INS NYC 2024 Program

Poster	Poster Session 02 Program Schedule 02/15/2024 08:00 am - 09:15 am Room: Majestic Complex (Posters 61-120) Poster Session 02: Aging \| MCI \| Neurodegenerative Disease - PART 1 Final Abstract #81 Utility of the Frontotemporal Lobar Degeneration Module (FTLD-MOD) to Distinguish Underlying Neurodegenerative Neuropathology in behavioral variant Frontotemporal Dementia Janelli Rodriguez, Northwestern University Feinberg School of Medicine, Chicago, United States Allegra Kawles, Northwestern University Feinberg School of Medicine, Chicago, United States Miranda Gurra, Northwestern University Feinberg School of Medicine, Chicago, United States Rachel Keszycki, Northwestern University Feinberg School of Medicine, Chicago, United States Antonia Zouridakis, Northwestern University Feinberg School of Medicine, Chicaga, United States Grace Minogue, Northwestern University Feinberg School of Medicine, Chicago, United States Alyssa Macomber, Northwestern University Feinberg School of Medicine, Chicago, United States Vivienne Lubbat, Northwestern University Feinberg School of Medicine, Chicago, United States Sandra Weintraub, Northwestern University Feinberg School of Medicine, Chicago, United States Nathan Gill, Northwestern University Feinberg School of Medicine, Chicago, United States Tamar Gefen, Northwestern University Feinberg School of Medicine, Chicago, United States Category: Dementia (Non-AD) Keyword 1: aging disorders Keyword 2: dementia - other cortical Keyword 3: neuropsychological assessment Objective: The Frontotemporal Lobar Degeneration Module (FTLD-MOD) was designed by the National Institute of Aging as a specialized neuropsychological battery to evaluate symptoms unique to FTLD-related clinical dementia syndromes including behavioral variant frontotemporal dementia (bvFTD). BvFTD is characterized by progressive decline in social comportment and behavioral changes. Different neuropathological diseases can be found at autopsy in individuals diagnosed antemortem with bvFTD, including FTLD (due to either 3-repeat (3R) or 4-repeat (4R) tauopathies or TDP-43 species) or, though less common, Alzheimer’s disease neuropathologic change (ADNC). Prior research has shown that while bvFTD due to FTLD pathology is associated with disinhibited behaviors (e.g., impulsivity), the same syndrome due to ADNC often presents with more affective symptoms (e.g., withdrawal or anxiety). The current study investigated whether performance on FTLD-MOD measures could differentiate between multiple neuropathologic diagnoses (i.e., FTLD-tau vs FTLD-TDP vs AD) that lead to a single clinical dementia syndrome (i.e., bvFTD). Participants and Methods: Fifty-five participants from the National Alzheimer's Coordinating Center (NACC) database with clinically diagnosed bvFTD and postmortem data available were included in the retrospective analysis. Autopsy-confirmed neuropathological diagnosis further classified participants into three groups; those with underlying Alzheimer’s disease neuropathologic change (ADNC; N = 16), the tau form of FTLD (FTLD-tau; N = 22), and the TDP form of FTLD (FTLD-TDP; N = 17). Group performance scores on FTLD-MOD questionnaires from the initial visit were analyzed. All participants had a global CDR of 0.5 or higher. Logistic and multinomial regression models controlling for visit age and education were used to test the ability of the FTLD-MOD to distinguish between underlying pathologic diagnoses. Results: The Behavioral Inhibition Scale (BIS; Form C4F), a 7-item informant questionnaire that measures withdrawal-related behavioral traits such as self-criticism and social anxiety, demonstrated a potential ability to distinguish between pathologic groups. Accordingly, each unit increase in total BIS score was associated with an increase in the odds of AD pathology compared to FTLD-tau or TDP (OR=1.26, p=0.04). No significant differences were found in the other FTLD-MOD questionnaires. Conclusions: Among individuals diagnosed with bvFTD during life, higher scores on the Behavioral Inhibition Scale of the FTLD-MOD appear to be associated with an increase in likelihood of AD pathology at autopsy relative to FTLD. Findings show that BIS may be clinically beneficial to help distinguish between underlying pathologic diagnoses that lead to bvFTD.

Poster

02/15/2024
08:00 am - 09:15 am
Room: Majestic Complex (Posters 61-120)

Poster Session 02: Aging | MCI | Neurodegenerative Disease - PART 1

Final Abstract #81

Utility of the Frontotemporal Lobar Degeneration Module (FTLD-MOD) to Distinguish Underlying Neurodegenerative Neuropathology in behavioral variant Frontotemporal Dementia

Janelli Rodriguez, Northwestern University Feinberg School of Medicine, Chicago, United States
Allegra Kawles, Northwestern University Feinberg School of Medicine, Chicago, United States
Miranda Gurra, Northwestern University Feinberg School of Medicine, Chicago, United States
Rachel Keszycki, Northwestern University Feinberg School of Medicine, Chicago, United States
Antonia Zouridakis, Northwestern University Feinberg School of Medicine, Chicaga, United States
Grace Minogue, Northwestern University Feinberg School of Medicine, Chicago, United States
Alyssa Macomber, Northwestern University Feinberg School of Medicine, Chicago, United States
Vivienne Lubbat, Northwestern University Feinberg School of Medicine, Chicago, United States
Sandra Weintraub, Northwestern University Feinberg School of Medicine, Chicago, United States
Nathan Gill, Northwestern University Feinberg School of Medicine, Chicago, United States
Tamar Gefen, Northwestern University Feinberg School of Medicine, Chicago, United States

Category: Dementia (Non-AD)

Keyword 1: aging disorders
Keyword 2: dementia - other cortical
Keyword 3: neuropsychological assessment

Objective:

The Frontotemporal Lobar Degeneration Module (FTLD-MOD) was designed by the National Institute of Aging as a specialized neuropsychological battery to evaluate symptoms unique to FTLD-related clinical dementia syndromes including behavioral variant frontotemporal dementia (bvFTD). BvFTD is characterized by progressive decline in social comportment and behavioral changes. Different neuropathological diseases can be found at autopsy in individuals diagnosed antemortem with bvFTD, including FTLD (due to either 3-repeat (3R) or 4-repeat (4R) tauopathies or TDP-43 species) or, though less common, Alzheimer’s disease neuropathologic change (ADNC). Prior research has shown that while bvFTD due to FTLD pathology is associated with disinhibited behaviors (e.g., impulsivity), the same syndrome due to ADNC often presents with more affective symptoms (e.g., withdrawal or anxiety). The current study investigated whether performance on FTLD-MOD measures could differentiate between multiple neuropathologic diagnoses (i.e., FTLD-tau vs FTLD-TDP vs AD) that lead to a single clinical dementia syndrome (i.e., bvFTD).

Participants and Methods:

Fifty-five participants from the National Alzheimer's Coordinating Center (NACC) database with clinically diagnosed bvFTD and postmortem data available were included in the retrospective analysis. Autopsy-confirmed neuropathological diagnosis further classified participants into three groups; those with underlying Alzheimer’s disease neuropathologic change (ADNC; N = 16), the tau form of FTLD (FTLD-tau; N = 22), and the TDP form of FTLD (FTLD-TDP; N = 17). Group performance scores on FTLD-MOD questionnaires from the initial visit were analyzed. All participants had a global CDR of 0.5 or higher. Logistic and multinomial regression models controlling for visit age and education were used to test the ability of the FTLD-MOD to distinguish between underlying pathologic diagnoses.

Results:

The Behavioral Inhibition Scale (BIS; Form C4F), a 7-item informant questionnaire that measures withdrawal-related behavioral traits such as self-criticism and social anxiety, demonstrated a potential ability to distinguish between pathologic groups. Accordingly, each unit increase in total BIS score was associated with an increase in the odds of AD pathology compared to FTLD-tau or TDP (OR=1.26, p=0.04). No significant differences were found in the other FTLD-MOD questionnaires.

Conclusions:

Among individuals diagnosed with bvFTD during life, higher scores on the Behavioral Inhibition Scale of the FTLD-MOD appear to be associated with an increase in likelihood of AD pathology at autopsy relative to FTLD. Findings show that BIS may be clinically beneficial to help distinguish between underlying pathologic diagnoses that lead to bvFTD.