Showing papers by "Katherine P. Rankin published in 2008"
TL;DR: The emerging role of neuropsychology is discussed in elucidating the brain organization of complex processes including empathy, behavioral control and inhibition, reward systems, appetitive behaviors, emotional regulation, and goal-orientation in frontotemporal dementia.
Abstract: Frontotemporal lobar degeneration (FTLD) represent a constellation of disorders that may be overlooked or misdiagnosed, despite being fairly common presenile neurodegenerative diseases. Although the cognitive disorder can be difficult to document, particularly early in the dementia course, neuropsychological evaluation can assist in the diagnosis. Neuropsychologists are in an excellent position to draw from related disciplines like personality theory and social psychology to better assess the types of changes that characterize the prodromal and early phases of the disease. This review summarizes the current state of the field in the diagnosis of FTLD and discusses the emerging role of neuropsychology in elucidating the brain organization of complex processes including empathy, behavioral control and inhibition, reward systems, appetitive behaviors, emotional regulation, and goal-orientation. As this review underscores, frontotemporal dementia remains a powerful model for studying brain–behavior relationships.
94 citations
TL;DR: Improve screening for behavioral dementias in primary care and mental health settings by quantifying spontaneous social behaviors specific to FTLD and specific, abnormal, interpersonal behaviors can alert nonexperts to the need for specialized dementia referral.
Abstract: Objective: Changes in social behavior are often the first symptoms of neurodegenerative disease. Patients with frontotemporal lobar degeneration (FTLD) often go undiagnosed, or are misclassified as psychiatric patients, because in the absence of cognitive deficits, nonexperts fail to recognize these social changes as dementia symptoms. The object of this study was to improve screening for behavioral dementias in primary care and mental health settings by quantifying spontaneous social behaviors specific to FTLD. Method: In a university hospital dementia clinic, examiners blind to subject diagnosis performed 1 hour of cognitive testing, then completed the Interpersonal Measure of Psychopathy, an 18-item checklist of observed inappropriate behaviors. Patients then underwent a multidisciplinary evaluation to derive a neurodegenerative or psychiatric diagnosis. Data were collected from 288 subjects: 45 Alzheimer's disease (National Institute of Neurologic and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association research criteria); 40 frontotemporal dementia, 21 semantic dementia, and 13 progressive nonfluent aphasia (Neary research criteria); 14 corticobasal degeneration and 21 progressive supranuclear palsy (Litvan research criteria); 37 dementia with Lewy bodies (McKeith research criteria); 16 vascular dementia (Ischemic Vascular Disease research criteria); 29 mixed vascular and Alzheimer's disease (Alzheimer's Disease Diagnostic and Treatment Centers criteria); and 35 primary psychiatric disorder (DSM-IV) patients and 17 normal older controls. The study was conducted from March 2002 to January 2005. Results: Statistical item analyses demonstrated specific patterns of social behavior that differentiated both frontotemporal dementia and semantic dementia patients from (1) nondementing older adults, (2) nondementing individuals with psychiatric conditions, (3) individuals with cerebrovascular disease, and (4) individuals with other neurodegenerative disorders. Semantic dementia patients verbally and physically interrupted evaluations, spoke perseveratively and tangentially, and resisted clinician redirection. Frontotemporal dementia patients were apathetic or disinhibited and were unconcerned about meeting clinician expectations. Conclusion: Specific, abnormal, interpersonal behaviors can alert nonexperts to the need for specialized dementia referral.
61 citations