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A meta-analysis of neuropsychological, social cognitive, and olfactory functioning in the behavioral and language variants of frontotemporal dementia

Published online by Cambridge University Press:  06 December 2018

Vidyulata Kamath Open the ORCID record for Vidyulata Kamath [Opens in a new window] ,
Grace-Anna S. Chaney ,
Jonathan DeRight  and
Chiadi U. Onyike
Vidyulata Kamath*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Baltimore, MD, USA
Grace-Anna S. Chaney
Affiliation:
Department of Psychiatry and Behavioral Sciences, Baltimore, MD, USA
Jonathan DeRight
Affiliation:
Department of Psychiatry and Behavioral Sciences, Baltimore, MD, USA
Chiadi U. Onyike
Affiliation:
Department of Psychiatry and Behavioral Sciences, Baltimore, MD, USA Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
*
Author for correspondence: Vidyulata Kamath, E-mail: vkamath@jhmi.edu
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Abstract

Background

Though meta-analyses of neuropsychological and social cognitive deficits in behavioral variant frontotemporal dementia (bvFTD) have been conducted, no study has comprehensively characterized and compared the neuropsychological, social cognitive, and olfactory profiles in the behavioral and language variants of FTD.

Methods

Our search yielded 470 publications meeting inclusion criteria representing 11 782 FTD patients and 19 451 controls. For each domain, we calculated Hedges’ g effect sizes, which represent the mean difference between the patient and control group divided by the pooled standard deviation. The heterogeneity of these effects was assessed with Cochran's Q-statistic using a random-effects model. Meta-regressions were employed to analyze the influence of demographic and disease characteristics.

Results

Though semantic variant primary progressive aphasia patients showed the greatest impairment across all task types, the three groups showed similar cognitive effect sizes once contributions from the language subdomain were excluded from analysis. Contrary to expectation, the magnitude of deficits in executive functioning, social cognition and olfaction were comparable between the three subgroups. Among indices, a metric of executive errors distinguished the behavioral variant of FTD from the language phenotypes.

Conclusions

These data indicate that social cognitive and traditional executive functioning measures may not capture differences between FTD syndromes. These results have important implications for the interpretation of neuropsychological assessments, particularly when applied to the differential diagnosis of FTD. It is hoped that these findings will guide clinical and research assessments and spur new studies focused on improving the measurement of FTD syndromes.

Keywords

Cognitionemotionfrontotemporal lobar degenerationprimary progressive aphasiaprogressive non-fluent aphasiasemantic dementiasemantic variant primary progressive aphasia
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 16 , December 2019 , pp. 2669 - 2680
Copyright
Copyright © Cambridge University Press 2018 

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