional and social functioning. Summary Behavioral variant frontotemporal dementia is a progressive neurodegenerative disorder with a far-reaching impact on patients and caregivers. Patients often present with emotional blunting, lack of empathy, apathy, and behavioral disinhibition. Non-pharmacologic interventions and caregiver support are the cornerstone of treatment. The use of cholinesterase inhibitors and memantine is not supported by the evidence. While current pharmacologic therapies target only certain symptoms, there are disease modifying agents currently in or nearing the clinical research stage.

Neuropsychiatric Symptoms, Caregiver Burden and Distress in Behavioral-Variant Frontotemporal Dementia and Alzheimer's Disease

2015 ◽  
Vol 40 (5-6) ◽  
pp. 268-275 ◽  
Author(s):  
Thais Bento Lima-Silva ◽  
Valéria Santoro Bahia ◽  
Viviane Amaral Carvalho ◽  
Henrique Cerqueira Guimarães ◽  
Paulo Caramelli ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Frontotemporal Dementia ◽  
Sex Education ◽  
Caregiver Burden ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Clinical Dementia Rating ◽  
Behavioral Variant Frontotemporal Dementia ◽  
Significant Difference

Background/Aims: We aimed to compare caregiver burden and distress in behavioral-variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) and to investigate which factors contribute to caregivers' burden and distress. Methods: Fifty patients and their caregivers were invited to participate. Among the patients, 20 had a diagnosis of bvFTD and 30 had AD. Caregivers and patients were statistically equivalent for age, sex, education and dementia severity according to Clinical Dementia Rating. The protocol included the Short Zarit Burden Inventory, the Neuropsychiatric Inventory (NPI), Disability Assessment for Dementia (DAD), the Cornell Scale for Depression in Dementia (CSDD), Addenbrooke's Cognitive Examination-Revised, the Executive Interview with 25 Items, Direct Assessment of Functional Status and the Geriatric Anxiety Inventory (GAI). Results: In the NPI, caregivers of bvFTD patients reported a higher presence and severity of neuropsychiatric symptoms and caregiver distress compared to caregivers of AD patients. There was no significant difference in the perceived burden. In bvFTD, DAD and GAI scores were significantly correlated with burden, whereas in AD, burden was correlated with CSDD and NPI scores. Psychiatric symptoms were associated with distress in both groups. Conclusions: Caregivers of bvFTD patients experienced higher levels of distress than caregivers of AD patients. Patients' functional limitations were associated with burden of caregivers of bvFTD patients, whereas neuropsychiatric symptoms were associated with caregiver strain in both groups.

Az autoimmun encephalitisek laboratóriumi vizsgálati lehetőségei

2018 ◽  
Vol 159 (3) ◽  
pp. 107-112
Author(s):  
Katalin Böröcz ◽  
Zsófia Hayden ◽  
Viktória Mészáros ◽  
Zsuzsanna Csizmadia ◽  
Kornélia Farkas ◽  
...  
Keyword(s):  
Psychiatric Symptoms ◽  
Early Stage ◽  
Neuronal Cell ◽  
Autoimmune Encephalitis ◽  
Immunosuppressive Drugs ◽  
Synaptic Proteins ◽  
Receptor Proteins ◽  
Surface Receptors ◽  
The Past ◽  
Paraneoplastic Limbic Encephalitis

Abstract: Introduction: The role of autoimmune responses against central nervous system (CNS) antigens in encephalitis presenting with non-classified neurologic or psychiatric symptoms has been appreciated in the past decade. Paraneoplastic limbic encephalitis has a poor prognosis and is most commonly associated with lung, ovarium, and testicular neoplasms, leading to immune reactions against intracellular antigens (anti-Hu/ANNA1, anti-Ri/ANNA2, anti-CV2/CRMP5 and anti-Ma2/Ta). In contrast, the recently described autoimmune encephalitis subtypes present with a broad spectrum of symptoms, respond to autoimmune therapies well and usually associate with autoantibodies against neuronal cell surface receptors (NMDAR, GABABR, AMPAR) or synaptic proteins (LGI1, CASPR2). Aim: Our aim is to bring to awareness the increasing number of autoimmune encephalitis patients requiring neurologic, psychiatric and intensive care and to emphasize the significance of detecting various autoantibodies in diagnosing patients. Method: In the past 6 years, our laboratory received 836 autoimmune encephalitis diagnostic test requests from a total of 717 patients. Serum and cerebrospinal fluid (CSF) samples were analysed with indirect immunofluorescence using a BIOCHIP consisting of cell lines transfected with 6 different receptor proteins. Results: IgG autoantibodies against receptor proteins were present in 7.5% of patients. The frequency of positive samples was the following: NMDAR > LGI1 > GABABR > CASPR2. Conclusion: Detecting autoantibodies facilitates the diagnosis of autoimmune encephalitis in an early stage. Patients diagnosed early can be effectively treated with plasmapheresis and immunosuppressive drugs. The efficiency of therapies can be monitored by autoantibody detection. Therefore, the diagnostic immune laboratory plays an important role in proper diagnosis and in the prevention of rapidly progressing symptoms. Orv Hetil. 2018; 159(3): 107–112.

The Clinical Value of the Faux Pas Test for Diagnosing Behavioral-Variant Frontotemporal Dementia

2020 ◽  
pp. 089198872096425
Author(s):  
Xavier Delbeuck ◽  
Marianne Pollet ◽  
Florence Pasquier ◽  
Stéphanie Bombois ◽  
Christine Moroni
Keyword(s):  
Frontotemporal Dementia ◽  
Neurological Diseases ◽  
Cognitive Impairments ◽  
High Sensitivity ◽  
Psychiatric Disease ◽  
Memory Clinic ◽  
Clinical Value ◽  
Behavioral Disturbances ◽  
Behavioral Variant Frontotemporal Dementia

Objective: We studied the clinical value of the faux pas test to diagnose behavioral-variant frontotemporal dementia. Methods: The faux pas test was administered to patients referred to a memory clinic in a context of behavioral disturbances. The diagnosis of behavioral-variant frontotemporal dementia (n = 14) or not (n = 25) was confirmed after a 3 years follow-up. Results: The faux pas test displayed a high sensitivity for behavioral-variant frontotemporal dementia (.83) however its specificity was only moderate (.64). Conclusions: Our results confirm that the FPT capture’s specific cognitive impairments in patients with behavioral-variant frontotemporal dementia. However, some patients with psychiatric disease or other neurological diseases may also show impaired scores.

Psychiatric Phenomena in Dementia of the Alzheimer Type

1992 ◽  
Vol 4 (3) ◽  
pp. 43-54 ◽  
Author(s):  
Alistair Burns
Keyword(s):  
Psychiatric Disorders ◽  
Brain Damage ◽  
Psychiatric Symptoms ◽  
Direct Result ◽  
Advanced Dementia ◽  
Alzheimer Type ◽  
Paranoid Ideation ◽  
Behavioral Disturbances ◽  
Personality Changes ◽  
Behavioral Features

Psychiatric symptoms and behavioral disturbances are of importance in dementia of the Alzheimer type (DAT) but have been relatively neglected by researchers. The main psychiatric symptoms are disorders of thought content (delusions and paranoid ideation), disorders of perception (hallucinations and misidentifications) and disorders of affect (depressed and elevated mood). They occur commonly in DAT, and there is evidence that they may indicate subtypes of the disorder in view of their demographic, structural, and prognostic correlates. Personality changes are very common, and these may be the earliest manifestation of dementia. Behavioral disturbances tend to be associated with advanced dementia and are particularly disruptive to caregivers. Structural correlates suggest that some behaviors are a direct result of brain damage. Psychiatric and behavioral features in DAT are important, as they may serve as a model for symptomatology in functional psychiatric disorders.

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