Frontal variant of frontotemporal dementia: a cross-sectional and longitudinal study of neuropsychiatric features.

Abstract

The term frontotemporal dementia (FTD) covers both the temporal and frontal presentations of this condition. The frontal variant (fv) presents with insidious changes in personality and behaviour, with neuropsychological evidence of disproportionate frontal dysfunction. Although psychiatric features are well recognized, there is little systematic data examining the mental state using assessment instruments and no reported studies of the longitudinal progress and assessment. Fifteen patients with a diagnosis of FTD(fv) were assessed using the Comprehensive Psychiatric Rating Scale (CPRS). A subgroup of five patients were reassessed annually using the same instrument, generating data over a 3-year period. At initial assessment a third of 15 patients had no psychiatric symptoms to report. Three patients reported symptoms of sadness, but only one patient met criteria for DSM-IV major depressive episode. One patient experienced symptoms of elation, but did not meet criteria for manic episode, while two patients had hypochondriacal complaints but did not meet DSM-IV criteria for hypochondriasis. One of these patients also experienced the compulsion to count but did not meet criteria for obsessive compulsive disorder. The objective mental state was, on the whole, not congruent with the reported symptoms. Five patients assessed over a 3-year period showed no progression of their subjectively reported symptoms. Psychiatric symptoms although often present were characterized by their shallowness, lack of elaboration and non-development over time.