Brazilian Version of Addenbrooke’s Cognitive Examination—Revised in the Differential Diagnosis of Alzheimer’S Disease and Behavioral Variant Frontotemporal Dementia

2021 ◽  
Author(s):  
Viviane Amaral-Carvalho ◽  
Thais Bento Lima-Silva ◽  
Luciano Inácio Mariano ◽  
Leonardo Cruz de Souza ◽  
Henrique Cerqueira Guimarães ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Differential Diagnosis ◽  
Diagnostic Accuracy ◽  
Frontotemporal Dementia ◽  
Predictive Value ◽  
Univariate Analysis ◽  
Behavioral Variant Frontotemporal Dementia ◽  
Present Sample ◽  
Addenbrooke’S Cognitive Examination

Abstract Introduction Alzheimer’s disease (AD) and behavioral variant frontotemporal dementia (bvFTD) are frequent causes of dementia and, therefore, instruments for differential diagnosis between these two conditions are of great relevance. Objective To investigate the diagnostic accuracy of Addenbrooke’s Cognitive Examination-Revised (ACE-R) for differentiating AD from bvFTD in a Brazilian sample. Methods The ACE-R was administered to 102 patients who had been diagnosed with mild dementia due to probable AD, 37 with mild bvFTD and 161 cognitively healthy controls, matched according to age and education. Additionally, all subjects were assessed using the Mattis Dementia Rating Scale and the Neuropsychiatric Inventory. The performance of patients and controls was compared by using univariate analysis, and ROC curves were calculated to investigate the accuracy of ACE-R for differentiating AD from bvFTD and for differentiating AD and bvFTD from controls. The verbal fluency plus language to orientation plus name and address delayed recall memory (VLOM) ratio was also calculated. Results The optimum cutoff scores for ACE-R were <80 for AD, <79 for bvFTD, and <80 for dementia (AD + bvFTD), with area under the receiver operating characteristic curves (ROC) (AUC) >0.85. For the differential diagnosis between AD and bvFTD, a VLOM ratio of 3.05 showed an AUC of 0.816 (Cohen’s d = 1.151; p < .001), with 86.5% sensitivity, 71.4% specificity, 72.7% positive predictive value, and 85.7% negative predictive value. Conclusions The Brazilian ACE-R achieved a good diagnostic accuracy for differentiating AD from bvFTD patients and for differentiating AD and bvFTD from the controls in the present sample.

scholarly journals THE ADDENBROOKE’S COGNITIVE EXAMINATION–REVISED (ACE-R) IN THE DIFFERENTIAL DIAGNOSIS BETWEEN ALZHEIMER’S DISEASE AND BEHAVIORAL VARIANT FRONTOTEMPORAL DEMENTIA: A POWERFUL LOGARITHM

2021 ◽  
Author(s):  
Viviane Amaral- Carvalho ◽  
Thais Lima- Silva ◽  
Luciano Mariano ◽  
Leonardo de Souza ◽  
Henrique Guimarães ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Logistic Regression ◽  
Differential Diagnosis ◽  
Frontotemporal Dementia ◽  
Latent Trait ◽  
Area Under The Curve ◽  
Scaling Analysis ◽  
Roc Curve Analysis ◽  
Behavioral Variant Frontotemporal Dementia

Background: The differential diagnosis between Alzheimer’s disease (AD) and behavioral variant frontotemporal dementia (bvFTD) is challenging, justifying improvement of cognitive tools for use in clinical practice. Objective: To develop a new logarithm based on discriminative items of the ACE-R. Methods: The ACE-R was administered to 102 patients with mild dementia due to probable AD and 37 with mild probable bvFTD. Mokken scaling analysis was applied to identify the latent trait on the AD Group. Multivariate logistic regression and ROC curve analysis were carried out. Results: Mean total scores in ACE-R were 70.2 ± 10.8 in AD and 72.2 ± 11.1 in bvFTD. AD Mokken ACE-R (AMokACE-R) comprises 12 items measuring the same latent concept. Logistic regression with cross-validation pointed that AMokACE-R + Age + Sex-male + ACE-R subitems Orientation and Memory share importance as independent variables (p <0.05). The proposed logarithm reached an area under the curve of 0.922, with 88% sensitivity/specificity, 71% PPV and 96% NPV. Conclusion: The new logarithm using the ACE-R achieved high diagnostic accuracy in discriminating AD and bvFTD, showing superiority to previous findings. Further analysis in larger samples, with biomarkers or pathological confirmation, are necessary to confirm these findings.

scholarly journals Distinct network topology in Alzheimer’s disease and behavioral variant frontotemporal dementia

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Adeline Su Lyn Ng ◽  
Juan Wang ◽  
Kwun Kei Ng ◽  
Joanna Su Xian Chong ◽  
Xing Qian ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Frontotemporal Dementia ◽  
Network Topology ◽  
Neuropsychiatric Symptoms ◽  
Brain Network ◽  
Salience Network ◽  
Behavioral Variant Frontotemporal Dementia ◽  
Control Networks ◽  
And Control

Abstract Background Alzheimer’s disease (AD) and behavioral variant frontotemporal dementia (bvFTD) cause distinct atrophy and functional disruptions within two major intrinsic brain networks, namely the default network and the salience network, respectively. It remains unclear if inter-network relationships and whole-brain network topology are also altered and underpin cognitive and social–emotional functional deficits. Methods In total, 111 participants (50 AD, 14 bvFTD, and 47 age- and gender-matched healthy controls) underwent resting-state functional magnetic resonance imaging (fMRI) and neuropsychological assessments. Functional connectivity was derived among 144 brain regions of interest. Graph theoretical analysis was applied to characterize network integration, segregation, and module distinctiveness (degree centrality, nodal efficiency, within-module degree, and participation coefficient) in AD, bvFTD, and healthy participants. Group differences in graph theoretical measures and empirically derived network community structures, as well as the associations between these indices and cognitive performance and neuropsychiatric symptoms, were subject to general linear models, with age, gender, education, motion, and scanner type controlled. Results Our results suggested that AD had lower integration in the default and control networks, while bvFTD exhibited disrupted integration in the salience network. Interestingly, AD and bvFTD had the highest and lowest degree of integration in the thalamus, respectively. Such divergence in topological aberration was recapitulated in network segregation and module distinctiveness loss, with AD showing poorer modular structure between the default and control networks, and bvFTD having more fragmented modules in the salience network and subcortical regions. Importantly, aberrations in network topology were related to worse attention deficits and greater severity in neuropsychiatric symptoms across syndromes. Conclusions Our findings underscore the reciprocal relationships between the default, control, and salience networks that may account for the cognitive decline and neuropsychiatric symptoms in dementia.

Different apathy clinical profile and neural correlates in behavioral variant frontotemporal dementia and Alzheimer's disease

2017 ◽  
Vol 33 (1) ◽  
pp. 141-150 ◽  
Author(s):  
Marta Fernández-Matarrubia ◽  
Jordi A. Matías-Guiu ◽  
María Nieves Cabrera-Martín ◽  
Teresa Moreno-Ramos ◽  
María Valles-Salgado ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Frontotemporal Dementia ◽  
Neural Correlates ◽  
Clinical Profile ◽  
Behavioral Variant Frontotemporal Dementia

scholarly journals Different Apathy Profile in Behavioral Variant of Frontotemporal Dementia and Alzheimer's Disease: A Preliminary Investigation

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Davide Quaranta ◽  
Camillo Marra ◽  
Concettina Rossi ◽  
Guido Gainotti ◽  
Carlo Masullo
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Frontotemporal Dementia ◽  
Sleep Disturbances ◽  
Preliminary Investigation ◽  
Univariate Analysis ◽  
Behavioral Changes ◽  
Neuropsychiatric Inventory ◽  
Multivariate Logistic Regression ◽  
Clinical Expression

Apathy is one of the most common behavioral symptoms of dementia; it is one of the salient features of behavioral variant of frontotemporal dementia (bvFTD) but is also very frequent in Alzheimer's disease. This preliminary investigation was aimed at assessing the type of apathy-related symptoms in a population of bvFTD and AD subjects showing comparable apathy severity. Each patient underwent a comprehensive neuropsychological assessment; behavioral changes were investigated by the neuropsychiatric inventory (NPI), using the NPI-apathy subscale to detect apathetic symptoms. At univariate analysis, bvFTD subjects showed lack of initiation (χ2=4.602,p=0.032), reduced emotional output (χ2=6.493,p=0.008), and reduced interest toward friends and family members (χ2=4.898,p=0.027), more frequently than AD subjects. BvFTD displayed higher scores than AD on NPI total score (p=0.005) and on subscales assessing agitation (p=0.004), disinhibition (p=0.007) and sleep disturbances (p=0.025); conversely, AD subjects were more impaired on memory, constructional abilities, and attention. On multivariate logistic regression, reduced emotional output was highly predictive of bvFTD (OR=18.266;p=0.008). Our preliminary findings support the hypothesis that apathy is a complex phenomenon, whose clinical expression is conditioned by the site of anatomical damage. Furthermore, apathy profile may help in differentiating bvFTD from AD.

scholarly journals Fronto-Striatal Atrophy in Behavioral Variant Frontotemporal Dementia and Alzheimer’s Disease

2015 ◽  
Vol 6 ◽  
Author(s):  
Maxime Bertoux ◽  
Claire O’Callaghan ◽  
Emma Flanagan ◽  
John R. Hodges ◽  
Michael Hornberger
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Frontotemporal Dementia ◽  
Behavioral Variant Frontotemporal Dementia

scholarly journals Interactions between decision-making and emotion in behavioral-variant frontotemporal dementia and Alzheimer’s disease

2020 ◽  
Vol 15 (6) ◽  
pp. 681-694
Author(s):  
Aurélie L Manuel ◽  
Daniel Roquet ◽  
Ramon Landin-Romero ◽  
Fiona Kumfor ◽  
Rebekah M Ahmed ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Decision Making ◽  
Frontotemporal Dementia ◽  
Delay Discounting ◽  
Animal Studies ◽  
Negative Emotion ◽  
Emotion Processing ◽  
Brain Regions ◽  
Behavioral Variant Frontotemporal Dementia

Abstract Negative and positive emotions are known to shape decision-making toward more or less impulsive responses, respectively. Decision-making and emotion processing are underpinned by shared brain regions including the ventromedial prefrontal cortex (vmPFC) and the amygdala. How these processes interact at the behavioral and brain levels is still unclear. We used a lesion model to address this question. Study participants included individuals diagnosed with behavioral-variant frontotemporal dementia (bvFTD, n = 18), who typically present deficits in decision-making/emotion processing and atrophy of the vmPFC, individuals with Alzheimer’s disease (AD, n = 12) who present with atrophy in limbic structures and age-matched healthy controls (CTRL, n = 15). Prior to each choice on the delay discounting task participants were cued with a positive, negative or neutral picture and asked to vividly imagine witnessing the event. As hypothesized, our findings showed that bvFTD patients were more impulsive than AD patients and CTRL and did not show any emotion-related modulation of delay discounting rate. In contrast, AD patients showed increased impulsivity when primed by negative emotion. This increased impulsivity was associated with reduced integrity of bilateral amygdala in AD but not in bvFTD. Altogether, our results indicate that decision-making and emotion interact at the level of the amygdala supporting findings from animal studies.

Sign in / Sign up

Export Citation Format

Share Document