Abstract Details

Title Utility of Neuropsychological Testing in the Differential Diagnosis of Early Behavioral Variant Frontotemporal Dementia (bvFTD) and Mild Cognitive Impairment (MCI)

Topic Aging and Dementia

Presentation(s) P03 - (-)

Poster/Presentation
Number 086

Objective

Background BACKGROUND: Despite advances in the clinical characterization of bvFTD, early diagnosis can be difficult. The present study assessed the utility of neuropsychological assessment in the differential diagnosis of early bvFTD and MCI.

Design/Methods DESIGN/METHODS: We compared the cognitive performance of patients with early bvFTD (n=22) and MCI (n=18) (MMSE >25) on a brief neuropsychological protocol assessing verbal and visual memory (Philadelphia Verbal Learning Test, PVLT; delayed recall of the Rey-Osterrieth figure), processing speed (Trail-Making Test-A), language (30-item Boston Naming Test), working memory (Digits Backward), visuospatial ability (Rey-Osterrieth figure), verbal generation (FAS letter fluency; category fluency), and conceptual flexibility (Trail-Making Test-B; modified Visual-Verbal Test).

Results RESULTS: Despite comparable MMSE scores (bvFTD MMSE=27.3, MCI MMSE=26.6, p>.05), bvFTD patients performed significantly worse than MCI patients on letter fluency (bvFTD=26.9, MCI=38.6, T=3.0, p<.05) and the modified Visual-Verbal Test (bvFTD=16.5, MCI=18.5, T=2.2, p<.05), but significantly better on PVLT delayed recall (bvFTD=5.4 MCI=2.1, T=4.6, p<.05) and delayed recall of the Rey-Osterrieth figure (bvFTD=12.4, MCI=7.5, T=2.5, p<.05). A logistic regression model that included conceptual flexibility, letter fluency, and PVLT delayed recall correctly classified 85.7% of patients with early bvFTD and 83.3% of patients with MCI.

Conclusions CONCLUSIONS: BvFTD and MCI produce distinct neuropsychological profiles at early stages of disease. Measures such as MMSE may be insensitive to these distinctions. BvFTD patients were more impaired in tasks of verbal generation and conceptual flexibility (consistent with frontal lobe dysfunction), while patients with MCI were more impaired in tests of verbal and visual memory (consistent with hippocampal dysfunction). Overall, a brief neuropsychological protocol utilizing tests of memory, letter fluency and conceptual flexibility can help differentiate early bvFTD from MCI.

Authors/Disclosures
PRESENTER	No disclosure on file
Katya Rascovsky (University of Pennsylvania Perelman School of Medicine)	No disclosure on file
David J. Libon, PhD (Rowan Univerity)	No disclosure on file
Ashley Boller	No disclosure on file
Murray Grossman, MD, FAAN (University of Pennsylvania)	Dr. Grossman has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology. The institution of Dr. Grossman has received research support from NIH.
Francesco Muntoni, MD (UCL Institute of Child Health)	Dr. Muntoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sarepta. Dr. Muntoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pfizer. Dr. Muntoni has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sarepta. Dr. Muntoni has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Biogen. Dr. Muntoni has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Muntoni has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. The institution of Dr. Muntoni has received research support from European Commission. The institution of Dr. Muntoni has received research support from Medical Research Council. The institution of Dr. Muntoni has received research support from Biogen. The institution of Dr. Muntoni has received research support from Muscular Dystrophy UK. The institution of Dr. Muntoni has received research support from MDA USA. The institution of Dr. Muntoni has received research support from Sarepta. The institution of Dr. Muntoni has received research support from Association Francoise Myopathies. Dr. Muntoni has received personal compensation in the range of $0-$499 for serving as a Clinical expert with UK NICE Committee.

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