Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 2003 Oct;74(10):1398–1402. doi: 10.1136/jnnp.74.10.1398

A study of stereotypic behaviours in Alzheimer's disease and frontal and temporal variant frontotemporal dementia

S Nyatsanza 1, T Shetty 1, C Gregory 1, S Lough 1, K Dawson 1, J Hodges 1
PMCID: PMC1757381  PMID: 14570833

Abstract

Objective: To document the prevalence and pattern of stereotypic behaviour in patients with Alzheimer's dementia and frontal and temporal variants of frontotemporal dementia. Secondly, to examine the relationship between stereotypic and other neuropsychiatric behaviours.

Methods: Patients with the following were studied; Alzheimer's disease (n=28), frontal variant frontotemporal dementia (fvFTD, n=18), and semantic dementia—the temporal lobe variant of FTD (n=13). All patients were assessed using the Neuropsychiatric Inventory (NPI), the Mini-Mental State Examination, Addenbrooke's Cognitive Examination, and the Clinical Dementia Rating scale. Patients were also rated on the newly devised Stereotypic and Ritualistic Behaviour (SRB) subscale, which was designed as an addendum to the NPI.

Results: There was no significant difference across diagnostic groups in terms of age, sex, or severity of cognitive deficits. The overall NPI was significantly higher in patients with fvFTD compared with the other two groups, but fvFTD and semantic dementia showed a similar, and significantly increased, prevalence of stereotypic behaviours on the SRB subscale. Within the FTD group as a whole these behaviours were more likely to be complex, whereas in Alzheimer's disease, when present, such behaviours tended to be more simple stereotypies or stimulus bound repetitive behaviours. Stereotypic behaviours were not correlated with either disease severity or the extent of cognitive impairment in the fvFTD group, but were in the other two diagnostic groups.

Conclusion: Complex stereotypic behaviours are a core feature of the dementing syndrome in FTD and may reflect early and specific deficits in orbitofrontal circuitry and basal ganglia involvement.

Full Text

The Full Text of this article is available as a PDF (196.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ames D., Cummings J. L., Wirshing W. C., Quinn B., Mahler M. Repetitive and compulsive behavior in frontal lobe degenerations. J Neuropsychiatry Clin Neurosci. 1994 Spring;6(2):100–113. doi: 10.1176/jnp.6.2.100. [DOI] [PubMed] [Google Scholar]
  2. Bozeat S., Gregory C. A., Ralph M. A., Hodges J. R. Which neuropsychiatric and behavioural features distinguish frontal and temporal variants of frontotemporal dementia from Alzheimer's disease? J Neurol Neurosurg Psychiatry. 2000 Aug;69(2):178–186. doi: 10.1136/jnnp.69.2.178. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cummings J. L., Mega M., Gray K., Rosenberg-Thompson S., Carusi D. A., Gornbein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994 Dec;44(12):2308–2314. doi: 10.1212/wnl.44.12.2308. [DOI] [PubMed] [Google Scholar]
  4. Folstein M. F., Folstein S. E., McHugh P. R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6. [DOI] [PubMed] [Google Scholar]
  5. Gregory C. A., Hodges J. R. Clinical features of frontal lobe dementia in comparison to Alzheimer's disease. J Neural Transm Suppl. 1996;47:103–123. doi: 10.1007/978-3-7091-6892-9_6. [DOI] [PubMed] [Google Scholar]
  6. Hodges J. R., Miller B. The neuropsychology of frontal variant frontotemporal dementia and semantic dementia. Introduction to the special topic papers: Part II. Neurocase. 2001;7(2):113–121. doi: 10.1093/neucas/7.2.113. [DOI] [PubMed] [Google Scholar]
  7. Hodges J. R., Patterson K., Oxbury S., Funnell E. Semantic dementia. Progressive fluent aphasia with temporal lobe atrophy. Brain. 1992 Dec;115(Pt 6):1783–1806. doi: 10.1093/brain/115.6.1783. [DOI] [PubMed] [Google Scholar]
  8. Hodges J. R., Patterson K., Ward R., Garrard P., Bak T., Perry R., Gregory C. The differentiation of semantic dementia and frontal lobe dementia (temporal and frontal variants of frontotemporal dementia) from early Alzheimer's disease: a comparative neuropsychological study. Neuropsychology. 1999 Jan;13(1):31–40. doi: 10.1037//0894-4105.13.1.31. [DOI] [PubMed] [Google Scholar]
  9. Hughes C. P., Berg L., Danziger W. L., Coben L. A., Martin R. L. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982 Jun;140:566–572. doi: 10.1192/bjp.140.6.566. [DOI] [PubMed] [Google Scholar]
  10. Levy M. L., Miller B. L., Cummings J. L., Fairbanks L. A., Craig A. Alzheimer disease and frontotemporal dementias. Behavioral distinctions. Arch Neurol. 1996 Jul;53(7):687–690. doi: 10.1001/archneur.1996.00550070129021. [DOI] [PubMed] [Google Scholar]
  11. Mathuranath P. S., Nestor P. J., Berrios G. E., Rakowicz W., Hodges J. R. A brief cognitive test battery to differentiate Alzheimer's disease and frontotemporal dementia. Neurology. 2000 Dec 12;55(11):1613–1620. doi: 10.1212/01.wnl.0000434309.85312.19. [DOI] [PubMed] [Google Scholar]
  12. McKhann G., Drachman D., Folstein M., Katzman R., Price D., Stadlan E. M. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984 Jul;34(7):939–944. doi: 10.1212/wnl.34.7.939. [DOI] [PubMed] [Google Scholar]
  13. Miller B. L., Darby A. L., Swartz J. R., Yener G. G., Mena I. Dietary changes, compulsions and sexual behavior in frontotemporal degeneration. Dementia. 1995 Jul-Aug;6(4):195–199. doi: 10.1159/000106946. [DOI] [PubMed] [Google Scholar]
  14. Neary D., Snowden J. S., Mann D. M. Classification and description of frontotemporal dementias. Ann N Y Acad Sci. 2000;920:46–51. doi: 10.1111/j.1749-6632.2000.tb06904.x. [DOI] [PubMed] [Google Scholar]
  15. Shigenobu Kazue, Ikeda Manabu, Fukuhara Ryuji, Maki Naruhiko, Hokoishi Kazuhiko, Nebu Akihiko, Yasuoka Takuo, Komori Kenjiro, Tanabe Hirotaka. The Stereotypy Rating Inventory for frontotemporal lobar degeneration. Psychiatry Res. 2002 Jun 1;110(2):175–187. doi: 10.1016/s0165-1781(02)00094-x. [DOI] [PubMed] [Google Scholar]
  16. Snowden J. S., Bathgate D., Varma A., Blackshaw A., Gibbons Z. C., Neary D. Distinct behavioural profiles in frontotemporal dementia and semantic dementia. J Neurol Neurosurg Psychiatry. 2001 Mar;70(3):323–332. doi: 10.1136/jnnp.70.3.323. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES