Comparative Study of Subcortical Atrophy in Patients with Frontotemporal Dementia and Dementia with Extrapyramidal Signs

Leonardo Caixeta 1, *, Renata Teles Vieira 2, Flávia Paes 4, Mauro Giovanni Carta 3, Antonio Egidio Nardi 4, Oscar Arias-Carrión 5, Nuno B. F Rocha 6, Henning Budde 7, Sergio Machado 4, 8
1 Neuropsychiatry, School of Medicine, Federal University of Goiás (UFG). Dementia Outpatient Unit, Hospital das Clínicas-UFG, Brazil
2 Behavioral and Cognitive Neurology Unit, Hospital das Clínicas, Federal University of Goiás, Goiânia (GO), Brazil
3 Department of Public Health, Clinic and Molecular Medicine - University of Cagliari, Italy
4 Laboratory of Panic and Respiration, Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), Brazil; National Institute for Translational Medicine (INCT-TM), Brazil
5 Unidad de Trastornos del Movimiento y Sueño (TMS), Hospital General Dr. Manuel Gea Gonzalez, Secretaria de Salud, México, DF, México
6 Polytechnic Institute of Porto, School of Allied Health Sciences, Portugal
7 Medical School Hamburg, Faculty of Human Sciences, Department of Pedagogy, Germany; Reykjavik University, School of Science and Engineering, Department of Sport Science, Iceland
8 Physical Activity Neuroscience, Physical Activity Postgraduate Program, Salgado de Oliveira University (UNIVERSO), Niterói, RJ, Brazil

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© Caixeta et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Instituto da Memória, Avenida Cristo Rei, 626, setor Jaó, Goiânia (GO), Brazil. CEP 74674290; Tel: + 55-62-32047223; E-mail:


Objectives : To investigate the severity of subcortical atrophy in frontotemporal dementia (FTD) without extrapyramidal symptoms (EPS) and dementia with EPS. In addition, we aim to verify if there is correlation between demographic and clinical characteristics and subcortical atrophy in the groups. Methodology : The sample was composed of 21 patients with dementia and EPS as well as 19 patients with FTD without EPS. A linear assessment was conducted in order to identify the degree of subcortical atrophy (i.e., bifrontal index - BFI) using MRI. Moreover, the Mini-Mental State Examination (MMSE), Pfeffer Functional Activities Questionnaire (FAQ) and the Clinical Dementia Rating (CDR) were used to investigate clinical aspects. Results : It was verified that patients with dementia and EPS was older than the patients with FTD (p=0.01). The severity of cognitive deficits was associated with BFI, as well as the dementia severity in the EPS group. Conclusion : FTD group presented mean BFI scores above the cutoff for normal elderly population, indicating the presence of subcortical atrophy in this group. Mean BFI was higher (although not statistically significant) in FTD group than in dementia with EPS, which can suggest at least that subcortical pathology in FTD may be as important as in the dementia with EPS group. Subcortical atrophy is a good biological marker for cognitive deterioration in FTD and in dementia with EPS.

Keywords: Bifrontal index, extrapyramidal signs, frontotemporal dementia, structural neuroimaging, subcortical atrophy. .