Document Detail


Neuroanatomy of apathy and disinhibition in frontotemporal lobar degeneration.
MedLine Citation:
PMID:  19158440     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the neural basis for the behavioral symptoms of frontotemporal lobar degeneration (FTLD) that cause the greatest caregiver distress.
BACKGROUND: FTLD is a progressive neurodegenerative disease associated with behavioral disturbances. Group studies have related these behaviors to volume loss on MRI.
METHODS: Forty caregivers of patients with the clinical diagnosis of FTLD completed the Neuropsychiatric Inventory. Twelve neuropsychiatric symptoms and the associated caregiver distress were assessed. Optimized voxel-based morphometry identified significant atrophy in subgroups of FTLD patients with isolated behavioral symptoms corresponding to the most distressing behaviors, and we correlated cortical atrophy directly with these distressing behavioral disorders in an unbiased group analysis.
RESULTS: The greatest stressors for caregivers were apathy and disinhibition (p < 0.005 for both contrasts). Partially distinct areas of cortical atrophy were associated with these behaviors in both individual patients with these symptoms and group-wide analyses, including the dorsal anterior cingulate cortex and dorsolateral prefrontal cortex in apathetic patients, and the medial orbital frontal cortex in disinhibited patients.
CONCLUSIONS: Caregiver stress in families of FTLD patients is due in large part to apathy and disinhibition. The anatomic distribution of cortical loss corresponding to these distressing social behaviors includes partially distinct areas within the frontal lobe.
Authors:
Lauren Massimo; Chivon Powers; Peachie Moore; Luisa Vesely; Brian Avants; James Gee; David J Libon; Murray Grossman
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-01-22
Journal Detail:
Title:  Dementia and geriatric cognitive disorders     Volume:  27     ISSN:  1421-9824     ISO Abbreviation:  Dement Geriatr Cogn Disord     Publication Date:  2009  
Date Detail:
Created Date:  2009-02-12     Completed Date:  2009-05-21     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  9705200     Medline TA:  Dement Geriatr Cogn Disord     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  96-104     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pa., USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Behavior
Brain / pathology*
Caregivers / psychology
Dementia / pathology*,  psychology*
Female
Humans
Image Processing, Computer-Assisted
Inhibition (Psychology)*
Magnetic Resonance Imaging
Male
Middle Aged
Stress, Psychological / psychology
Grant Support
ID/Acronym/Agency:
AG15116/AG/NIA NIH HHS; AG17586/AG/NIA NIH HHS; NS44266/NS/NINDS NIH HHS; NS53488/NS/NINDS NIH HHS; P01 AG017586/AG/NIA NIH HHS; P50 NS053488/NS/NINDS NIH HHS; R01 AG015116/AG/NIA NIH HHS; R01 NS044266/NS/NINDS NIH HHS
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