Clinical characteristics of parkinsonism in frontotemporal dementia according to subtypes

• Published in: Journal of the neurological sciences 2017-01, Vol.372, p.51-56
• Main Authors: Park, Hee Kyung, Park, Kee Hyung, Yoon, Bora, Lee, Jae-Hong, Choi, Seong Hye, Joung, Jee H., Yoon, Soo Jin, Kim, Byeong C., Kim, Seung Hyun, Kim, Eun-Joo, Na, Duk L., Park, Kyung Won
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Cognition Disorders - diagnosis; Cognition Disorders - etiology; Female; Frontotemporal dementia; Frontotemporal Lobar Degeneration - classification; Frontotemporal Lobar Degeneration - complications; Humans; Male; Mental Status Schedule; Middle Aged; Motor neuron disease; Neuropsychological Tests; Parkinsonian Disorders - diagnosis; Parkinsonian Disorders - etiology; Parkinsonism; Primary progressive aphasia; Retrospective Studies; Severity of Illness Index
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2016.11.033

We investigated the prevalence of parkinsonism in frontotemporal dementia (FTD) subtypes and the cognitive and behavioral differences between FTD with and without parkinsonism in a well-structured, prospective cohort. One hundred and ninety-one FTD patients were enrolled and all patients underwent comprehensive neurological evaluations, neuropsychological tests, and the Unified Parkinson's Disease Rating Scale. The prevalence of parkinsonism was 38.7% (74 patients), and included 33 (46.5%) behavioral variant FTD (bvFTD), 16 (24.2%) semantic dementia (SD), 19 (45.2%) progressive nonfluent aphasia (PNFA), and 6 (50%) FTD associated with motor neuron disease (FTD-MND). SD patients with parkinsonism had higher CDR sum of boxes scores (9.7±4.5 vs 6.2±4.5, p=0.024), frontal behavioral inventory total score (33.7±20.5 vs 24.3±14.5, p=0.045), and executive function score of frontal executive dysfunction, disinhibition, and apathy (28.9±13.7 vs 19.2±12.9, p=0.021) than those without parkinsonism. Seoul Instrumental Activities of Daily Living score (bvFTD: 23.5±11.7 vs 17.3±11.3, p=0.031, SD: 23.1±11.1 vs 11.3±9.3, p=0.005) was higher for bvFTD and SD with parkinsonism than for those without parkinsonism. Parkinsonism is found to be more common in patients with bvFTD, PNFA, and FTD-MND patients than those with SD. Behavioral disturbances were more prominent in SD with parkinsonism than without. Additional studies are needed to determine the pathomechanism and optimal treatment of parkinsonism in different FTD subtypes. •Parkinsonism was present in about 40% of FTD and in all FTD subtypes.•Global cognitive deficits did not differ between FTD with and without parkinsonism.•Behavioral disturbances were more severe in SD patients with parkinsonism than in those without.•Instrumental ADL index was more impaired in bvFTD and SD patients with parkinsonism than in those without.•Parkinsonism may serve as an important clue to the diagnosis of FTD.