A very light lunch: Interoceptive deficits and food aversion at onset in a case of behavioral variant frontotemporal dementia

Alzheimers Dement (Amst). 2018 Nov 3:10:750-754. doi: 10.1016/j.dadm.2018.10.001. eCollection 2018.

Abstract

Introduction: Patients affected by the behavioral variant frontotemporal dementia (bvFTD) frequently experience, at a delayed onset, abnormal eating behavior involving increased food intake. Although delusional food-related symptoms have attracted much attention, the behavioral and neural features of food aversion manifestations in bvFTD remain poorly documented.

Methods: We describe the rare case of a patient with bvFTD presenting with lack of interoception for swallowing and digestion, coupled with a dramatic food aversion at onset. We also compared his MRI scan to 84 healthy individuals using a voxel-based morphometry approach.

Results: We found gray matter density reductions involving the postcentral gyrus bilaterally, insulae, and right medial orbitofrontal cortex.

Discussion: Our results shed new light on the behavioral and neuroanatomical features of food aversion and interoception deficits in bvFTD, suggesting that besides orbitofrontal cortex, also a distributed system associated with interoception might play a role in such behavioral manifestation.

Keywords: Behavioral variant frontotemporal dementia; Eating disturbances; Insula; Interoception; Voxel-based morphometry.