[P03.086] Utility of Neuropsychological Testing in the Differential Diagnosis of Early Behavioral Variant Frontotemporal Dementia (bvFTD) and Mild Cognitive Impairment (MCI)

Jenna Gasenberg, Philadelphia, PA, Katya Rascovsky, Philadelphia, PA, David Libon, Philadelphia, PA, Ashley Boller, Philadelphia, PA, Murray Grossman, Philadelphia, PA

OBJECTIVE: To determine whether neuropsychological testing can discriminate between patients with mild behavioral variant Frontotemporal Dementia (bvFTD) and Mild Cognitive Impairment (MCI). 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: 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: 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: 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.
Category - Aging and Dementia: Clinical

Tuesday, March 19, 2013 2:00 PM

Session P03: Frontotemporal Lobar Degeneration: Language and Cognition (2:00 PM-6:30 PM)