Distinct clinical features and outcomes in motor neuron disease associated with behavioural variant frontotemporal dementia

Elena Cortés-Vicente, Janina Turon-Sans, Ellen Gelpi, Jordi Clarimón, Sergi Borrego-Écija, Oriol Dols-Icardo, Ignacio Illán-Gala, Alberto Lleó, Isabel Illa, Rafael Blesa, Ammar Al-Chalabi, Ricard Rojas-Garciá

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Abstract

© 2018 S. Karger AG, Basel. All rights reserved. Aim: To determine the motor phenotype and outcome in a clinically ascertained group of patients with motor neuron disease (MND) and frontotemporal dementia (FTD). Methods: This is an observational retrospective clinical study of patients fulfilling the clinical criteria for MND-FTD. A contemporary series of patients with amyotrophic lateral sclerosis (ALS) without dementia were included for comparison. Demographic, clinical, genetic, and neuropathological data were collected. A descriptive and comparative data analysis was performed. Results: We identified 22 patients with MND-FTD. Selective distal upper limb muscle weakness and atrophy with non-significant lower limb weakness during follow-up was the most frequent motor pattern, present in 18 patients-in 15 of them associated with severe dysphagia. Aspiration pneumonia was the most common cause of death (12/19; 63%) despite gastrostomy. One-third of the patients did not develop upper motor neuron dysfunction. When compared to classic ALS without dementia (n = 162), these features were significantly different. A neuro-pathological examination was performed on 7 patients, and it confirmed the presence of MND with TDP43 protein aggregates in all patients. Conclusions: The MND-FTD patients frequently displayed a distinctive motor pattern characterized by weakness and atrophy in distal upper limb muscles and dysphagia, with no or little spreading to other regions. These features may help to define specific subgroups of patients, which is important with regard to clinical management, outcome, and research.
Original languageEnglish
Pages (from-to)220-231
JournalDementia and Geriatric Cognitive Disorders
Volume45
Issue number3-4
DOIs
Publication statusPublished - 1 Jul 2018

Keywords

  • Amyotrophic lateral sclerosis
  • Clinical aspects
  • Frontotemporal dementia
  • Genetics of neurodegenerative diseases
  • Neuropathology

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    Cortés-Vicente, E., Turon-Sans, J., Gelpi, E., Clarimón, J., Borrego-Écija, S., Dols-Icardo, O., Illán-Gala, I., Lleó, A., Illa, I., Blesa, R., Al-Chalabi, A., & Rojas-Garciá, R. (2018). Distinct clinical features and outcomes in motor neuron disease associated with behavioural variant frontotemporal dementia. Dementia and Geriatric Cognitive Disorders, 45(3-4), 220-231. https://doi.org/10.1159/000488528