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Neuroanatomical correlates of apathy and disinhibition in behavioural variant frontotemporal dementia

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Abstract

Neuroanatomical correlates of apathy and disinhibition, behavioral abnormalities in behavioral variant Frontotemporal dementia (bvFTD) remain unclear. In this study 45 participants (25 bvFTD patients and 20 controls) provided data on clinical, neuropsychological, behavioral (on Frontal Systems Behavior (FrSBe) Scale), cortical volume (on voxel-based morphometry (VBM)) and tract based spatial fractional anisotropy ((FA) on magnetic resonance imaging (MRI), allowing examination of the neural correlates of apathy and disinhibition. The patients with bvFTD had predominant grey matter loss and corresponding white matter fractional anisotropy reduction in the frontal and temporal lobe compared to the controls. Grey matter loss in frontal, temporal and limbic structures correlated with apathy and degeneration in temporal limbic brain areas correlated with disinhibition. FA changes in inferior fronto-occipital fasciculus and forceps minor correlated with apathy and fibre integrity changes in the superior longitudinal fasciculus correlated with disinhibition. The current study suggests that apathy and disinhibition arises due to changes in the frontal, temporal and limbic brain areas  in bvFTD.

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Acknowledgements

The authors wish to thank the participants in this study and their caregivers.

Author Contribution: SR, BC and TV carried out the study and did data collection and data analysis. SR, KC, JV and PSM contributed to the preparation of the manuscript. PSM conceived the idea of and designed the study and got the grant for carrying out the study. JV contributed to getting the grant for the study.

Funding

This study was supported by grants provided by the National Institute on Aging (NIA), USA (grant no. R21AG029799 to JV and R01AG039330–01) to PSM.

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Authors and Affiliations

  1. Cognition and Behavioural Neurology Section, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Trivandrum, India

    Raghavan Sheelakumari & Pavagada S. Mathuranath

  2. Department of Neurology, Maulana Hospital, Perinthalmanna, Kerala, India

    Cheminnikara Bineesh

  3. Department of Electronics and Instrumentation, Noorul Islam University, Kumaracoil, Thuckalay, Tamilnadu, India

    Tinu Varghese

  4. Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Trivandrum, India

    Chandrasekharan Kesavadas

  5. Integrated Divisions of Cognitive and Motor Aging (Neurology) and Geriatrics (Medicine), Albert Einstein College of Medicine, Bronx, NY, USA

    Joe Verghese

  6. Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Banglore, Karnataka, 560029, India

    Pavagada S. Mathuranath

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  1. Raghavan Sheelakumari
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  2. Cheminnikara Bineesh
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  3. Tinu Varghese
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  4. Chandrasekharan Kesavadas
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  5. Joe Verghese
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  6. Pavagada S. Mathuranath
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Correspondence to Pavagada S. Mathuranath.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Supplementary Fig. 1

Regions of reduced gray matter density (red-yellow) in behavioral variant FTD subjects compared to controls, P < 0.05(FWE corrected). (PNG 316 kb)

High Resolution (TIF 815 kb)

Supplementary Fig. 2

Patterns of white matter tract degeneration in behavioral variant group compared with controls. Tract based spatial statistics voxel wise group differences (significance level of P < 0.05, FWE corrected for multiple comparisons across space using threshold free cluster enhancement) are shown in red-yellow (FA). (PNG 362 kb)

High Resolution (TIF 1364 kb)

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Sheelakumari, R., Bineesh, C., Varghese, T. et al. Neuroanatomical correlates of apathy and disinhibition in behavioural variant frontotemporal dementia. Brain Imaging and Behavior 14, 2004–2011 (2020). https://doi.org/10.1007/s11682-019-00150-3

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