Can behavioral symptoms differentiate cortical from subcortical dementia - A comparative study of behavioral profile of Parkinson’s disease dementia and behavioral variant of frontotemporal dementia

Abstract

Patients of behavioural variant of frontotemporal dementia (bvFTD) exhibit prominent behavioural abnormalities along with executive dysfunction. Whereas executive dysfunction is also common in subcortical dementias because of disturbance in fronto-subcortical connection, behavioural symptoms are less frequent. To determine the frequencies of behavioural symptomatology of patients with subcortical (Parkinson's disease with dementia or PDD) and frontal cortical dementia (behavioural variant of Frontotemporal dementia or bvFTD) and to find out the discriminating value of behavioural characteristics in differentiating these two group of patients. Patients were consecutively recruited from Cognitive and Movement Disorder Clinics following standard diagnostic criteria. A total 20 bvFTD and 20 PDD patients were recruited. Behavioural symptoms were noted from reliable caregiver following the questionnaire prepared by Bathgate et al. (2000). Whereas eating and vegetative behaviour were more frequent in bvFTD (85% vs 45%, p = 0.018), the neuropsychiatric behaviours were more common in PDD group 80.0% vs 50.0%, p = 0.095). Although didn’t achieve statistical significance, other symptoms found to be discriminating in two condition were (i) sensory behaviour (p = 0.056), (ii) cognitive mediated behaviour (p = 0.794), (iii) affect-social behaviour (p = 0.162), and (iv) compulsion-ritual behaviour (p = 0.33). The behaviour related to environmental dependency were not found prominent in either groups (p = 0.155), although utilization behavior and echopraxia were more common in bvFTD. Behavioural abnormalities were more common in bvFTD group with prominent abnormality in eating & vegetative behaviour, sensory behaviour, cognitive mediated behaviour, affect-social behaviour, compulsion-ritual behaviour and the PDD group showed marked neuropsychiatry behavioural abnormalities.