Executive and behavioral deficits share common neural substrates in frontotemporal lobar degeneration - a pilot FDG-PET study

Psychiatry Res. 2010 Jun 30;182(3):274-80. doi: 10.1016/j.pscychresns.2010.02.009. Epub 2010 May 20.

Abstract

Behavioral and executive dysfunctions are typical symptoms of frontotemporal lobar degeneration, associated with its subtypes frontotemporal and semantic dementia. Although both functions depend on the frontal lobes, no study has yet compared their neural correlates in frontotemporal lobar degeneration. Accordingly, we correlated clinical scores of behavioral and executive deficits with glucose utilization as measured by [(18)F]fluorodeoxyglucose positron emission tomography in 17 patients with frontotemporal lobar degeneration and 9 age- and sex-matched control subjects. Impairment in executive functions was measured by the Behavioral Assessment of the Dysexecutive Syndrome, a modified Stroop paradigm and/or the Tower of Toronto Test. Behavioral deficits were examined with the Neuropsychiatric Inventory. Executive dysfunction was correlated with diminished glucose utilization in frontomedial and frontolateral cortices. Brain regions included the anterior cingulate and midcingulate gyri, anterior medial frontal cortex, and left frontolateral cortex. Behavioral deficits were associated with mainly frontomedial networks, particularly the anterior medial frontal cortex, gyrus rectus, and area subcallosa. Our pilot study reveals partially overlapping neural correlates of executive and behavioral dysfunction in frontotemporal lobar degeneration. The results suggest that some behavioral deficits, namely disinhibition and appetite and eating abnormalities, are particularly related to executive dysfunction. This hypothesis might be further explored in studies involving larger patient groups.

MeSH terms

  • Aged
  • Behavioral Symptoms* / diagnostic imaging
  • Behavioral Symptoms* / etiology
  • Behavioral Symptoms* / pathology
  • Brain Mapping*
  • Cognition Disorders* / diagnostic imaging
  • Cognition Disorders* / etiology
  • Cognition Disorders* / pathology
  • Executive Function / physiology*
  • Female
  • Fluorodeoxyglucose F18
  • Frontotemporal Lobar Degeneration* / complications
  • Frontotemporal Lobar Degeneration* / diagnostic imaging
  • Frontotemporal Lobar Degeneration* / pathology
  • Humans
  • Male
  • Mental Status Schedule
  • Middle Aged
  • Neuropsychological Tests
  • Pilot Projects
  • Positron-Emission Tomography / methods
  • Statistics as Topic

Substances

  • Fluorodeoxyglucose F18