Addition of the FTD Module to the Neuropsychiatric Inventory improves classification of frontotemporal dementia spectrum disorders

Lize C Jiskoot; Lucy L Russell; Caroline V Greaves; Esther van Schaik; Esther van den Berg; Jackie M Poos; Liset de Boer; Laura Donker Kaat; Harro Seelaar; Yolande A L Pijnenburg; John C van Swieten; Jonathan D Rohrer

doi:10.1007/s00415-023-11596-3

Addition of the FTD Module to the Neuropsychiatric Inventory improves classification of frontotemporal dementia spectrum disorders

J Neurol. 2023 May;270(5):2674-2687. doi: 10.1007/s00415-023-11596-3. Epub 2023 Feb 22.

Authors

Lize C Jiskoot^{1

2

3}, Lucy L Russell⁴, Caroline V Greaves⁴, Esther van Schaik⁵, Esther van den Berg⁵, Jackie M Poos⁵, Liset de Boer⁵, Laura Donker Kaat^{5

6}, Harro Seelaar⁵, Yolande A L Pijnenburg⁷, John C van Swieten⁵, Jonathan D Rohrer⁴

Affiliations

¹ Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Room NF-331, Dr. Molenwaterplein 40, 3015 CE, Rotterdam, The Netherlands. l.c.jiskoot@erasmusmc.nl.
² Dementia Research Centre, Department of Neurodegenerative Disease, University College London Queen Square Institute of Neurology, London, UK. l.c.jiskoot@erasmusmc.nl.
³ Dementia Research Centre (DRC), National Hospital for Neurology and Neurosurgery, University College London (UCL), 8-11 Queen Square, Box 16, London, WC1N 3BG, UK. l.c.jiskoot@erasmusmc.nl.
⁴ Dementia Research Centre, Department of Neurodegenerative Disease, University College London Queen Square Institute of Neurology, London, UK.
⁵ Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Room NF-331, Dr. Molenwaterplein 40, 3015 CE, Rotterdam, The Netherlands.
⁶ Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands.
⁷ Department of Neurology, Amsterdam University Medical Centre, Amsterdam, The Netherlands.

Abstract

Most neuropsychiatric symptoms (NPS) common in frontotemporal dementia (FTD) are currently not part of the Neuropsychiatric Inventory (NPI). We piloted an FTD Module that included eight extra items to be used in conjunction with the NPI. Caregivers of patients with behavioural variant FTD (n = 49), primary progressive aphasia (PPA; n = 52), Alzheimer's dementia (AD; n = 41), psychiatric disorders (n = 18), presymptomatic mutation carriers (n = 58) and controls (n = 58) completed the NPI and FTD Module. We investigated (concurrent and construct) validity, factor structure and internal consistency of the NPI and FTD Module. We performed group comparisons on item prevalence, mean item and total NPI and NPI with FTD Module scores, and multinomial logistic regression to determine its classification abilities. We extracted four components, together explaining 64.1% of the total variance, of which the largest indicated the underlying dimension 'frontal-behavioural symptoms'. Whilst apathy (original NPI) occurred most frequently in AD, logopenic and non-fluent variant PPA, the most common NPS in behavioural variant FTD and semantic variant PPA were loss of sympathy/empathy and poor response to social/emotional cues (part of FTD Module). Patients with primary psychiatric disorders and behavioural variant FTD showed the most severe behavioural problems on both the NPI as well as the NPI with FTD Module. The NPI with FTD Module correctly classified more FTD patients than the NPI alone. By quantifying common NPS in FTD the NPI with FTD Module has large diagnostic potential. Future studies should investigate whether it can also prove a useful addition to the NPI in therapeutic trials.

Keywords: Classification; Dementia; FTD; Neuropsychiatric inventory; Neuropsychiatric symptoms.

MeSH terms

Alzheimer Disease* / diagnosis
Behavioral Symptoms
Caregivers
Frontotemporal Dementia* / diagnosis
Frontotemporal Dementia* / genetics
Frontotemporal Dementia* / psychology
Humans

Abstract

MeSH terms

Grants and funding