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Patterns of neuropsychological impairment in frontotemporal dementia

From the New Jersey Institute for Successful Aging (D.J.L.), University of Medicine and Dentistry of New Jersey–School of Osteopathic Medicine; Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; and Department of Neurology (P.M., J.F., S.A., G.M., K.C., M.G.), University of Pennsylvania School of Medicine, Philadelphia.

Address correspondence and reprint requests to Dr. David J. Libon, New Jersey Institute for Successful Aging, University of Medicine and Dentistry of New Jersey–School of Osteopathic Medicine, Suite 1800, 42 East Laurel Rd., Stratford, NJ 08084; e-mail: libondj{at}UMDNJ.edu

Objective: To differentiate frontotemporal dementia (FTD) subtypes from each other and from probable Alzheimer disease (AD) using neuropsychological tests.

Methods: Patients with FTD and AD (n = 109) were studied with a comprehensive neuropsychological protocol at first contact. Data were subjected to a principal components analysis (PCA) to extract core neuropsychological features. A five-factor solution accounted for 72.89% of the variance and yielded factors related to declarative memory, working memory/visuoconstruction, processing speed/mental flexibility, lexical retrieval, and semantic memory.

Results: Between- and within-group analyses revealed that patients with AD obtain their lowest scores on tests of declarative memory while semantic dementia (SemD) patients are particularly disadvantaged on tests of semantic memory. On tests of processing speed/mental flexibility time to completion was faster for social comportment/dysexecutive (SOC/EXEC) patients, but these patients made more errors on some tests. Patients with corticobasal degeneration (CBD) and progressive nonfluent aphasia (PNFA) were impaired on tests of working memory. Logistic regression analyses using factor scores successfully assigned FTD subgroups and AD patients into their respective diagnostic categories.

Conclusion: Patients with differing frontotemporal dementia phenotypes can be distinguished from each other and from Alzheimer disease using neuropsychological tests.

Supported in part by the US Public Health Service (AG17586, AG15116, AG10124, and NS44266) and the Dana Foundation.

Disclosure: The authors report no conflicts of interest.

Received January 23, 2006. Accepted in final form October 6, 2006.

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