Beyond cognitive reserve: Behavioural reserve hypothesis in Frontotemporal Dementia

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• 作者：Enrico Premi^a ; ^e ; Valentina Garibotto^b ; Stefano Gazzina^a ; Mario Grassi^c ; Maura Cosseddu^a ; Barbara Paghera^d ; Marinella Turla^e ; Alessandro Padovani^a ; Barbara Borroni^a ; ^{bborroni@inwind.it}
• 关键词：Frontotemporal Dementia ; Brain cognitive reserve hypothesis ; Frontal behavioural inventory ; Confirmatory factor analysis ; SPECT ; Statistical parametric mapping
• 刊名：Behavioural Brain Research
• 出版年：2013
• 出版时间：15 May, 2013
• 年：2013
• 卷：245
• 期：Complete
• 页码：58-62
• 全文大小：415 K

文摘

Background

The brain reserve hypothesis posits that there are individual differences in the ability to cope with brain pathology, and that brain damage extent and clinical symptoms are not tightly linked. If cognitive reserve hypothesis has been demonstrated in Alzheimer Disease and Frontotemporal Dementia (FTD), no evidence of reserve mechanisms on behavioural disturbances has been corroborated yet. In FTD, distinct behavioural phenotypes may be identified.

Objective

To test the behavioural reserve hypothesis in behavioural variant FTD (bvFTD).

Methods

As previously demonstrated, bvFTD patients were grouped into four behavioural phenotypes, i.e. ¡°disinhibited¡±, ¡°apathetic¡±, ¡°language¡±, and ¡°aggressive¡±, by means of Confirmatory Factor Analysis on behavioural assessment. Educational achievement was considered as proxy measure of reserve on behavioural disturbances, and cerebral SPECT as an indirect expression of brain pathology. On each group, the effect of education on brain damage was assessed by slope analysis.

Results

A specific effect of education attainment on ¡°disinhibited¡± phenotype was observed, the higher the education, the greater the hypoperfusion in the right inferior frontal gyrus and the left medial frontal gyrus and right caudate (P < 0.001). On the other behavioural phenotypes, no effect of education was reported in modulating brain damage.

Conclusions

We suggest that in neurodegenerative diseases the concept of brain reserve might be extended, as compensatory mechanisms are in action not only for cognitive deficits but for behavioural disturbances as well.