F2‐03‐03: Characterization of the behavioral and dysexecutive variants of Alzheimer's disease

• DOI: 10.1016/j.jalz.2015.07.118
• Publication Date: 2015-12-15T10:35:04Z
• Authors: Rik Ossenkoppele; Yolande A.L. Pijn...; David Perry; Brendan Cohn-Sheehy; Nienke M.E. Schel...; Jacob W. Vogel; Joel Kramer; Annelies van der ...; Renaud La Joie; Howard Rosen; Wiesje M. van der...; Lea Grinberg; Annemieke Rozemuller; Eric Huang; Bart N.M. van Ber...; Bruce L. Miller; Frederik Barkhof; William J. Jagust; Philip Scheltens; William Seeley; Gil D. Rabinovici
• Keywords: Neuropathology; Parahippocampal gyrus

A “frontal variant of Alzheimer's disease” has been described in patients with predominant behavioral or dysexecutive deficits caused by disease (AD) pathology. The description these rare AD phenotypes limited to case reports and small series, many characteristics are not well understood. We included 55 “behavioral-variant” (bvAD) a neuropathological diagnosis high-likelihood (n=17) and/or biomarker evidence pathology (n=44). In addition, we 29 autopsy/biomarker-defined dysexecutive-predominant syndrome (deAD). First, chart reviews were performed ascertain clinical features. Next, compared neuropsychological function brain atrophy (applying voxel-based morphometry) bvAD/deAD matched typical (amnestic-predominant) (tAD, n=58), autopsy-confirmed/AD biomarker-negative bvFTD (n=59), controls (n=61). First symptoms more often cognitive than behavioral. Apathy was the most common feature, while hyperorality perseverative/compulsive behaviors less prevalent. 52% bvAD met diagnostic criteria for possible bvFTD. 60% 40% deAD carried at least one Apolipoprotein E ε4 (ApoE4) allele. showed worse memory scores did differ from tAD, executive composite lower tAD.Voxelwise contrasts between revealed marked bilateral temporoparietal regions only frontal cortex. gray matter reductions lateral temporal gyrus, anterior posterior cingulate, inferior parietal lobule parahippocampal gyrus. Compared deAD, involvement, whereas tAD slightly affected posteriorly atrophy. Among 24 autopsied patients, two had primary co-morbid FTD-spectrum