Abstract
BackgroundThis study aimed to clarify the neuropsychiatric symptoms of right-sided predominant semantic dementia (SD-R) by comparing them with those of behavioral variant frontotemporal dementia (bvFTD), left-sided predominant SD (SD-L), and Alzheimer’s disease (AD). This study also aimed to identify clinical factors related to caregiver burden for bvFTD, SD-R, and SD-L.MethodsThe neuropsychiatric symptoms of 28 patients with bvFTD, 14 patients with SD-R, 24 patients with SD-L, and 43 patients with AD were evaluated using the Neuropsychiatric Inventory (NPI) and the Stereotypy Rating Inventory (SRI). Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Dementia severity was assessed using the Clinical Dementia Rating. Activities of daily living were assessed using the Lawton Instrument Activities of Daily Living (IADL) scale and the Physical Self-Maintenance Scale. We compared the NPI and SRI scores among the four groups using the Kruskal-Wallis test. In addition, clinical factors related to caregiver burden, represented by the Japanese version of the Zarit Burden Interview (J-ZBI), were analyzed using multiple regression analysis in the bvFTD, SD-R, and SD-L groups.ResultsThe NPI total score and the NPI subscale scores of apathy and disinhibition were significantly higher in the bvFTD group than in the SD-L and AD groups. The SD-R group scores were closer to those of the bvFTD group than the SD-L group. The SRI total score and SRI subscale scores for eating and cooking and speaking were significantly higher in the bvFTD, SD-R, and SD-L groups than in the AD group. The NPI total score was significantly associated with the J-ZBI score in the bvFTD group. The NPI total score and Lawton IADL scale score were independently associated with the J-ZBI score in the SD-R group. Furthermore, the NPI total score and MMSE score were independently associated with the J-ZBI score in the SD-L group.ConclusionsSD-R seemed to be a similar condition to bvFTD rather than SD-L regarding behavioral symptoms. Our results suggest that each frontotemporal dementia subgroup requires different approaches to reduce the caregiver burden.
Highlights
This study aimed to clarify the neuropsychiatric symptoms of right-sided predominant semantic dementia (SD-R) by comparing them with those of behavioral variant frontotemporal dementia, left-sided predominant SD (SD-L), and Alzheimer’s disease (AD)
Of the 2503 patients who were diagnosed with dementia or mild cognitive impairment in the two institutes, 28, 14, 24, and 43 patients with behavioral variant frontotemporal dementia (bvFTD), Right-sided predominant semantic dementia (SD-R), Left-sided predominant semantic dementia (SD-L), and AD, respectively, met the inclusion criteria (Fig. 1)
Upon dividing SD into the SD-R and SD-L groups based on temporal lobe atrophy predominance, we found no significant differences in the total Neuropsychiatric Inventory (NPI) score and NPI subscale scores of disinhibition and apathy between the bvFTD and SD-R groups, the bvFTD group had significantly higher scores than the SD-L group
Summary
This study aimed to clarify the neuropsychiatric symptoms of right-sided predominant semantic dementia (SD-R) by comparing them with those of behavioral variant frontotemporal dementia (bvFTD), left-sided predominant SD (SD-L), and Alzheimer’s disease (AD). FTD includes three clinical subtypes: behavioral variant frontotemporal dementia (bvFTD), semantic dementia (SD), and progressive non-fluent aphasia (PNFA). Yiannopoulou et al [9] reported that the total Neuropsychiatric Inventory (NPI) [10] score of bvFTD was significantly higher than that of both SD and PNFA. Rosen et al [8] reported that both bvFTD and SD had a significantly higher NPI score than PNFA. These inconsistent results raise questions as to whether SD exhibit behavioral disorders comparable to bvFTD or whether they are milder than bvFTD
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