Abstract Details

Title Primary Reward Seeking in Frontotemporal Dementia

Topic Behavioral Neurology

Presentation(s) P05 - (-)

Poster/Presentation
Number 111

Objective

Background BACKGROUND: Several of the characteristic symptoms of bvFTD suggest abnormal processing of rewards. These include craving of sweet foods, overeating, apathy, and overspending. The use of alcohol and drugs of abuse and changes in sexual behavior have also been reported. Many of the regions that are vulnerable to degeneration in bvFTD, including ventromedial prefrontal cortex, ventral striatum, and anterior insula, are also implicated in processing of rewards. Primary rewards, such as pleasant food, sex, and drugs, may be particularly salient to bvFTD patients.

Design/Methods DESIGN/METHODS: Records were reviewed for patients with bvFTD who participated in research at the UCSF Memory and Aging Center. Information was gathered regarding change in seeking of primary rewards, particularly overeating/sweet food craving, hyper- or hyposexuality, and new or increased use of alcohol and drugs. We defined a primary reward seeking score from 0-3, with increased seeking of food, sexual, and drug reward each given one point. The anatomic correlates of these behaviors were determined by voxel-based morphometry (VBM).

Results RESULTS: Of 93 patients reviewed, overeating or sweet craving occurred in 71 (76.3%), alcohol or drug use in 27 (29%), and hypersexuality was found in 13 (14%). Five (5.4%) were described as hyposexual. VBM was performed on 85 patients. Having a higher primary reward seeking score correlated with atrophy in the right ventral pallidum (p<.05, Family Wise Error corrected). When assessed individually, the three reward-related behaviors were associated with atrophy in partially overlapping right hemisphere reward-circuit regions including putamen, insula, and hypothalamus.

Conclusions CONCLUSIONS: Primary reward seeking behaviors are frequent in bvFTD and are associated with degeneration of reward circuit structures, suggesting either an enhanced sensitivity to primary reward or decreased sensitivity to negative consequences of their behavior.

Authors/Disclosures
David Perry, MD PRESENTER	The institution of Dr. Perry has received research support from NIH/NIA.
Douglas L. Arnold, MD, FAAN (Montreal Neurological Institute, McGill Univ)	Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for BMS. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Frequency Therapeutics. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Xfacto communications. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Find therapeutics. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GSK. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Idorsia. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kiniksa. Dr. Arnold has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Clario.
Virginia Sturm, PhD	Dr. Sturm has nothing to disclose.
Bruce L. Miller, MD, FAAN (University of California, San Francisco)	Dr. Miller has nothing to disclose.
Howard J. Rosen, MD (UCSF)	Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly . Dr. Rosen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alector. The institution of Dr. Rosen has received research support from NIH. The institution of Dr. Rosen has received research support from State of CA. Dr. Rosen has a non-compensated relationship as a Consultant with Prevail Therapeutics that is relevant to AAN interests or activities. Dr. Rosen has a non-compensated relationship as a consultant with Alchemab that is relevant to AAN interests or activities.
Joel Kramer, PhD (UCSF Medical Center)	The institution of Dr. Kramer has received research support from tau consortium. Dr. Kramer has received publishing royalties from a publication relating to health care.

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