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Clinical Presentation of Prodromal Frontotemporal Dementia

Division of Neurology, Geriatric Psychiatry Outreach Team, Vancouver Hospital, Vancouver, British Columbia, brad.hallam{at}vch.ca

Noah D. Silverberg, PhD

Department of Psychology, University of Windsor, Windsor, Ontario

Amanda K. LaMarre, MA

Department of Psychology

Ian R. A. Mackenzie, MD

Department of Pathology and Laboratory Medicine, University of British Columbia

Howard H. Feldman, MD

Division of Neurology, Clinic for Alzheimer's Disease and Related Disorders, University of British Columbia Hospital, Vancouver, British Columbia, Canada

Background. Misrecognition of symptoms in the early stages of frontotemporal dementia (FTD) frequently contributes to diagnostic delay. Three frameworks have been proposed for the clinical identification of prodromal FTD: (1) cognitive profiling, (2) the presence of behavioral/psychiatric symptoms in the absence of memory complaints, and (3) a combined approach of cognitive, behavioral, and neuroimaging features. Objective. To evaluate current conceptual frameworks for the clinical recognition of prodromal FTD with current empirical evidence. Method. We performed a comprehensive PsychINFO and MEDLINE database search to identify articles investigating the prodromal symptoms of FTD. Conclusions. The 3 frameworks capture important aspects of the clinical picture of prodromal FTD but require further refinement. The prodromal stage of FTD is characterized by both cognitive and behavioral features. Diagnostic accuracy will likely be improved by considering a combination of cognitive and behavioral features, because some features overlap with prodromes for Alzheimer's disease and vascular dementia.

Key Words: frontotemporal dementia • mild cognitive impairment • mild behavioral impairment • neuropsychiatric symptoms

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