Abstract

Social cognition impairment has been recognized as an early and characteristic change in behavioral variant frontotemporal dementia (bvFTD). The Mini Social Cognition and Emotional Assessment (mini-SEA) is a clinical tool to rapidly evaluate social cognition. In this study, we explored the diagnostic value of social cognition by assessing the Chinese version of the mini-SEA and other standard neuropsychological tests in 22 patients with mild bvFTD, 26 patients with mild Alzheimer's disease (AD), including mild cognitive impairment (MCI) and mild dementia, and 30 control subjects. The discriminatory powers of these tests were evaluated and compared using the receiver operating characteristic curve (ROC). The mini-SEA scores of the bvFTD patients were significantly lower than those of the controls (Z = –6.850, adjusted P < 0.001) and AD patients (Z = –3.737, adjusted P = 0.001). ROC analysis showed that the mini-SEA had a high discriminatory power for differentiating bvFTD from the controls, with an area under the curve (AUC) value of 0.989 (95% CI = 0.905-1.000, P < 0.001). The AUC value of the mini-SEA for differentiating bvFTD from AD was 0.899 (95% CI = 0.777-0.967, P < 0.001), higher than that of the Auditory Verbal Learning Test Delayed Recall (AUC = 0.793), Boston Naming Test (AUC = 0.685) or Frontal Assessment Battery (AUC = 0.691). The Chinese version of mini-SEA is a good clinical tool for the early diagnosis of bvFTD, and has a high sensitivity and specificity to discriminate bvFTD from AD.

Highlights

  • Behavioral variant frontotemporal dementia is a pathologically and genetically heterogeneous neurodegenerative disorder characterized by progressive behavioral abnormalities, personality changes and impaired social interaction [1]

  • Compared with the control group, Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB) scores were significantly worse in the behavioral variant frontotemporal dementia (bvFTD) (Z = −5.208, adjusted P < 0.001 and Z = –4.919, adjusted P < 0.001, respectively) and Alzheimer’s disease (AD) patients (Z = –6.132, adjusted P < 0.001 and Z = –3.426, adjusted P = 0.002, respectively)

  • Worse performance of the Frontal Behavioral Inventory (FBI) tests was seen in bvFTD than AD (Z = 5.813, P < 0.001)

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Summary

Introduction

Behavioral variant frontotemporal dementia (bvFTD) is a pathologically and genetically heterogeneous neurodegenerative disorder characterized by progressive behavioral abnormalities, personality changes and impaired social interaction [1]. It is a leading cause of early-onset neurodegenerative dementia along with Alzheimer’s disease (AD) [2]. The diagnostic criteria are sensitive and practical, but accurate diagnosis of bvFTD remains to be improved [5]. The application of traditional executive function tests in the early and differential diagnosis of bvFTD has yielded inconsistent results [6, 7]. More and more researchers are turning their attention to social cognition testing in order to improve the criteria of bvFTD

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