By Simon Ducharme, Bruce H. Price, Mykol Larvie, Darin D. Dougherty, and Bradford C. Dickerson | American Journal of Psychiatry | September 1, 2015

Summary:

Frontotemporal dementia (FTD) describes a heterogeneous group of neurodegenerative diseases featuring various combinations of behavioral changes, language abnormalities, social cognitive impairment, and executive function deficits. FTD is divided into two major clinical syndromes: the behavioral variant (bvFTD) (1) and the language variants referred to as primary progressive aphasias (2).

Identifying bvFTD is challenging because symptoms can be subtle in the early stages, and they may combine features that are traditionally within the realm of psychiatry (e.g., personality changes, lack of empathy, compulsions) and others usually seen by neurologists (e.g., aphasia, cognitive impairments). Patients are often first evaluated in general psychiatric settings, and about 50% are initially diagnosed with a primary psychiatric illness (3).

Knowledge about FTD has grown exponentially over the past 10 years, and it is crucial for psychiatrists to include bvFTD as part of their differential diagnosis in a wide range of adult psychiatric disorders. In this article, we review the clinical approach to bvFTD, focusing in particular on the differential diagnosis between bvFTD and primary psychiatric disorders.

Read the full paper here.

By Erika Hayasaki | The Atlantic | January 9, 2014

While Alzheimer’s usually affects older people, and is detected as a person begins to lose memory, frontotemporal dementia causes people to lose their personalities first, and usually hits in the prime of their lives — the 30s, 40s, and 50s.

Over the last decade, new research in patients with frontotemporal dementia and other illnesses, has helped neuroscientists understand more about the roles different parts of the brain play in where our personalities come from.

A study released in October by Dr. Brad Dickerson, [Dr. Lisa Feldman Barrett,] and colleagues at Harvard Medical School in the Journal of Neurology, Neurosurgery & Psychiatry pinpointed regions in the brain that showed atrophy from frontotemporal dementia and found that those with the most damage to the “perception network” (amygdala, orbitofrontal cortex, superior temporal, and fusiform cortex) also showed the most prominent difficulty responding to social cues, facial expressions, and eye gaze, and had the most trouble interpreting gestures and body language—the kind of cues that sarcasm relies on.

Read the full article at The Atlantic Monthly.