TY - JOUR
T1 - The Frontotemporal Dementia versus Primary Psychiatric Disorder (FTD versus PPD) Checklist: A Bedside Clinical Tool to Identify Behavioral Variant FTD in Patients with Late-Onset Behavioral Changes
T2 - A Bedside Clinical Tool to Identify Behavioral Variant FTD in Patients with Late-Onset Behavioral Changes
AU - Ducharme, Simon
AU - Pearl-Dowler, Leora
AU - Gossink, Flora
AU - McCarthy, Jillian
AU - Lai, Jimmy
AU - Dickerson, Bradford C.
AU - Chertkow, Howard
AU - Rapin, Lucile
AU - Vijverberg, Everard
AU - Krudop, Welmoed
AU - Dols, Annemieke
AU - Pijnenburg, Yolande
N1 - Funding Information: Dr. Ducharme receives salary and operating funds from the Fonds de Recherche du Québec – Santé. Research at the Amsterdam University Medical Centre Alzheimer Centre is part of the neurodegener-ation research program of the Neuroscience Campus Amsterdam. Amsterdam University Medical Centre Alzheimer Centre is supported by Alzheimer Nederland and Stichting VUmc funds. Publisher Copyright: © 2019 IOS Press and the authors. All rights reserved. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: Differentiating early behavioral variant frontotemporal dementia (bvFTD) and primary psychiatric disorders (PPD) is complex and biomarkers have limited accuracy, leading to inaccurate diagnoses. Objectives: Develop a simple bedside clinical tool to differentiate bvFTD from PPD. Methods: A checklist of clinical features differentiating bvFTD from PPD was developed based on literature and clinical experience. The checklist was filled prospectively for 29 consecutive patients (Montreal Neurological Hospital) with lateonset (≥ age 40) behavioral changes suggestive of bvFTD. The checklist was subsequently retrospectively completed on the baseline visit (N = 137) of the Late-Onset Frontal Lobe study (Amsterdam). In both cohorts, patients were followed 2 years to establish a final best clinical diagnosis, categorizing patients into Probable FTD (N = 46), Possible FTD (N = 8), Other Cognitive Disorder (N = 36), Other Neurological Disorder (N = 10), or PPD (N = 66). Results: All items distinguished the two groups except "duration more than 5 years", which was removed to create a final 17-item version. Mean checklist scores were significantly different across all groups (Oneway ANOVA F(4,161) = 27.462, p < 0.001). The PPD group had lower scores than all other dementia categories, with the largest difference between Probable FTD (X = 12.04) and PPD (X = 7.48). A score ≥ 11 was found to be strongly indicative of bvFTD (specificity 93.9%, sensitivity 71.1%, PPV 89.2%). Scores ≤8 were strongly indicative of a PPD (specificity 91.3%, sensitivity 77.3%, PPV 92.7%). Patient with scores of 9.10 are considered indeterminate. Conclusions: Although further prospective validation is required, the "FTD vs PPD Checklist" could provide a simple tool to improve diagnostic accuracy, particularly in non-specialized settings.
AB - Background: Differentiating early behavioral variant frontotemporal dementia (bvFTD) and primary psychiatric disorders (PPD) is complex and biomarkers have limited accuracy, leading to inaccurate diagnoses. Objectives: Develop a simple bedside clinical tool to differentiate bvFTD from PPD. Methods: A checklist of clinical features differentiating bvFTD from PPD was developed based on literature and clinical experience. The checklist was filled prospectively for 29 consecutive patients (Montreal Neurological Hospital) with lateonset (≥ age 40) behavioral changes suggestive of bvFTD. The checklist was subsequently retrospectively completed on the baseline visit (N = 137) of the Late-Onset Frontal Lobe study (Amsterdam). In both cohorts, patients were followed 2 years to establish a final best clinical diagnosis, categorizing patients into Probable FTD (N = 46), Possible FTD (N = 8), Other Cognitive Disorder (N = 36), Other Neurological Disorder (N = 10), or PPD (N = 66). Results: All items distinguished the two groups except "duration more than 5 years", which was removed to create a final 17-item version. Mean checklist scores were significantly different across all groups (Oneway ANOVA F(4,161) = 27.462, p < 0.001). The PPD group had lower scores than all other dementia categories, with the largest difference between Probable FTD (X = 12.04) and PPD (X = 7.48). A score ≥ 11 was found to be strongly indicative of bvFTD (specificity 93.9%, sensitivity 71.1%, PPV 89.2%). Scores ≤8 were strongly indicative of a PPD (specificity 91.3%, sensitivity 77.3%, PPV 92.7%). Patient with scores of 9.10 are considered indeterminate. Conclusions: Although further prospective validation is required, the "FTD vs PPD Checklist" could provide a simple tool to improve diagnostic accuracy, particularly in non-specialized settings.
KW - Behavioral variant frontotemporal dementia
KW - diagnosis
KW - frontotemporal dementia
KW - psychiatric disorders
KW - scale
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85059850224&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30584146
UR - http://www.scopus.com/inward/record.url?scp=85059850224&partnerID=8YFLogxK
U2 - https://doi.org/10.3233/JAD-180839
DO - https://doi.org/10.3233/JAD-180839
M3 - Article
C2 - 30584146
SN - 1387-2877
VL - 67
SP - 113
EP - 124
JO - Journal of Alzheimer s disease
JF - Journal of Alzheimer s disease
IS - 1
ER -