Downey, LE; (2014) Defining the neuropsychological and neuroimaging phenotype of behavioural variant frontotemporal dementia. Doctoral thesis , UCL (University College London).

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Abstract

Frontotemporal dementia (FTD) is the second most common cause of early-onset dementia after Alzheimer’s disease (AD). There exists a paucity of quantifiable, sensitive, and specific biomarkers to detect this disease and track its manifestation and progression. The primary aim of this thesis was to develop and investigate new biomarkers for FTD, and focused on the examination of neuropsychological biomarkers in the behavioural variant of FTD (bvFTD) and their neuroanaotmical correlates. Chapters 4 and 5 explored social cognition in patients with FTD and the neural correlates of this behaviour. bvFTD patients displayed gross dysfunction in the perception of sarcasm and the ability to understand basic social signals, and this mapped onto a larger social cognition neural network that has previously been defined in the literature. These findings delineate a brain network substrate for the social impairment that characterises FTD syndromes. In Chapters 6 and 7, I explored the executive functions of task switching, reaction time, and neural timing in patients with FTD. Results indicated several dissociable executive capacities, which mapped onto discrete neural areas as part of a larger executive function network, suggesting that structures implicated in aspects of executive functioning can be targeted by FTD and may underpin aspects of the bvFTD phenotype. In the final Chapter, I devised a novel battery to examine the bases of psychosis in FTD patients with the C9ORF72 mutation, which demonstrated a specific and unique impairment in the ability to interpret somatosensory proprioceptive information in these patients, which may represent a candidate mechanism for psychosis. The studies described in this thesis contribute to the growing interest in characterising and understanding the neuropsychological phenotypes of bvFTD. Improved understanding of the anatomical associations of neuropsycholgical performance in this patient population could potentially facilitate earlier and more accurate diagnosis and symptom management

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