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J Neurol (2012) 259:10711080 DOI 10.1007/s00415-011-6300-x
ORIGINAL COMMUNICATION
Executive dysfunction in frontotemporal dementia is related to abnormalities in frontal white matter tracts
M. C. Tartaglia Y. Zhang C. Racine
V. Laluz J. Neuhaus L. Chao J. Kramer
H. Rosen B. Miller M. Weiner
Received: 24 July 2011 / Revised: 17 October 2011 / Accepted: 19 October 2011 / Published online: 29 October 2011 Springer-Verlag 2011
Abstract Cognitive decits in behavioral-variant fronto-temporal dementia (bvFTD) and AD are linked to frontal and temporal lobe gray matter (GM) pathology. The aim of this study was to assess the relative contribution of white (WM) and GM abnormalities to cognitive dysfunction in bvFTD and AD. Fractional anisotropy (FA) for the corpus callosum, cingulum (Cg), and uncinate fasciculus (Unc) was determined in 17 bvFTD and 10 AD patients who underwent neuropsychological testing. Regressions were performed to assess the relative contribution of WM and GM abnormalities to cognitive decits. Multiple regression analysis revealed that in bvFTD, the left anterior Cg FA was related to executive function, the right anterior Cg FA to visual-spatial attention and working memory, the right posterior Cg to visual-constructional abilities and the left Unc FA to Modied Trails Errors. After adding corresponding GM volumes, the left anterior Cg FA, the right
anterior cingulate FA, the right posterior cingulate FA and the left uncinate FA remained signicant predictors of the cognitive tasks. In the AD group, the left posterior Cg FA and right descending Cg FA were related to visual recall performance but did not remain signicant predictors when GM volumes were added to the regression. These results suggest that reduced integrity of specic WM tracts contribute to cognitive decits observed in bvFTD after accounting for GM atrophy. In AD, memory impairment was related to WM tract injury but this relationship was no longer observed when GM volumes were included.
Keywords Cingulum Executive function
Frontotemporal dementia Alzheimers disease
White matter tracts
Introduction
Neurodegenerative diseases are associated with specic cognitive decits. While typical Alzheimers disease (AD) patients display primarily memory and visual-spatial impairments, behavioral-variant frontotemporal dementia (bvFTD) patients have greater executive dysfunction and behavioral decits [16]. Executive function encompasses planning, judgment, reasoning, problem solving, organization, attention, abstraction, and mental exibility [42]. The cognitive decits observed in AD and FTD are...