Differences in Discriminability and Response Bias on Rey Auditory Verbal Learning Test Delayed Recognition in Behavioral Variant Frontotemporal Dementia and Alzheimer's Disease.

E Van Den Berg,L.M Heijnen,S Franzen,F.J De Jong,J.C Van Swieten,R Meijboom,R.M.E Steketee,J.M Poos,L.C Jiskoot,H Seelaar,J.M Papma

doi:10.1017/s1355617720000375

Abstract

Episodic memory is impaired in Alzheimer's disease (AD) dementia but thought to be relatively spared in behavioral variant frontotemporal dementia (bvFTD). This view is challenged by evidence of memory impairment in bvFTD. This study investigated differences in recognition memory performance between bvFTD and AD. We performed a retrospective analysis on the recognition trial of the Rey Auditory Verbal Learning Test in patients with bvFTD (n = 85), AD (n = 55), and control participants (n = 59). Age- and education-adjusted between-group analysis was performed on the total score and indices of discriminative ability and response bias. Correlations between recognition and measures of memory, language, executive functioning, and construction were examined. Patients with AD had a significantly lower total recognition score than patients with bvFTD (control 28.8 ± 1.5; bvFTD 24.8 ± 4.5; AD 23.4 ± 3.6, p < .01). Both bvFTD and AD had worse discriminative ability than controls (A' control 0.96 ± 0.03; bvFTD 0.87 ± 0.03; AD 0.84 ± 0.10, p < .01), but there was no difference in response bias (B" control 0.9 ± 0.2; bvFTD 1.6 ± 1.47; AD 1.4± 1.4, p < .01). AD had worse discriminability than bvFTD (p < .05). Discriminability was associated with memory for both patient groups (median correlation coefficient r = .34) and additionally associated with language (r = .31), but not executive functioning (r = -.03) in bvFTD. Response bias was unrelated to other cognitive functions (r = -.02). Discriminability, but not response bias, differentiated patients with bvFTD from AD. The presence of an impaired discrimination index suggests a "pure" (recognition) memory deficit in bvFTD.

Highlights

Behavioral variant frontotemporal dementia and Alzheimer’s disease (AD) are the two most common early onset dementias (Ratvanali, Brayne, Dawson, & Hodges, 2002)
Several studies report memory deficits in Behavioral variant frontotemporal dementia (bvFTD) that are equal in nature and extent to those found in AD (e.g., Gregory, Orrell, Sahakian, & Hodges, 1997; Hornberger et al, 2010; Pennington et al, 2011; Ricci et al, 2012)
Patients with bvFTD were significantly younger than patients with AD and controls [F(2,199) = 12.3, p < .001, η2 = 0.11]

Summary

INTRODUCTION

Behavioral variant frontotemporal dementia (bvFTD) and Alzheimer’s disease (AD) are the two most common early onset dementias (Ratvanali, Brayne, Dawson, & Hodges, 2002). Patients with bvFTD tend to outperform AD patients in recognition memory (Hornberger et al, 2010) and sometimes even show no impairment compared to control participants (Pasquier, Grymonprez, Lebert, Van der Linden, 2001; Ricci et al, 2012) This finding may be attributed to the fact that cueing in recognition memory tasks enables patients with bvFTD to overcome retrieval problems (at least to some extent), but the recognition deficits in AD reflect true forgetting of the items. The aims of the present study were (1) to examine differences in recognition memory performance on a widely used verbal memory test (RAVLT) between patients with bvFTD and AD, (2) to compare measures of discrimination and response bias between these groups, and (3) to investigate associations between recognition memory and other measures of memory, language, executive functioning within and between the groups, and disease severity

Participants

RESULTS

DISCUSSION