Hyperorality in Frontotemporal Dementia: How Psychiatric and Neural Correlates Change Across the Disease Course
Year: 2024
Type: preprint
Abstract: Objectives Hyperorality is one of the core features of behavioral variant frontotemporal dementia (bvFTD), however, the cognitive, psychiatric, and neuroanatomic correlates of hyperorality across disease stages remain unclear. This study works to fill this knowledge gap by exploring these associations in the early and advanced stages of bvFTD. Methods Participants with sporadic and genetic bvFTD were enrolled in the ARTFL LEFFTDS Longitudinal Frontotemporal Lobar Degeneration consortium (ALLFTD). The primary analyses used baseline data to compare cognitive and psychiatric symptoms in those with and without hyperorality stratified by disease severity. Linear multivariable regressions adjusting for age and total intracranial volume were used to examine baseline associations between regional gray matter volumes and hyperorality status. Five anatomic regions of interest were pre-selected for analysis based on previously identified neuroanatomic correlates of hyperorality in bvFTD. Results Hyperorality was present in 50% of early-stage bvFTD participants (n = 136) and was associated with higher rates of ritualistic/compulsive behavior. Hyperorality was present in 63% of advanced-stage participants (n = 208) and was associated higher rates of apathy, and ritualistic/compulsive behavior. Regional gray matter volumes were similar in those with and without hyperorality in early-stage participants. In the advanced-stage participants, hyperorality was associated with lower gray matter volumes in the right dorsal and ventral striatum. Conclusions Hyperorality emerges early in bvFTD and is accompanied by deficits in social cognition and complex-ritualistic behavior prior to clinically significant gray matter volume loss. These findings suggest that early identification and treatment of hyperorality could improve neuropsychiatric trajectories in bvFTD.
Source: medRxiv
Authors: Christopher B. Morrow, Chiadi Onyike, Alexander Pantelyat, Gwenn S. Smith, Jeannie Leoutsakos, Andreia V. Faria, Neill R. Graff-Radford, R. Ryan Darby, Nupur Ghoshal, Adam M. Staffaroni, Katya Rascovsky, Toji Miyagawa, Akshata Balaji, Kyrana Tsapkini, Maria I. Lapid, Mario F. Mendez, Irene Litvan, Belen Pascual, Julio C. Rojas, Zbigniew K. Wszolek, Kimiko Domoto-Reilly, John Kornak, Vidyulata Kamath
Institutions: Johns Hopkins University, Johns Hopkins Medicine, Johns Hopkins Hospital, Mayo Clinic, Mayo Clinic in Florida, Vanderbilt University Medical Center, Washington University in St. Louis, University of California, San Francisco, University of Pennsylvania, University of California, Los Angeles, University of California San Diego, Houston Methodist, Houston Methodist Research Institute, University of Washington
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4405364630