Clinico-Pathological Correlations of the Frontal Lobe Syndrome: Results of a Large Brain Bank Study

• Published in: Dementia and geriatric cognitive disorders 2015-09, Vol.40 (3-4), p.121-129
• Main Authors: Krudop, Welmoed A., Bosman, Sjanne, Geurts, Jeroen J.G., Sikkes, Sietske A.M., Verwey, Nicolaas A., Stek, Max L., Scheltens, Philip, Rozemuller, Annemieke J.M., Pijnenburg, Yolande A.L.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Alzheimer Disease - pathology; Autopsy; Complications and side effects; Development and progression; Diagnosis; Female; Frontal Lobe - pathology; Frontal lobe dysfunction; Frontotemporal Dementia - pathology; Humans; Male; Middle Aged; Netherlands; Neurodegenerative diseases; Neurodegenerative Diseases - pathology; Original Research Article; Retrospective Studies; Risk factors; Statistics; Tissue Banks
• ISSN: 1420-8008; 1421-9824
• DOI: 10.1159/000430460

Aims: A clinical frontal lobe syndrome (FLS) is generally attributed to functional or structural disturbances within frontal-subcortical circuits. We studied the distribution of pathological brain changes in FLS. Additionally, the prevalence of FLS among various disorders was studied. Methods: We systematically screened clinical files of donors to the Netherlands Brain Bank (n = 2,814) for FLS. A total of 262 FLS cases were identified, and the distribution of postmortem pathological changes within the frontal-subcortical circuits was extracted from their neuropathological reports. Results: In 244 out of 262 patients (93%), pathological changes within the frontal-subcortical circuits were found: 90 subjects (34%) with frontal cortical pathology and 18 (7%) with pathology restricted to subcortical grey matter nuclei, whereas 136 subjects (52%) showed both cortical and subcortical pathology. In 18 subjects (7%), no pathology was found in the examined areas. The prevalence of FLS was highest in frontal-temporal lobar degeneration, followed by progressive supranuclear palsy and vascular dementia [χ 2 (6, n = 1,561) = 222.64, p < 0.01]. Conclusion: In this large brain bank study, the distribution of pathological changes in subjects with FLS was shown to be frontal-subcortical for the first time. A minority of FLS cases had pathology in the subcortical regions only or no frontal pathology at all.