Behavioral variant of frontotemporal dementia or frontal variant of alzheimer's disease? a case study
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | http://hdl.handle.net/1843/62841 |
Resumo: | Alzheimer’s disease (AD) has heterogeneous clinical presentations. Amnestic progressive disorder leading to dementia is the most typical, but non-amnestic presentations are also recognized. Here we report a case of frontal variant of AD. A right-handed woman, aged 68 years, was referred for progressive behavioral disorders and personality changes. She had a corroborated history of dietary changes, hyperorality, impulsivity, affective indifference and apathy, with functional impairment. Cognitive assessment yielded severe executive deficits. Positron emission tomography with fluorodeoxyglucose showed marked hypometabolism in frontotemporal regions, with relative preservation of parietal regions. CSF AD biomarkers showed low Aβ42, high Tau and high P-Tau. The patient fulfilled criteria for probable behavioral variant frontotemporal dementia. However, considering the AD pathophysiological signature on CSF biomarkers, a diagnosis of frontal variant of AD was established. In the perspective of disease-modifying therapies, it is important to identify atypical Alzheimer presentations, as these patients may be candidates for specific treatments. |
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2024-01-15T21:19:00Z2024-01-15T21:19:00Z201913335636010.1590/1980-57642018dn13-03001519805764http://hdl.handle.net/1843/62841Alzheimer’s disease (AD) has heterogeneous clinical presentations. Amnestic progressive disorder leading to dementia is the most typical, but non-amnestic presentations are also recognized. Here we report a case of frontal variant of AD. A right-handed woman, aged 68 years, was referred for progressive behavioral disorders and personality changes. She had a corroborated history of dietary changes, hyperorality, impulsivity, affective indifference and apathy, with functional impairment. Cognitive assessment yielded severe executive deficits. Positron emission tomography with fluorodeoxyglucose showed marked hypometabolism in frontotemporal regions, with relative preservation of parietal regions. CSF AD biomarkers showed low Aβ42, high Tau and high P-Tau. The patient fulfilled criteria for probable behavioral variant frontotemporal dementia. However, considering the AD pathophysiological signature on CSF biomarkers, a diagnosis of frontal variant of AD was established. In the perspective of disease-modifying therapies, it is important to identify atypical Alzheimer presentations, as these patients may be candidates for specific treatments.A doença de Alzheimer (DA) tem apresentações clínicas heterogêneas. Amnésia progressiva associada a demência é a forma mais comum, mas apresentações não-amnésticas são também reconhecidas. Relatamos um caso de variante frontal da DA. Um mulher destra, de 68 anos, consultou-se devido a transtornos comportamentais progressivos, com alterações de personalidade. Modificações de padrão alimentar, hiperoralidade, impulsividade, indiferença afetiva e apatia, com declínio funcional, foram corroboradas pela família. A avaliação cognitiva evidenciou grave disfunção executiva. A tomografia de emissão de pósitrons com flúordeoxiglicose revelou proeminente hipometabolismo em regiões frontotemporais, com relativa preservação de regiões parietais. A análise de biomarcadores de DA no líquido cefalorraquidiano mostrou redução de níveis de Aβ42, com aumento de níveis de Tau e P-Tau. A paciente preencheu critérios diagnósticos para demência frontotemporal (variante comportamental) provável. Contudo, considerando o perfil de biomarcadores em favor de fisiopatologia da DA, o diagnóstico de variante frontal de DA foi estabelecido. Na perspectiva de tratamentos modificadores da doença, é crucial identificar apresentações atípicas da DA, visto que esses pacientes podem ser candidatos a terapias específicas.porUniversidade Federal de Minas GeraisUFMGBrasilMED - DEPARTAMENTO DE CLÍNICA MÉDICADementia & NeuropsychologiaAlzheimer’s diseaseFrontotemporal DementiaBiomarkersAlzheimer’s diseaseFrontotemporal DementiaBiomarkersBehavioral variant of frontotemporal dementia or frontal variant of alzheimer's disease? a case studyVARIANTE COMPORTAMENTAL DA DEMÊNCIA FRONTOTEMPORAL OU VARIANTE FRONTAL DA DOENÇA DE ALZHEIMER? UM ESTUDO DE CASOinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.1590/1980-57642018dn13-030015Leonardo Cruz de SouzaLuciano Inácio MarianoRenata Freire de MoraesPaulo Caramelliapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/62841/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALBehavioral variant of frontotemporal dementia pdfa.pdfBehavioral variant of frontotemporal dementia pdfa.pdfapplication/pdf4002221https://repositorio.ufmg.br/bitstream/1843/62841/2/Behavioral%20variant%20of%20frontotemporal%20dementia%20pdfa.pdf9386783aaa0b025023bc5b4540610cb1MD521843/628412024-01-15 18:26:30.679oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2024-01-15T21:26:30Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Behavioral variant of frontotemporal dementia or frontal variant of alzheimer's disease? a case study |
dc.title.alternative.pt_BR.fl_str_mv |
VARIANTE COMPORTAMENTAL DA DEMÊNCIA FRONTOTEMPORAL OU VARIANTE FRONTAL DA DOENÇA DE ALZHEIMER? UM ESTUDO DE CASO |
title |
Behavioral variant of frontotemporal dementia or frontal variant of alzheimer's disease? a case study |
spellingShingle |
Behavioral variant of frontotemporal dementia or frontal variant of alzheimer's disease? a case study Leonardo Cruz de Souza Alzheimer’s disease Frontotemporal Dementia Biomarkers Alzheimer’s disease Frontotemporal Dementia Biomarkers |
title_short |
Behavioral variant of frontotemporal dementia or frontal variant of alzheimer's disease? a case study |
title_full |
Behavioral variant of frontotemporal dementia or frontal variant of alzheimer's disease? a case study |
title_fullStr |
Behavioral variant of frontotemporal dementia or frontal variant of alzheimer's disease? a case study |
title_full_unstemmed |
Behavioral variant of frontotemporal dementia or frontal variant of alzheimer's disease? a case study |
title_sort |
Behavioral variant of frontotemporal dementia or frontal variant of alzheimer's disease? a case study |
author |
Leonardo Cruz de Souza |
author_facet |
Leonardo Cruz de Souza Luciano Inácio Mariano Renata Freire de Moraes Paulo Caramelli |
author_role |
author |
author2 |
Luciano Inácio Mariano Renata Freire de Moraes Paulo Caramelli |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Leonardo Cruz de Souza Luciano Inácio Mariano Renata Freire de Moraes Paulo Caramelli |
dc.subject.por.fl_str_mv |
Alzheimer’s disease Frontotemporal Dementia Biomarkers |
topic |
Alzheimer’s disease Frontotemporal Dementia Biomarkers Alzheimer’s disease Frontotemporal Dementia Biomarkers |
dc.subject.other.pt_BR.fl_str_mv |
Alzheimer’s disease Frontotemporal Dementia Biomarkers |
description |
Alzheimer’s disease (AD) has heterogeneous clinical presentations. Amnestic progressive disorder leading to dementia is the most typical, but non-amnestic presentations are also recognized. Here we report a case of frontal variant of AD. A right-handed woman, aged 68 years, was referred for progressive behavioral disorders and personality changes. She had a corroborated history of dietary changes, hyperorality, impulsivity, affective indifference and apathy, with functional impairment. Cognitive assessment yielded severe executive deficits. Positron emission tomography with fluorodeoxyglucose showed marked hypometabolism in frontotemporal regions, with relative preservation of parietal regions. CSF AD biomarkers showed low Aβ42, high Tau and high P-Tau. The patient fulfilled criteria for probable behavioral variant frontotemporal dementia. However, considering the AD pathophysiological signature on CSF biomarkers, a diagnosis of frontal variant of AD was established. In the perspective of disease-modifying therapies, it is important to identify atypical Alzheimer presentations, as these patients may be candidates for specific treatments. |
publishDate |
2019 |
dc.date.issued.fl_str_mv |
2019 |
dc.date.accessioned.fl_str_mv |
2024-01-15T21:19:00Z |
dc.date.available.fl_str_mv |
2024-01-15T21:19:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/62841 |
dc.identifier.doi.pt_BR.fl_str_mv |
10.1590/1980-57642018dn13-030015 |
dc.identifier.issn.pt_BR.fl_str_mv |
19805764 |
identifier_str_mv |
10.1590/1980-57642018dn13-030015 19805764 |
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http://hdl.handle.net/1843/62841 |
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por |
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por |
dc.relation.ispartof.none.fl_str_mv |
Dementia & Neuropsychologia |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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Universidade Federal de Minas Gerais |
dc.publisher.initials.fl_str_mv |
UFMG |
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Brasil |
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MED - DEPARTAMENTO DE CLÍNICA MÉDICA |
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Universidade Federal de Minas Gerais |
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reponame:Repositório Institucional da UFMG instname:Universidade Federal de Minas Gerais (UFMG) instacron:UFMG |
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