Exploring Signatures of Neurodegeneration in Early-Onset Older-Age Bipolar Disorder and Behavioral Variant Frontotemporal Dementia

Frontiers in Neurology

Claudia Carmassi¹  Diana L. Matallana³  Rodrigo Pardo⁵  Francy Cruz-Sanabria⁵  Cristian Triviño-Martínez⁷  Pablo Alexander Reyes⁸  Milena García-García⁹ 

[1] Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy;Department of Translational Research, New Surgical, and Medical Technologies, University of Pisa, Pisa, Italy;Memory and Cognition Clinic, Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia;Mental Health Department, Hospital Universitario Fundación Santa Fe, Bogotá, Colombia;Neurosciences Research Group, Institute of Genetics, Universidad Nacional de Colombia, Bogotá, Colombia;Ph.D. Program in Neuroscience, Department of Psychiatry, Pontificia Universidad Javeriana, Bogotá, Colombia;Psychiatry Department, School of Medicine, Aging Institute, Pontificia Universidad Javeriana, Bogotá, Colombia;Radiology Department, Hospital Universitario San Ignacio, Bogotá, Colombia;School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia;

关键词: neurodegeneration;    structural connectivity;    surface-based morphometry;    diffusion tensor imaging;    neuropsychology;    frontotemporal dementia;   

DOI  :  10.3389/fneur.2021.713388

来源: DOAJ

【 摘 要 】

Introduction: Older-age bipolar disorder (OABD) may involve neurocognitive decline and behavioral disturbances that could share features with the behavioral variant of frontotemporal dementia (bvFTD), making the differential diagnosis difficult in cases of suspected dementia.Objective: To compare the neuropsychological profile, brain morphometry, and structural connectivity patterns between patients diagnosed with bvFTD, patients classified as OABD with an early onset of the disease (EO-OABD), and healthy controls (HC).Methods: bvFTD patients (n = 25, age: 66 ± 7, female: 64%, disease duration: 6 ± 4 years), EO-OABD patients (n = 17, age: 65 ± 9, female: 71%, disease duration: 38 ± 8 years), and HC (n = 28, age: 62 ± 7, female: 64%) were evaluated through neuropsychological tests concerning attention, memory, executive function, praxis, and language. Brain morphometry was analyzed through surface-based morphometry (SBM), while structural brain connectivity was assessed through diffusion tensor imaging (DTI).Results: Both bvFTD and EO-OABD patients showed lower performance in neuropsychological tests of attention, verbal fluency, working memory, verbal memory, and praxis than HC. Comparisons between EO-OABD and bvFTD showed differences limited to cognitive flexibility delayed recall and intrusion errors in the memory test. SBM analysis demonstrated that several frontal, temporal, and parietal regions were altered in both bvFTD and EO-OABD compared to HC. In contrast, comparisons between bvFTD and EO-OABD evidenced differences exclusively in the right temporal pole and the left entorhinal cortex. DTI analysis showed alterations in association and projection fibers in both EO-OABD and bvFTD patients compared to HC. Commissural fibers were found to be particularly affected in EO-OABD. The middle cerebellar peduncle and the pontine crossing tract were exclusively altered in bvFTD. There were no significant differences in DTI analysis between EO-OABD and bvFTD.Discussion: EO-OABD and bvFTD may share an overlap in cognitive, brain morphometry, and structural connectivity profiles that could reflect common underlying mechanisms, even though the etiology of each disease can be different and multifactorial.

【 授权许可】

Unknown