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Review
. 2020 Fall;32(4):376-384.
doi: 10.1176/appi.neuropsych.20010003. Epub 2020 Jun 5.

Bipolar Disorder Among Patients Diagnosed With Frontotemporal Dementia

Mario F Mendez  1 , Leila Parand  1 , Golnoush Akhlaghipour  1
Affiliations
Review

Bipolar Disorder Among Patients Diagnosed With Frontotemporal Dementia

Mario F Mendez et al. J Neuropsychiatry Clin Neurosci. 2020 Fall.

Abstract

Objective: Previous studies have documented manic and hypomanic symptoms in behavioral variant frontotemporal dementia (bvFTD), suggesting a relationship between bipolar disorder and bvFTD.

Methods: The investigators conducted a literature review as well as a review of the psychiatric histories of 137 patients with bvFTD, and patients with a prior diagnosis of bipolar disorder were identified. The clinical characteristics of patients' bipolar disorder diagnosis, family history, features of bvFTD, and results from fluorodeoxyglucose positron emission tomography (FDG-PET), as well as autopsy findings, were evaluated.

Results: Among the 137 patients, 14 (10.2%) had a psychiatric diagnosis of bipolar disorder, eight of whom met criteria for bipolar disorder (type I, N=6; type II, N=2) 6-12 years preceding onset of classic symptoms of progressive bvFTD. Seven of the eight patients with bipolar disorder had a family history of mood disorders, four had bitemporal predominant hypometabolism on FDG-PET, and two had a tauopathy involving temporal lobes on autopsy. Three additional patients with late-onset bipolar I disorder proved to have a nonprogressive disorder mimicking bvFTD. The remaining three patients with bvFTD had prior psychiatric symptoms that did not meet criteria for a diagnosis of bipolar disorder. The literature review and the findings for one patient further suggested a shared genetic mutation in some patients.

Conclusions: Manic or hypomanic episodes years before other symptoms of bvFTD may be a prodrome of this dementia, possibly indicating anterior temporal involvement in bvFTD. Other patients with late-onset bipolar disorder exhibit the nonprogressive frontotemporal dementia phenocopy syndrome. Finally, a few patients with bvFTD have a genetic predisposition for both disorders.

Keywords: Bipolar Disorder Dementia; Frontotemporal Dementia; Mania.

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References

    1. Lanata SC, Miller BL: The behavioural variant frontotemporal dementia (bvFTD) syndrome in psychiatry. J Neurol Neurosurg Psychiatry 2016; 87(5):501–511 - PMC - PubMed
    1. Rascovsky K, Hodges JR, Knopman D, et al.: Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain 2011; 134(Pt 9):2456–2477 - PMC - PubMed
    1. Vieira RT, Caixeta L, Machado S, et al.: Epidemiology of early-onset dementia: a review of the literature. Clinical practice and epidemiology in mental health: CP & EMH 2013; 9:88. - PMC - PubMed
    1. Burdick KE, Ketter TA, Goldberg JF, et al.: Assessing cognitive function in bipolar disorder: challenges and recommendations for clinical trial design. J Clin Psychiatry 2015; 76(3):e342–350 - PMC - PubMed
    1. Pose M, Cetkovich M, Gleichgerrcht E, et al.: The overlap of symptomatic dimensions between frontotemporal dementia and several psychiatric disorders that appear in late adulthood. Int Rev Psychiatry 2013; 25(2):159–167 - PubMed

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