Validation of criteria for frontotemporal dementia with right anterior temporal lobe predominance

IF 13 1区医学 Q1 CLINICAL NEUROLOGY

Alzheimer's & Dementia Pub Date : 2025-07-01 DOI:10.1002/alz.70443

Na-Yeon Jung, SeungWook Kim, Joon-Kyung Seong, Duk L. Na, Sang Won Seo, Jihwan Yun, Eun Hye Lee, Daeun Shin, Heeyoung Kang, Sung Hoon Kang, Kyung Won Park, Geon Ha Kim, Jee Hyang Jeong, Hee Jin Kim, Sun Min Lee, Hyemin Jang, So Young Moon, Eun-Joo Kim, and the Longitudinal Study of Early Onset Dementia and Family Members (LEAF) Investigators

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Abstract

INTRODUCTION

Frontotemporal dementia (FTD) with right anterior temporal lobe (rATL) predominance lacks universally agreed-upon diagnostic criteria. This study validated the Amsterdam diagnostic tree (ADT) for right temporal variant FTD (rtvFTD) and the diagnostic criteria for semantic behavioral variant FTD (sbvFTD), examining clinical, behavioral, and imaging differences.

METHODS

The study included 138 patients with behavioral variant FTD and 87 with semantic variant primary progressive aphasia who had 3D T1-weighted magnetic resonance imaging scans. The participants were grouped into rtvFTD and sbvFTD by respective imaging criteria.

RESULTS

We identified 42 rtvFTD and 20 sbvFTD patients. ADT showed 81% sensitivity and 29% specificity, whereas sbvFTD criteria had 45% sensitivity and 55% specificity.

DISCUSSION

The unfavorable validation of both diagnostic criteria in Korean FTD patients may result from socio-cultural differences, the lack of standardized tools for assessing abnormal behaviors, and the retrospective nature of the study. The perspectives on rATL also differed between the two studies.

Highlights

Frontotemporal dementia (FTD) with right anterior temporal lobe (rATL) predominance is a controversial FTD syndrome, also referred to as right temporal variant FTD (rtvFTD), or right predominant semantic variant primary progressive aphasia.
Two clinical criteria for rATL have been proposed: One is the Amsterdam diagnostic tree for rtvFTD and the other is for semantic behavioral variant FTD (sbvFTD).
Our validation study suggested the need for standardized tools and highlighted theoretical distinctions between rtvFTD and sbvFTD.

Abstract Image

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额颞叶痴呆伴右前颞叶优势的诊断标准验证

以右前颞叶（rATL）为主的额颞叶痴呆（FTD）缺乏普遍认可的诊断标准。本研究验证了阿姆斯特丹诊断树（ADT）对右颞变异性FTD （rtvFTD）和语义行为变异性FTD （sbvFTD）的诊断标准，检查了临床、行为和影像学差异。方法对138例行为变异性FTD患者和87例语义变异性原发性进行性失语症患者进行三维t1加权磁共振成像扫描。根据各自的影像学标准将参与者分为rtvFTD和sbvFTD。结果42例rtvFTD和20例sbvFTD。ADT的敏感性为81%，特异性为29%，而sbvFTD的敏感性为45%，特异性为55%。在韩国FTD患者中，两种诊断标准的无效验证可能是由于社会文化差异，缺乏评估异常行为的标准化工具，以及该研究的回顾性。两项研究对rATL的观点也存在差异。右前颞叶（rATL）为主的额颞叶痴呆（FTD）是一种有争议的FTD综合征，也被称为右前颞叶变异性FTD (rtvFTD)，或右前语义变异性原发性进行性失语症。rATL的两种临床标准已被提出：一种是rtvFTD的阿姆斯特丹诊断树，另一种是语义行为变体FTD （sbvFTD）。我们的验证研究表明需要标准化的工具，并强调了rtvFTD和sbvFTD之间的理论区别。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer's & Dementia 医学-临床神经学

CiteScore

14.50

自引率

5.00%

发文量

299

审稿时长

3 months

期刊介绍： Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.