Dementia of frontal lobe type.

TLDR

A significant proportion of presenile dementia patients with primary cerebral atrophy lack Alzheimer’s disease, and one non‑Alzheimer form, dementia of frontal lobe type (DFT), is identified by a frontal‑lobe neuropsychological profile confirmed by SPECT. The authors illustrate DFT through case histories of seven patients presenting social misconduct, personality change, disinhibition, with physical well‑being and few neurological signs. DFT patients exhibited economic and concrete speech, verbal stereotypes, variable memory impairment, marked frontal‑lobe task abnormalities, no visuo‑spatial deficits, and differed qualitatively from Alzheimer patients in clinical presentation, neurological signs, psychological disability, EEG, SPECT, and demographics, suggesting DFT may be more common and possibly represent Pick’s disease.

Abstract

A significant proportion of patients with presenile dementia due to primary cerebral atrophy do not have Alzheimer9s disease. One form of non-Alzheimer dementia may be designated as dementia of frontal lobe type (DFT), on the basis of a characteristic neuropsychological picture suggestive of frontal lobe disorder, confirmed by findings on single photon emission tomography. The case histories of seven patients exemplify the disorder: a presentation of social misconduct and personality change, unconcern and disinhibition, in the presence of physical well-being and few neurological signs. Assessment revealed economic and concrete speech with verbal stereotypes, variable memory impairment, and marked abnormalities on tasks sensitive to frontal lobe function. Visuo-spatial disorder was invariably absent. Comparisons of DFT and Alzheimer patients revealed qualitative differences in clinical presentation, neurological signs, profile of psychological disability, electroencephalography, single photon emission tomography and demography. DFT, which may represent forms of Pick9s disease, may be more common than is often recognised.