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Serial position effects rapidly distinguish Alzheimer’s from frontotemporal dementia

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Abstract

Objective

A significant proportion of patients with behavioural variant frontotemporal dementia (bvFTD) show memory impairments similar to patients with Alzheimer’s disease (AD), making them prone to misdiagnosis in early disease stages. Our objective was to establish a rapid and efficient memory measure that enhances discrimination between patients with dementia due to Alzheimer’s disease and amnestic presentations of behavioural variant frontotemporal dementia.

Method

Word list learning data of patients with diagnoses of AD and both amnestic and non-amnestic presentations of bvFTD were analysed. The overall recall rate and the relative contributions of the first two (primacy items) and last two words (recency items) to recall performance were compared between groups.

Results

Overall recall rate was indistinguishable between patients with AD and amnestic bvFTD. However, AD patients’ recall was mostly driven by recency items, whereas amnestic bvFTD patients’ performance was mostly driven by primacy items.

Conclusion

We conclude that obtaining a simple recency dominance index from a single, 15-item word list memory trial can help discriminate patients with AD from patients with bvFTD, even if they present with similarly severe memory impairment.

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Acknowledgements

We thank Angelina Höfig and Nils Kleine for their support with data acquisition. We are grateful to the patients and their carers who agreed to contribute data to this research.

Author information

Author notes

  1. Thomas Duning and Andreas Johnen contributed equally.

Authors and Affiliations

  1. Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Albert-Schweitzer-Campus, Building A1, 48149, Münster, Germany

    Nadine Kloth, Jolene Lemke, Heinz Wiendl, Sven G. Meuth, Thomas Duning & Andreas Johnen

Authors
  1. Nadine Kloth
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  2. Jolene Lemke
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  3. Heinz Wiendl
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  4. Sven G. Meuth
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Corresponding author

Correspondence to Nadine Kloth.

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Conflicts of interest

Nadine Kloth reports no competing interests. Jolene Lemke reports no competing interests. Heinz Wiendl receives honoraria for acting as a member of Scientific Advisory Boards and as consultant for Biogen, Evgen, MedDay Pharmaceuticals, Merck Serono, Novartis, Roche Pharma AG, Sanofi-Genzyme, as well as speaker honoraria and travel support from Alexion, Biogen, Cognomed, F. Hoffmann-La Roche Ltd., Gemeinnützige Hertie-Stiftung, Merck Serono, Novartis, Roche Pharma AG, Sanofi-Genzyme, TEVA, and WebMD Global. Prof. Wiendl is acting as a paid consultant for Abbvie, Actelion, Biogen, IGES, Johnson & Johnson, Novartis, Roche, Sanofi-Genzyme, and the Swiss Multiple Sclerosis Society. His research is funded by the German Ministry for Education and Research (BMBF), Deutsche Forschungsgesellschaft (DFG), Else Kröner Fresenius Foundation, Fresenius Foundation, Hertie Foundation, NRW Ministry of Education and Research, Interdisciplinary Center for Clinical Studies (IZKF) Muenster and RE Children’s Foundation, Biogen GmbH, GlaxoSmithKline GmbH, Roche Pharma AG, Sanofi-Genzyme. Sven G. Meuth receives honoraria for lecturing, and travel expenses for attending meetings from Almirall, Amicus Therapeutics Germany, Bayer Health Care, Biogen, Celgene, Diamed, Genzyme, MedDay Pharmaceuticals, Merck Serono, Novartis, Novo Nordisk, ONO Pharma, Roche, Sanofi-Aventis, Chugai Pharma, QuintilesIMS and Teva. His research is funded by the German Ministry for Education and Research (BMBF), Deutsche Forschungsgemeinschaft (DFG), Else Kröner Fresenius Foundation, German Academic Exchange Service, Hertie Foundation, Interdisciplinary Center for Clinical Studies (IZKF) Muenster, German Foundation Neurology and Almirall, Amicus Therapeutics Germany, Biogen, Diamed, Fresenius Medical Care, Genzyme, HERZ Burgdorf, Merck Serono, Novartis, ONO Pharma, Roche, and Teva. Thomas Duning received honoraria and travel expenses from Genzyme, Shire, Bristol-Myers Squibb, Boehringer-Ingelheim Pharma, Sanofi Aventis, Eisai, Novartis, Bayer Vital, Merz Pharma, Actelion, Amicus for serving as a speaker and consultant. He received research support from Genzyme, Shire, Amicus and Actelion. For conducting of studies on dementia, he received grants from Novartis, Merz Pharma, Roche and Biogen. Andreas Johnen received honoraria and travel expenses for acting as a speaker for Actelion Pharmaceuticals and Biogen unrelated to the content of this study.

Ethical standards

The study was conducted at the Department of Neurology of the University Hospital Muenster and was approved by the ethics committee of the regional Medical Association (Ärztekammer Westfalen-Lippe, 2012-365-f-S).

Informed consent

All participants gave written informed consent.

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Kloth, N., Lemke, J., Wiendl, H. et al. Serial position effects rapidly distinguish Alzheimer’s from frontotemporal dementia. J Neurol 267, 975–983 (2020). https://doi.org/10.1007/s00415-019-09662-w

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  • DOI: https://doi.org/10.1007/s00415-019-09662-w

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