Abstract
Although the neuropathologic changes and diagnostic criteria for the neurodegenerative disorder Alzheimer’s disease (AD) are well-established, the clinical symptoms vary largely. Symptomatically, frontal variant of AD (fv-AD) presents very similarly to behavioral variant frontotemporal dementia (bvFTD), which creates major challenges for differential diagnosis. Here, we report two patients who present with progressive cognitive impairment, early and prominent behavioral features, and significant frontotemporal lobe atrophy on magnetic resonance imaging, consistent with an initial diagnosis of probable bvFTD. However, multimodal functional neuroimaging revealed neuropathological data consistent with a diagnosis of probable AD for one patient (pathology distributed in the frontal lobes) and a diagnosis of probable bvFTD for the other patient (hypometabolism in the bilateral frontal lobes). In addition, the fv-AD patient presented with greater executive impairment and milder behavioral symptoms relative to the bvFTD patient. These cases highlight that recognition of these atypical syndromes using detailed neuropsychological tests, biomarkers, and multimodal neuroimaging will lead to greater accuracy in diagnosis and patient management.
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Acknowledgments
The authors sincerely thank Hui-Hong Zhang for patient data collection and follow-up. This work was supported by grants from the Tianjin Health Bureau of Science and Technology Research Foundation (2013KG121), Tianjin Science and Technology Plan Foundation (2013ZCZDSY01600), the Special Fund of National Clinical and Medical Research (L2014071), and Youth Fund of the National Nature Science Foundation of China (81301629).
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Li, P., Zhou, YY., Lu, D. et al. Correlated patterns of neuropsychological and behavioral symptoms in frontal variant of Alzheimer disease and behavioral variant frontotemporal dementia: a comparative case study. Neurol Sci 37, 797–803 (2016). https://doi.org/10.1007/s10072-015-2405-9
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DOI: https://doi.org/10.1007/s10072-015-2405-9