Neuroanatomical correlates of apathy and disinhibition in behavioural variant frontotemporal dementia
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ORIGINAL RESEARCH
Neuroanatomical correlates of apathy and disinhibition in behavioural variant frontotemporal dementia Raghavan Sheelakumari 1 & Cheminnikara Bineesh 2 & Tinu Varghese 3 & Chandrasekharan Kesavadas 4 & Joe Verghese 5 & Pavagada S. Mathuranath 1,6
# Springer Science+Business Media, LLC, part of Springer Nature 2019
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. Keywords Behavioral variant FTD . Fractional anisotropy . Inferior fronto-occipital fasciculus . Frontal system Behavioral scale
Introduction Frontotemporal Dementia (FTD) is characterized by early changes in personality and social conduct (Neary et al. 2005). Even though behavioral abnormalities are common in all FTD syndromes, predominant changes occur in frontal or behavioral variant FTD (bvFTD) (McKhann et al. 2001). Insidious onset personality changes, behavioral abnormalities, and poor insight are seen in patients with bvFTD. Previous studies have suggested that volume loss in particular brain
regions leads to specific behavioral abnormalities (Whitwell et al. 2007; Williams, Nestor, & Hodges 2005). The bvFTD is characterized by the presence of behavioral manifestations of apathy, disinhibition and executive dysfunction. Patients with apathy have lack of initiative, interest and emotional concern, and patients with disinhibition present with production of socially inappropriate comments and/or actions (Robert et al. 2002). In the early stages of the disease, the distinction between the behavioral profiles is evident, but a significant overlap may occur in the later stages (Snowden et al. 2001).
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11682-019-00150-3) contains supplementary material, which is available to authorized users. * Pavagada S. Mathuranath [email protected] 1
Cognition and Behavioural Neurology Section, Department of Neuro
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