Abstract
Behavioral variant frontotemporal dementia (bvFTD) is a syndrome defined by a set of core clinical criteria, which include disinhibition; apathy or inertia; loss of sympathy or empathy; perseverative, stereotyped, or compulsive/ritualistic behavior; and hyperorality. The clinical features of bvFTD overlap substantially with those of psychiatric disease, particularly major depressive disorder and bipolar affective disorder. The similarities between bvFTD and primary psychiatric disease results in a significant diagnostic challenge for clinicians. Understanding the neuropsychiatric aspects of bvFTD may assist in differentiating bvFTD from a primary psychiatric disorder.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Rabinovici GD, Miller BL (2010) Frontotemporal lobar degeneration. CNS Drugs 24(5):375–398
Rascovsky K, Hodges JR, Knopman D et al (2011) Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain 134(9):2456–2477
Gorno-Tempini ML, Hillis AE, Weintraub S et al (2011) Classification of primary progressive aphasia and its variants. Neurology 76(11):1006–1014
Johnson JK, Diehl J, Mendez MF et al (2005) Frontotemporal lobar degeneration: demographic characteristics of 353 patients. Arch Neurol 62(6):925–930
Woolley JD, Khan BK, Murthy NK et al (2011) The diagnostic challenge of psychiatric symptoms in neurodegenerative disease: rates of and risk factors for prior psychiatric diagnosis in patients with early neurodegenerative disease. J Clin Psychiatry 72(2):126–133
Seeley WW, Crawford R, Rascovsky K et al (2008) Frontal paralimbic network atrophy in very mild behavioral variant frontotemporal dementia. Arch Neurol 65(2):249–255
Eckart JA, Sturm VE, Miller BL et al (2012) Diminished disgust reactivity in behavioral variant frontotemporal dementia. Neuropsychologia 50(5):786–790
Perry DC, Datta S, Sturm VE et al (2017) Reward deficits in behavioural variant frontotemporal dementia include insensitivity to negative stimuli. Brain J Neurol 140(12):3346–3356
Le Ber I, Guedj E, Gabelle A et al (2006) Demographic, neurological and behavioural characteristics and brain perfusion SPECT in frontal variant of frontotemporal dementia. Brain J Neurol 129(Pt 11):3051–3065
Lanata SC, Miller BL (2016) The behavioural variant frontotemporal dementia (bvFTD) syndrome in psychiatry. J Neurol Neurosurg Psychiatry 87(5):501–511
Manoochehri M, Huey ED (2012) Diagnosis and management of behavioral issues in frontotemporal dementia. Curr Neurol Neurosci Rep 12(5):528–536
Miller B, Llibre Guerra JJ (2019) Frontotemporal dementia. Handb Clin Neurol 165:33–45
Diehl-Schmid J, Perneczky R, Koch J et al (2013) Guilty by suspicion? Criminal behavior in frontotemporal lobar degeneration. Cogn Behav Neurol Off J Soc Behav Cogn Neurol 26(2):73–77
Rosen HJ, Allison SC, Schauer GF et al (2005) Neuroanatomical correlates of behavioural disorders in dementia. Brain J Neurol 128(11):2612–2625
Franceschi M, Anchisi D, Pelati O et al (2005) Glucose metabolism and serotonin receptors in the frontotemporal lobe degeneration. Ann Neurol 57(2):216–225
Massimo L, Powers C, Moore P et al (2009) Neuroanatomy of apathy and disinhibition in frontotemporal lobar degeneration. Dement Geriatr Cogn Disord 27(1):96–104
Sturm VE, Sollberger M, Seeley WW et al (2013) Role of right pregenual anterior cingulate cortex in self-conscious emotional reactivity. Soc Cogn Affect Neurosci 8(4):468–474
Swartz JR, Miller BL, Lesser IM et al (1997) Frontotemporal dementia: treatment response to serotonin selective reuptake inhibitors. J Clin Psychiatry 58(5):212–216
Herrmann N, Black SE, Chow T et al (2012) Serotonergic function and treatment of behavioral and psychological symptoms of frontotemporal dementia. Am J Geriatr Psychiatry Off J Am Assoc Geriatr Psychiatry 20(9):789–797
Robert P, Lanctôt KL, Agüera-Ortiz L et al (2018) Is it time to revise the diagnostic criteria for apathy in brain disorders? The 2018 international consensus group. Eur Psychiatr 54:71–76
Marin RS (1991) Apathy: a neuropsychiatric syndrome. J Neuropsychiatry Clin Neurosci 3(3):243–254
Robert P, Onyike CU, Leentjens AFG et al (2009) Proposed diagnostic criteria for apathy in Alzheimer’s disease and other neuropsychiatric disorders. Eur Psychiatry 24(2):98–104
Clarke DE, Ko JY, Lyketsos C et al (2010) Apathy and cognitive and functional decline in community-dwelling older adults: results from the Baltimore ECA longitudinal study. Int Psychogeriatr 22(5):819–829
Merrilees J, Dowling GA, Hubbard E et al (2013) Characterization of apathy in persons with frontotemporal dementia and the impact on family caregivers. Alzheimer Dis Assoc Disord 27(1):62–67
Levy R, Dubois B (2006) Apathy and the functional anatomy of the prefrontal cortex-basal ganglia circuits. Cereb Cortex 16(7):916–928
Sheelakumari R, Bineesh C, Varghese T et al (2019) Neuroanatomical correlates of apathy and disinhibition in behavioural variant frontotemporal dementia. Brain Imaging Behav.
Zamboni G, Huey ED, Krueger F et al (2008) Apathy and disinhibition in frontotemporal dementia: insights into their neural correlates. Neurology 71(10):736–742
Eslinger PJ, Moore P, Antani S et al (2012) Apathy in frontotemporal dementia: behavioral and neuroimaging correlates. Behav Neurol 25(2):127–136
Dolder CR, Nicole Davis L, McKinsey J (2010) Use of psychostimulants in patients with dementia. Ann Pharmacother 44(10):1624–1632
Rosenberg PB, Lanctôt KL, Drye LT et al (2013) Safety and efficacy of methylphenidate for apathy in Alzheimer’s disease: a randomized, placebo-controlled trial. J Clin Psychiatry 74(8):810–816
Padala PR, Padala KP, Lensing SY et al (2018) Methylphenidate for apathy in community-dwelling older veterans with mild Alzheimer’s disease: a double-blind, randomized, placebo-controlled trial. Am J Psychiatry 175(2):159–168
Scherer RW, Drye L, Mintzer J et al (2018) The apathy in dementia methylphenidate trial 2 (ADMET 2): study protocol for a randomized controlled trial. Trials 19(1):46
Huey ED, Garcia C, Wassermann EM et al (2008) Stimulant treatment of frontotemporal dementia in 8 patients. J Clin Psychiatry 69(12):1981–1982
Carr AR, Mendez MF (2018) Affective empathy in behavioral variant frontotemporal dementia: a meta-analysis. Front Neurol 9
Hsieh S, Irish M, Daveson N et al (2013) When one loses empathy: its effect on carers of patients with dementia. J Geriatr Psychiatry Neurol 26(3):174–184
Pomponi M, Ricciardi L, La Torre G et al (2016) Patient’s loss of empathy is associated with caregiver burden. J Nerv Ment Dis 204(9):717–722
Mendez MF (2010) The unique predisposition to criminal violations in frontotemporal dementia. J Am Acad Psychiatry Law 38(3):318–323
Liljegren M, Naasan G, Temlett J et al (2015) Criminal behavior in frontotemporal dementia and Alzheimer disease. JAMA Neurol 72(3):295–300
Singer T, Lamm C (2009) The social neuroscience of empathy. Ann N Y Acad Sci 1156(1):81–96
Rankin KP, Kramer JH, Miller BL (2005) Patterns of cognitive and emotional empathy in frontotemporal lobar degeneration. Cogn Behav Neurol 18(1):28–36
Baez S, Manes F, Huepe D et al (2014) Primary empathy deficits in frontotemporal dementia. Front Aging Neurosci 6:262
Shamay-Tsoory SG, Aharon-Peretz J, Perry D (2009) Two systems for empathy: a double dissociation between emotional and cognitive empathy in inferior frontal gyrus versus ventromedial prefrontal lesions. Brain 132(3):617–627
Dermody N, Wong S, Ahmed R et al (2016) Uncovering the neural bases of cognitive and affective empathy deficits in Alzheimer’s disease and the behavioral-variant of frontotemporal dementia. J Alzheimers Dis 53(3):801–816
Hurlemann R, Patin A, Onur OA et al (2010) Oxytocin enhances amygdala-dependent, socially reinforced learning and emotional empathy in humans. J Neurosci 30(14):4999–5007
Jesso S, Morlog D, Ross S et al (2011) The effects of oxytocin on social cognition and behaviour in frontotemporal dementia. Brain J Neurol 134(Pt 9):2493–2501
Finger EC, MacKinley J, Blair M et al (2015) Oxytocin for frontotemporal dementia: a randomized dose-finding study of safety and tolerability. Neurology 84(2):174–181
Mendez MF, Perryman KM, Miller BL et al (1997) Compulsive behaviors as presenting symptoms of frontotemporal dementia. J Geriatr Psychiatry Neurol 10(4):154–157
Olney NT, Spina S, Miller BL (2017) Frontotemporal Dementia. Neurol Clin 35(2):339–374
Mateen FJ, Josephs KA (2009) The clinical spectrum of stereotypies in frontotemporal lobar degeneration. Mov Disord: Off J Mov Disord Soc 24(8):1237–1240
Moheb N, Charuworn K, Ashla MM et al (2019) Repetitive behaviors in frontotemporal dementia: compulsions or impulsions? J Neuropsychiatry Clin Neurosci 31(2):132–136
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association
Stein DJ (2002) Obsessive-compulsive disorder. Lancet 360(9330):397–405
Veale D, Roberts A (2014) Obsessive-compulsive disorder. BMJ 348
Robbins T, Curran H, de Wit H (2012) Special issue on impulsivity and compulsivity. Psychopharmacology 219(2):251–252
Berlin GS, Hollander E (2014) Compulsivity, impulsivity, and the DSM-5 process. CNS Spectr 19(1):62–68
Ames D, Cummings JL, Wirshing WC et al (1994) Repetitive and compulsive behavior in frontal lobe degenerations. J Neuropsychiatry Clin Neurosci 6(2):100–113
Perry DC, Whitwell JL, Boeve BF et al (2012) Voxel-based morphometry in patients with obsessive-compulsive behaviors in behavioral variant frontotemporal dementia. Eur J Neurol 19(6):911–917
Mitchell E, Tavares TP, Palaniyappan L et al (2019) Hoarding and obsessive-compulsive behaviours in frontotemporal dementia: clinical and neuroanatomic associations. Cortex 121:443–453
Rosso SM, Roks G, Stevens M et al (2001) Complex compulsive behaviour in the temporal variant of frontotemporal dementia. J Neurol 248(11):965–970
McMurtray AM, Chen AK, Shapira JS et al (2006) Variations in regional SPECT hypoperfusion and clinical features in frontotemporal dementia. Neurology 66(4):517–522
Josephs KA, Whitwell JL, Jack CR (2008) Anatomic correlates of stereotypies in frontotemporal lobar degeneration. Neurobiol Aging 29(12):1859–1863
Furlan JC, Henri-Bhargava A, Freedman M (2014) Clomipramine in the treatment of compulsive behavior in frontotemporal dementia: a case series. Alzheimer Dis Assoc Disord 28(1):95–98
Cruz M, Marinho V, Fontenelle LF et al (2008) Topiramate may modulate alcohol abuse but not other compulsive behaviors in frontotemporal dementia: case report. Cogn Behav Neurol 21(2):104–106
Mendez MF, Shapira JS, McMurtray A et al (2007) Preliminary findings: behavioral worsening on donepezil in patients with frontotemporal dementia. Am J Geriatr Psychiatry 15(1):84–87
Sourander P, Sjögren H (2008) The concept of Alzheimer’s disease and its clinical implications. In: Ciba foundation symposium – Alzheimer’s disease and related conditions. Wiley, p 11–36
Neary D, Snowden JS, Gustafson L et al (1998) Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology 51(6):1546–1554
Piguet O, Hornberger M, Shelley BP et al (2009) Sensitivity of current criteria for the diagnosis of behavioral variant frontotemporal dementia. Neurology 72(8):732–737
Miller BL, Darby AL, Swartz JR et al (1995) Dietary changes, compulsions and sexual behavior in frontotemporal degeneration. Dementia 6(4):195–199
Mendez MF, Licht EA, Shapira JS (2008) Changes in dietary or eating behavior in frontotemporal dementia versus Alzheimer’s disease. Am J Alzheimers Dis Other Demen 23(3):280–285
Woolley JD, Gorno-Tempini M-L, Seeley WW et al (2007) Binge eating is associated with right orbitofrontal-insular-striatal atrophy in frontotemporal dementia. Neurology 69(14):1424–1433
Whitwell JL, Sampson EL, Loy CT et al (2007) VBM signatures of abnormal eating behaviours in frontotemporal lobar degeneration. NeuroImage 35(1):207–213
Yi DS, Bertoux M, Mioshi E et al (2013) Fronto-striatal atrophy correlates of neuropsychiatric dysfunction in frontotemporal dementia (FTD) and Alzheimer’s disease (AD). Dement Neuropsychol 7(1):75–82
Piguet O, Petersén Å, Yin Ka Lam B et al (2011) Eating and hypothalamus changes in behavioral-variant frontotemporal dementia. Ann Neurol 69(2):312–319
Ikeda M, Shigenobu K, Fukuhara R et al (2004) Efficacy of fluvoxamine as a treatment for behavioral symptoms in frontotemporal lobar degeneration patients. Dement Geriatr Cogn Disord 17(3):117–121
Lebert F, Stekke W, Hasenbroekx C et al (2004) Frontotemporal dementia: a randomised, controlled trial with trazodone. Dement Geriatr Cogn Disord 17(4):355–359
Block NR, Sha SJ, Karydas AM et al (2016) Frontotemporal dementia and psychiatric illness: emerging clinical and biological links in gene carriers. Am J Geriatr Psychiatry 24(2):107–116
Banks SJ, Weintraub S (2008) Neuropsychiatric symptoms in behavioral variant frontotemporal dementia and primary progressive aphasia. J Geriatr Psychiatry Neurol 21(2):133–141
Gossink F, Vijverberg E, Pijnenburg Y et al (2018) Neuropsychiatry in clinical practice: the challenge of diagnosing behavioral variant frontotemporal dementia. J Neuropsychiatry 02(01)
Gossink FT, Dols A, Kerssens CJ et al (2016) Psychiatric diagnoses underlying the phenocopy syndrome of behavioural variant frontotemporal dementia. J Neurol Neurosurg Psychiatry 87(1):64–68
Hasin DS, Sarvet AL, Meyers JL et al (2018) Epidemiology of adult DSM-5 major depressive disorder and its specifiers in the United States. JAMA Psychiat 75(4):336–346
Knopman DS, Roberts RO (2011) Estimating the number of persons with frontotemporal lobar degeneration in the US population. J Mol Neurosci 45(3):330–335
Charney DS, Sklar PB, Buxbaum JD et al (2018) Charney & Nestler’s neurobiology of mental illness. Oxford University Press, New York
Lu X, Zhong Y, Ma Z et al (2019) Structural imaging biomarkers for bipolar disorder: meta-analyses of whole-brain voxel-based morphometry studies. Depress Anxiety 36(4):353–364
Redlich R, Almeida JJR, Grotegerd D et al (2014) Brain morphometric biomarkers distinguishing unipolar and bipolar depression. A voxel-based morphometry-pattern classification approach. JAMA Psychiat 71(11):1222–1230
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Peet, B.T., Castro-Suarez, S., Miller, B.L. (2021). The Neuropsychiatric Features of Behavioral Variant Frontotemporal Dementia. In: Ghetti, B., Buratti, E., Boeve, B., Rademakers, R. (eds) Frontotemporal Dementias . Advances in Experimental Medicine and Biology, vol 1281. Springer, Cham. https://doi.org/10.1007/978-3-030-51140-1_2
Download citation
DOI: https://doi.org/10.1007/978-3-030-51140-1_2
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-51139-5
Online ISBN: 978-3-030-51140-1
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)