Neuropsychological Decline in Frontotemporal Lobar Degeneration: A Longitudinal Analysis

• Published in: Neuropsychology 2009-05, Vol.23 (3), p.337-346
• Main Authors: Libon, David J, Xie, Sharon X, Wang, Xingmei, Massimo, Lauren, Moore, Peachie, Vesely, Luisa, Khan, Alea, Chatterjee, Anjan, Coslett, H. Branch, Hurtig, Howard I, Liang, Tsao-Wei, Grossman, Murray
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Aged; Aged, 80 and over; Alzheimer Disease - complications; Alzheimer Disease - diagnosis; Alzheimer Disease - psychology; Alzheimer's Disease; Aphasia - complications; Aphasia - diagnosis; Aphasia - psychology; Biological and medical sciences; Cognition Disorders - etiology; Cognition Disorders - psychology; Cognitive Impairment; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia; Dementia - complications; Dementia - diagnosis; Dementia - psychology; Female; Follow-Up Studies; Human; Humans; Language Tests; Longitudinal Studies; Male; Medical sciences; Middle Aged; Neurocognition; Neurodegeneration; Neurology; Neuropsychological Tests; Neuropsychology; Organic mental disorders. Neuropsychology; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychomotor Performance; Psychopathology. Psychiatry; Semantics; Subtypes (Disorders); Task Performance and Analysis; Temporal Lobe; Time Factors; Verbal Learning; Visual Perception
• ISSN: 0894-4105; 1931-1559
• DOI: 10.1037/a0014995

Few studies have assessed whether the patterns of neuropsychological impairment in patients with different frontotemporal lobar degeneration (FTLD) subtypes remain distinct over the duration of their illness or devolve into a common, undifferentiated neuropsychological state. A longitudinal neuropsychological analysis was obtained over 100 months assessing executive control, language/naming, and visuoconstruction in 441 patients diagnosed with Alzheimer's disease (AD) and four FTLD subtypes, i.e., a social comportment/dysexecutive (SOC/EXEC) disorder; progressive non-fluent aphasia (PNFA); semantic dementia (SemD); and corticobasal degeneration (CBD). Initial group differences on each measure were maintained over the duration of illness, including several double dissociations. For example, AD patients exhibited a decline in 'animal' fluency; PNFA patients had difficulty on tests of executive control, SemD maintained their impairment on tests of naming, and CBD had presented with performance on visuoconstructional tests. None of the group by neuropsychological task interactions evaluating longitudinal decline was significant, suggesting that performance does not converge onto a common subtype over time. These data indicate that distinct patterns of neuropsychological impairment are maintained longitudinally, reflecting the unique anatomic distribution of relative disease burden in AD and FTLD.