Improving the Diagnosis of the Frontal Variant of Alzheimer's Disease with the DAPHNE Scale.

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Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_F36CF4966FCE
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Improving the Diagnosis of the Frontal Variant of Alzheimer's Disease with the DAPHNE Scale.
Journal
Journal of Alzheimer's disease
Author(s)
Lehingue E., Gueniat J., Jourdaa S., Hardouin J.B., Pallardy A., Courtemanche H., Rocher L., Etcharry-Bouyx F., Auriacombe S., Mollion H., Formaglio M., Rouaud O., Bretonnière C., Thomas-Antérion C., Boutoleau-Bretonnière C.
ISSN
1875-8908 (Electronic)
ISSN-L
1387-2877
Publication state
Published
Issued date
2021
Peer-reviewed
Oui
Volume
79
Number
4
Pages
1735-1745
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
The frontal variant of Alzheimer's disease (fAD) is poorly understood and poorly defined. The diagnosis remains challenging. The main differential diagnosis is the behavioral variant of frontotemporal degeneration (bvFTD). For fAD, there is some dissociation between the clinical frontal presentation and imaging and neuropathological studies, which do not always find a specific involvement of the frontal lobes. DAPHNE is a behavioral scale, which demonstrated excellent performance to distinguish between bvFTD and AD.
The aim of the present study was to assess the reliability of this new tool to improve the clinical diagnosis of fAD.
Twenty fAD patients and their caregivers were prospectively included and were compared with 36 bvFTD and 22 AD patients.
The three main behavioral disorders in the fAD patients were apathy, loss of empathy, and disinhibition. Three disorders were discriminant because they were less frequent and less severe in the fAD patients than in the bvFTD patients, namely hyperorality, neglect, and perseverations. This specific pattern of behavioral disorders was corroborated by SPECT or 18FDG PET-CT scan that showed that patients with fAD could have a medial frontal hypoperfusion, whereas in bvFTD patients the orbitofrontal cortex was the main involved region, with more diffuse hypoperfusion.
We demonstrated that DAPHNE had good sensitivity and good specificity to discriminate between the three groups and in particular between fAD and bvFTD patients. DAPHNE is a quick tool that could help clinicians in memory clinics not only to differentiate bvFTD from typical AD but also from fAD.
Keywords
Aged, Alzheimer Disease/diagnosis, Alzheimer Disease/pathology, Cohort Studies, Diagnosis, Differential, Female, Frontal Lobe/pathology, Frontotemporal Dementia/diagnosis, Humans, Male, Middle Aged, Neuropsychological Tests, Alzheimer’s disease, behavioral disorders, frontotemporal dementia, scale
Pubmed
Web of science
Open Access
Yes
Create date
26/01/2021 13:52
Last modification date
02/12/2023 7:29
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