Psychosis in frontotemporal dementia

J Alzheimers Dis. 2014;42(2):485-99. doi: 10.3233/JAD-140312.

Abstract

Frontotemporal dementia (FTD) is a neurodegenerative disorder, associated with a progressive decline in behavior caused by focal degeneration of the frontal lobes. Psychosis was an underestimated symptom of FTD, however, recent genetic research has revealed a high prevalence of psychosis in certain genetic groups. The primary objective of this work is to review the literature on psychosis in FTD and to propose directions for future research, with reference to findings on psychosis in schizophrenia. A search was performed using PubMed, MEDLINE, and EMBASE. Search terms included "frontotemporal dementia", "psychosis", "schizophreni*", "psychotic symptoms", "hallucinations", and "delusions", and it identified 122 articles. Results revealed: 1) prevalence is approximately 10%, 2) TDP-43 type B and FUS pathologies might have relatively high frequency of psychosis, 3) psychosis in FTD is higher with genetic mutations of C9ORF72 and GRN, 4) imaging researches did not achieve conclusive results, and 5) no treatment for psychosis in FTD is currently available. A limitation of this systematic review is that it includes a small number of studies specifically examining psychosis in FTD. It is suggested that a possible overlap exists between FTD and schizophrenia. This potential overlap indicates a vulnerability to psychosis due to brain systems and pathways shared by these disorders.

Keywords: Frontotemporal dementia; gene mutation; neuropathology; psychosis; schizophrenia.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • C9orf72 Protein
  • Databases, Bibliographic / statistics & numerical data
  • Frontotemporal Dementia / complications*
  • Frontotemporal Dementia / genetics
  • Humans
  • Intercellular Signaling Peptides and Proteins / genetics
  • Progranulins
  • Proteins / genetics
  • Psychotic Disorders / etiology*
  • Psychotic Disorders / genetics

Substances

  • C9orf72 Protein
  • C9orf72 protein, human
  • GRN protein, human
  • Intercellular Signaling Peptides and Proteins
  • Progranulins
  • Proteins