First Symptoms and Neurocognitive Correlates of Behavioral Variant Frontotemporal Dementia

Hernando Santamaría-García, Pablo Reyes, Adolfo García, Sandra Baéz, Angela Martinez, José Manuel Santacruz, Andrea Slachevsky, Mariano Sigman, Diana Matallana, Agustín Ibañez

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Background: Previous works highlight the neurocognitive differences between apathetic and disinhibited clinical presentations of the behavioral variant frontotemporal dementia (bvFTD). However, little is known regarding how the early presentation (i.e., first symptom) is associated to the neurocognitive correlates of the disease's clinical presentation at future stages of disease. Objectives: We analyzed the neurocognitive correlates of patients with bvFTD who debuted with apathy or disinhibition as first symptom of disease. Methods: We evaluated the neuropsychological, clinical, and neuroanatomical (3T structural images) correlates in a group of healthy controls (n=30) and two groups of bvFTD patients (presented with apathy [AbvFTD, n=18] or disinhibition [DbvFTD, n=16]). To differentiate groups according to first symptoms, we used multivariate analyses. Results: The first symptom in patients described the evolution of the disease. AbvFTD and DbvFTD patients showed increased brain atrophy and increased levels of disinhibition and apathy, respectively. Whole brain analyzes in AbvFTD revealed atrophy in the frontal, insular, and temporal areas. DbvFTD, in turn, presented atrophy in the prefrontal regions, temporoparietal junction, insula, and temporoparietal region. Increased atrophy in DbvFTD patients (compared to AbvFTD) was observed in frontotemporal regions. Multivariate analyses confirmed that a set of brain areas including right orbitofrontal, right dorsolateral prefrontal, and left caudate were enough to distinguish the patients' subgroups.Conclusion: First symptom in bvFTD patients described the neurocognitive impairments after around three years of disease, playing an important role in the early detection, disease tracking, and neuroanatomical specification of bvFTD, as well as in future research on potential disease-modifying treatments.

Original languageEnglish
Pages (from-to)957-970
Number of pages14
JournalJournal of Alzheimer's Disease
Issue number3
StatePublished - 2016


  • Apathy
  • apathy
  • behavioral variant frontotemporal dementia
  • first symptom
  • voxel-based morphometry


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