ࡱ> 2417 bjbjUU . 7|7| lNNNNNNNb2 bKJ```````$ ! ]N`````NN```tN`N``NN`> NA؊b|0K Pp bbNNNNPsychometric tests distinguish frontotemporal dementia from AD: A clinicopathologic study Liscic Rajka M*, 3, Storandt Martha2, 3, Cairns Nigel J, , Morris John C, Topic area: Early detection and diagnosis Keyword(s): Frontotemporal lobar degeneration- Alzheimer's disease- Psychometric tests- APOE- Amyloid beta - Early symptoms Background: Frontotemporal lobar degeneration (FTLD) is a heterogeneous group of disorders that may be mistaken clinically for Alzheimer's disease (AD). A proportion of patients who meet the NINCDS-ADRDA criteria for AD have FTLD confirmed at autopsy with or without neuropathological AD-type changes. Cerebral deposition of A( peptide is the initiating event in AD, associated with APOE 4 allele. Thus, more sensitive clinical diagnostic tools are required to distinguish between the pathological phenotypes. Objectives: To identify clinical features, including psychometric tests that might reliably distinguish AD from FTLD at initial presentation. To asses the role of APOE 4 allele as a determinant for coexisting A pathology. Methods: A retrospective review of 48 neuropathologically confirmed cases of FTLD (70.69.5 years; 27 had completed psychometric testing) yielded clinical and neuropsychological features for comparison with 27 age-, sex-, education-, and severity-matched individuals with AD. Neary clinical criteria for FTLD were used and a standard battery of psychometric tests was administered. Where DNA was available, cases were APOE genotyped. Results: At first visit, those with FTLD demonstrated more disinhibition and impulsivity (p=0.0004, Fischers exact test), and less withdrawal (p=0.01) than those with AD. They also had more dysfluency (p=0.01), agrammatism (p=0.004), and speech hesitancy (p=0.03). The two clinical phenotypes had comparable executive dysfunction (p=0.33), but the AD group had more memory complaints (p=0.01). The FTLD individuals performed better than those with AD on a visual test of episodic memory but worse on word fluency (p<0.05) (performance correlated with aphasic features). Only 4 of 35 individuals who were genotyped had one APOE 4 allele. 11/48 cases had additional AD-type pathology. Conclusions: Clinical and cognitive features of FTLD may overlap with AD, particularly for memory and executive function, although behavioral problems and language difficulties distinguish those with FTLD. Psychometric tests help distinguish FTLD from AD, especially word fluency task, sensitive to frontal lobe dysfunction. APOE 4 allele frequency of 6% in FTLD is similar to that of normal aged individuals. Compounding the overlap of FTLD and AD clinical phenotypes is the presence of AD-type pathology in one-fourth of FTLD individuals. Author information: *Liscic Rajka M, MD, PhD. Institute for Medical Research and Occupational Health, Ksaverska St. 2, P.O.Box 291, 10001 Zagreb, Croatia,  HYPERLINK "mailto:rliscic@imi.hr" rliscic@imi.hr, and Departments of Neurology, Pathology and Immunology, Psychology and the ADRC, School of Medicine, Washington University, St. Louis, MO, USA Z[ijm~RS]24 b d r rY)*̪̰̰ٔن}0JCJmHsHjCJUmHsHjCJUmHsH6B*CJaJph CJ\aJB*CJaJph jbCJaJCJaJ 6CJ]CJ6CJ]mHsH CJmHsH0J>*B*H*ph 0JB*ph0J>*B*ph 5CJ\0@Z[RSd rWXYZn$a$mHsH,1h. A!"#$% DyK rliscic@imi.hryK ,mailto:rliscic@imi.hr i8@8 NormalCJ_HaJmH sH tH <A@< Default Paragraph Font4B@4 Body Text$a$mHsH.U@. Hyperlink >*B*ph>V@> FollowedHyperlink >*B* ph  @Z[RSR2    00000000000000000000  M r  X -.67;BSTYbg&',4;<@CH_m^o      ) 0    ?@YQ2F s   3chy~c - -   rliscicUC:\Documents and Settings\rliscic\Desktop\MADRID 2006\ABSTRACT-ICAD-Liscic et al..doc@S2BSS@{XXX X  P@PPP@PPP(@UnknownGz Times New Roman5Symbol3& z Arial"qh" fB" f  20d? 2q?Psychometric tests distinguish frontotemporal dementia from AD:rliscicrliscicOh+'00 @L h t  @Psychometric tests distinguish frontotemporal dementia from AD:sycrlisciclislis Normal.dotcrliscic10sMicrosoft Word 9.0d@GZ@R'@R'@ >؊ ՜.+,D՜.+,l( hp|  imi?  @Psychometric tests distinguish frontotemporal dementia from AD: Title 8@ _PID_HLINKSAd?mailto:rliscic@imi.hr  "#$%&'(*+,-./03Root Entry FЌcA؊5Data 1TableWordDocument. SummaryInformation(!DocumentSummaryInformation8)CompObjjObjectPoolЌcA؊ЌcA؊  FMicrosoft Word Document MSWordDocWord.Document.89q