Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- coarsening of personality, social behavior, and habits
- progressive loss of language fluency or comprehension
- development of memory impairment, disorientation, or apraxias
- progressive self-neglect and abandonment of work, activities, and social contacts
Outros fatores diagnósticos
- early age at onset
- family history of FTD
- altered eating habits
- inattentiveness, puerile preoccupations, economy of effort, impulsive responding, and compulsive behaviors
- signs of amyotrophic lateral sclerosis (ALS)
- parkinsonian symptoms
- fasciculations, atrophy, hyperreflexia, and other signs of motor neuron disease
- glabellar, snout, sucking, rooting, or grasp reflex
- loss of bladder and bowel control
Fatores de risco
- mutations in MAPT gene
- mutations in GRN gene
- mutations in C9orf72 gene
- traumatic brain injury
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- formal cognitive testing
- brain MRI
- brain CT
- CBC
- serum CRP
- serum thyroid-stimulating hormone (TSH)
- free thyroxine (T4)
- metabolic panel
- serum BUN
- serum creatinine
- LFTs
- serum vitamin B12 levels
- serum folate levels
- syphilis serology
- HIV testing
- serum enzyme-linked immunosorbent assay
Investigações a serem consideradas
- brain fluorodeoxyglucose (FDG)-PET
- brain single-photon emission computed tomography (SPECT)
- brain biopsy
- genetic testing
- connective tissue panel
- serum erythrocyte sedimentation rate
Novos exames
- cerebrospinal fluid analysis
Algoritmo de tratamento
all patients
Colaboradores
Autores
Raghava Kurup Radhakrishnan, DPM(NIMHANS), DNB(Psych), MRCPsych
Consultant Psycho-geriatrician
Waitemata District Health Board
Auckland
New Zealand
Declarações
RKR declares that he has no competing interests.
Sachin Jauhari, DMH, MRCPsych, FRANZCP
Consultant Psycho-geriatrician
Waitemata District Health Board
Honorary Senior Lecturer in Old Age Psychiatry
University of Auckland
Auckland
New Zealand
Declarações
SJ declares that he has no competing interests.
Agradecimentos
Dr Raghava Kurup Radhakrishnan and Dr Sachin Jauhari would like to gratefully acknowledge Dr Lawrence Whalley and Dr Chiadi Onyike, the previous contributors to this topic, and colleagues Dr Ann Boston (clinical psychologist), Dr Zara Godinovich (clinical psychologist), and Diane Ellis (clinical nurse specialist) for their suggestions.
Declarações
LW, CO, AB, ZG, and DE declare that they have no competing interests.
Revisores
Daniel Kaufer, MD
Director
Memory Disorders Program
Department of Neurology
University of North Carolina at Chapel Hill
NC
Declarações
DK has received research support, speaking honoraria, and consulting fees from Eisai, Forest Laboratories, Johnson & Johnson, Medivation, Novartis, Ortho-McNeil, and Pfizer.
Bruce L. Miller, MD
Professor of Neurology
University of California
San Francisco
CA
Declarações
BLM declares that he has no competing interests.
Philip Scheltens, MD, PhD
Professor of Neurology
Department of Neurology/Alzheimer Center
VU University Medical Center
Amsterdam
The Netherlands
Declarações
PS declares that he has no competing interests.
Referências
Principais artigos
Rascovsky K, Hodges JR, Knopman D, et al. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain. 2011 Sep;134(Pt 9):2456-77.Texto completo Resumo
Rascovsky K, Hodges JR, Knopman D, et al. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain. 2011 Sep;134(Pt 9):2456-77.Texto completo Resumo
Moore KM, Nicholas J, Grossman M, et al. Age at symptom onset and death and disease duration in genetic frontotemporal dementia: an international retrospective cohort study. Lancet Neurol. 2020 Feb;19(2):145-56.Texto completo Resumo
Mackenzie IR, Neumann M. Molecular neuropathology of frontotemporal dementia: insights into disease mechanisms from postmortem studies. J Neurochem. 2016 Aug;138(suppl 1):54-70.Texto completo Resumo
NHMRC Partnership Centre for Dealing with Cognitive and Related Functional Decline in Older People. Clinical practice guidelines and principles of care for people with dementia. Feb 2016 [internet publication].Texto completo
Dyer SM, Harrison SL, Laver K, et al. An overview of systematic reviews of pharmacological and non-pharmacological interventions for the treatment of behavioral and psychological symptoms of dementia. Int Psychogeriatr. 2018 Mar;30(3):295-309.Texto completo Resumo
Buoli M, Serati M, Caldiroli A, et al. Pharmacological management of psychiatric symptoms in frontotemporal dementia: a systematic review. J Geriatr Psychiatry Neurol. 2017 May;30(3):162-9. Resumo
Trieu C, Gossink F, Stek ML, et al. Effectiveness of pharmacological interventions for symptoms of behavioral variant frontotemporal dementia: a systematic review. Cogn Behav Neurol. 2020 Mar;33(1):1-15. Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Alzheimer disease (AD)
- Dementia with Lewy bodies (DLB)
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Mais Diagnósticos diferenciaisDiretrizes
- Clinical guidance in neuropalliative care: an AAN position statement
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Mais DiretrizesFolhetos informativos para os pacientes
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Dementia: frontotemporal dementia
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