Neurological Sciences

, Volume 32, Issue 1, pp 101–105 | Cite as

Vitamin B12 deficiency associated with symptoms of frontotemporal dementia

Original Article


We report the case of an elderly patient with cobalamin deficiency who progressively developed cognitive and behavioral symptoms associated with neuropsychiatric disturbances. His neuropsychological profile showed many features suggestive for a frontal-dysexecutive syndrome and was related to a predominant asymmetric (right > left) frontal lobe hypoperfusion. He completely recovered after a treatment with vitamin B12 and follow-up of 7 years showed that his improvement remained stable. Along with the other cases reported in the literature, our case also proves that there are some cases of vitamin B12 deficiency that can manifest with the symptoms of frontotemporal dementia and that they are completely reversible after substitution therapy.


Vitamin B12 Dementia Frontal-dysexecutive symptoms 


  1. 1.
    Reynolds E (2006) Vitamin B12, folic acid, and the nervous system. Lancet Neurol 5(11):949–960CrossRefPubMedGoogle Scholar
  2. 2.
    Goebels N, Soyka M (2000) Dementia associated with vitamin B12 deficiency: presentation of two cases and review of the literature. J Neuropsychiatry Clin Neurosci 12(3):389–394PubMedGoogle Scholar
  3. 3.
    Osimani A, Berger A, Fiedman J, Bat-Sheba PK, Abarbanel JM (2005) Neuropsychology of vitamin B12 deficiency in elderly dementia patients and control subjects. J Geriatr Psychiatry Neurol 18:33–38CrossRefPubMedGoogle Scholar
  4. 4.
    Whyte EM, Mulsant BH, Butters MA et al (2002) Cognitive and behavioural correlates of low vitamin 12 levels in elderly patients with progressive dementia. Am J Geriatr Psychiatry 10:321–327PubMedGoogle Scholar
  5. 5.
    Basun H, Fratiglioni L, Winblad B (1994) Cobalamin levels are not reduced in Alzheimer’s disease: results from a population-based study. J Am Geriatr Soc 42:132–134PubMedGoogle Scholar
  6. 6.
    Van Dyck CH, Lyness JM, Rohrbaugh RM, Siegal AP (2008) Cognitive and psychiatric effects of vitamin B12 replacement in dementia with low serum B12 levels: a nursing home study. Int Psychogeriatr 17:1–10Google Scholar
  7. 7.
    Nilsson K, Warkentin S, Hultberg B, Fäldt R, Gustafson L (2000) Treatment of cobalamin deficiency in dementia, evaluated clinically and with cerebral blood flow measurements. Aging (Milano) 12(3):199–207Google Scholar
  8. 8.
    Schreinzer D, Barnas C, Fisher P (2003) Frontotemporal dementia associated with vitamin B12 deficiency. J Am Geriatr Soc 51:280–281CrossRefPubMedGoogle Scholar
  9. 9.
    Akdal G, Yener GG, Pinar K (2008) Treatment responsive executive and behavioural dysfunction associated with vitamin B12 deficiency. Neurocase 14(2):147–150CrossRefPubMedGoogle Scholar
  10. 10.
    Neary D, Snowden JS, Gustafson MD et al (1998) Frontotemporal lobar degeneration. A consensus on clinical diagnostic criteria. Neurology 51:1546–1554PubMedGoogle Scholar
  11. 11.
    Measso G, Cavarzeran F, Zappalà G, Lebowitz BD, Crook TH, Pirozzolo FJ, Amaducci LA, Massari D, Grigoletto F (1993) The mini mental state examination: normative study of an Italian random sample. Dev Neuropsychol 9:77–85CrossRefGoogle Scholar
  12. 12.
    Carlesimo GA, Caltagirone C, Gainotti G (1996) The mental deterioration battery: normative data, diagnostic reliability and qualitative analyses of cognitive impairment. Eur Neurol 36:378–384CrossRefPubMedGoogle Scholar
  13. 13.
    Shulman K, Gold DP, Cohen CA, Zucchero CA (1993) Clock-drawing and dementia in the community: a longitudinal study. Int J Geriatr Psychiatry 8(6):487–496CrossRefGoogle Scholar
  14. 14.
    Behrens MI, Díaz V, Vásquez C, Donoso A (2003) Dementia caused by vitamin B12 deficiency clinical case. Rev Med Chil 131(8):915–919PubMedGoogle Scholar
  15. 15.
    Bottiglieri T (1997) S-Adenometionine (SAM) neuropharmachology: implications for pharmachological therapy of psychiatric and neurological diseases. Expert Opin Investig Drugs 6:417–426CrossRefPubMedGoogle Scholar
  16. 16.
    McCaddon A, Regland B, Hudson P, Davies G (2002) Functional vitamin B(12) deficiency and Alzheimer disease. Neurology 58:1395–1399PubMedGoogle Scholar
  17. 17.
    Lund and Manchester Groups (1994) Consensus statement: clinical and neuropathological criteria for frontotemporal dementia. J Neurol Neurosurg Psychiatry 57:416–418CrossRefGoogle Scholar
  18. 18.
    Orsini A, Grossi D, Capitani E, Laiacona M, Papagno C, Vallar G (1987) Verbal and spatial immediate memory span: normative data from 1355 adults and 1112 children. Ital J Neurol Sci 8:539–548CrossRefPubMedGoogle Scholar
  19. 19.
    Basso A, Capitani E, Laiacona M (1987) Raven’s coloured progressive matrices: normative values on 305 adult normal controls. Funct Neurol 2:189–194PubMedGoogle Scholar
  20. 20.
    Spinnler H, Tognoni G (1987) Standardizzazione e taratura italiana di test neuropsicologici. Ital J Neurol Sci 8(Suppl. 6):5–120Google Scholar
  21. 21.
    Kaplan E, Goodglass H, Weintraub S (1976) Boston naming test. Experimental edition. Aphasia Research Center, Boston University, BostonGoogle Scholar
  22. 22.
    Beck AT, Ward CH, Mendelson M et al (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Department of NeuroscienceAzienda Ospedaliera S. Camillo ForlaniniRomeItaly
  2. 2.University “La Sapienza” and “Fondazione Santa Lucia”RomeItaly
  3. 3.Unit of Neurology, Regina Apostolorum HospitalAlbano (Rome)Italy

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