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. 2021 Apr 6;13(1):e12178.
doi: 10.1002/dad2.12178. eCollection 2021.

Frontotemporal dementia subtypes based on behavioral inhibition deficits

Valérie Godefroy  1 , Delphine Tanguy  1   2 , Arabella Bouzigues  1 , Idil Sezer  1 , Johan Ferrand-Verdejo  1 , Carole Azuar  3 , David Bendetowicz  1   3   4 , Guilhem Carle  4 , Armelle Rametti-Lacroux  1 , Stéphanie Bombois  3 , Emmanuel Cognat  5   6 , Pierre Jannin  2 , Xavier Morandi  2 , Isabelle Le Ber  1   3 , Richard Levy  1   3   4 , Bénédicte Batrancourt  1 , Raffaella Migliaccio  1   3   4
Affiliations

Frontotemporal dementia subtypes based on behavioral inhibition deficits

Valérie Godefroy et al. Alzheimers Dement (Amst). .

Abstract

Introduction: We aimed to investigate phenotypic heterogeneity in the behavioral variant of frontotemporal dementia (bvFTD) through assessment of inhibition deficits.

Methods: We assessed occurrences of 16 behavioral inhibition deficits from video recordings of 15 bvFTD patients (early stage) and 15 healthy controls (HC) in an ecological setting. We extracted dimensions of inhibition deficit and analyzed their correlations with cognitive and clinical measures. Using these dimensions, we isolated patient clusters whose atrophy patterns were explored.

Results: After identifying two patterns of inhibition deficit (compulsive automatic behaviors and socially unconventional behaviors), we isolated three behavioral clusters with distinct atrophy patterns. BvFTD-G0 (N = 3), an outlier group, showed severe behavioral disturbances and more severe ventromedial prefrontal cortex/orbitofrontal cortex atrophy. Compared to bvFTD-G1 (N = 6), bvFTD-G2 (N = 6) presented higher anxiety and depression along with less diffuse atrophy especially in midline regions.

Discussion: Identifying clinico-anatomical profiles through behavior observation could help to stratify bvFTD patients for adapted treatments.

Keywords: compulsivity; disinhibition; ecological design; frontotemporal dementia; gray matter atrophy; subtypes.

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Conflict of interest statement

The authors declare no competing interests.

Figures

FIGURE 1
FIGURE 1
Hierarchical clustering analysis used to define subgroups of behavioral variant of frontotemporal dementia (bvFTD) patients (N = 15). After including patients with very high F1 scores into bvFTD‐G0 (N = 3), two subgroups were identified: bvFTD‐G1 (N = 6) and bvFTD‐G2 (N = 6). Vertical numbers at the bottom of the dendrogram are the study‐specific identifier codes of the participants
FIGURE 2
FIGURE 2
Distribution of the total occurrences of 15 behaviors relating to disinhibition among the three subgroups of behavioral variant of frontotemporal dementia (bvFTD) patients (bvFTD‐G0, N = 3/bvFTD‐G1, N = 6/bvFTD‐G2, N = 6), and healthy controls (HC, N = 15)
FIGURE 3
FIGURE 3
Comparisons of cognitive and clinical scores between two subgroups of behavioral variant of frontotemporal dementia (bvFTD) patients (bvFTD‐G1, N = 6 and bvFTD‐G2, N = 6) and healthy controls (HC, N = 15). Cognitive scores: (A) Hayling error: measure of cognitive disinhibition, (B) mini‐Social Cognition & Emotional Assessment (mini‐SEA) Faux Pas Test: measure of complex social cognition and (C) mini‐SEA emotion: measure of emotion recognition. Clinical scores: (D) DAS, Dimensional Apathy Scale: measure of apathy; HADS, Hospital Anxiety and Depression Scale (E) anxiety and (F) depression. Levels of significance (based on uncorrected P‐values); ns, non‐significant; *P < .05; **P < .01; ***P < .001
FIGURE 4
FIGURE 4
Voxel‐based morphometry–derived gray matter atrophy maps of each behavioral variant of frontotemporal dementia (bvFTD) subgroup: bvFTD‐G0 group of outliers (N = 3), bvFTD‐G1 (N = 6), and bvFTD‐G2 (N = 6). The (1‐p) value maps show the atrophy patterns compared to healthy controls (HC, N = 15) and are superimposed onto a whole‐brain Montreal Neurological Institute template. Effects are corrected for age and sex, and for family‐wise error at the whole brain level at P < .01
See this image and copyright information in PMC

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