Cognitive Neurology and Alzheimer's Disease Research Centre, Parkwood Institute, London, ON, Canada.
Lawson Health Research Institute, London, ON, Canada.
J Neurol. 2023 Aug;270(8):3750-3757. doi: 10.1007/s00415-023-11713-2. Epub 2023 Apr 16.
Changes in motor activity are common in individuals with Frontotemporal dementia (FTD). Yet, it remains unclear why some individuals become motorically hyperactive, while others hypoactive even in early stages of the disease. This study aimed to examine the relationship between motor activity level and (1) FTD clinical subtype, and (2) cortical thickness and subcortical volumes. Eighty-two charts were retrospectively reviewed from patients meeting consensus criteria for one of the three main clinical subtypes of FTD: probable bvFTD, semantic variant Primary Progressive Aphasia (PPA), or non-fluent variant PPA. Participants were assigned to one of three groups: (1) hyperactive, (2) hypoactive, or (3) no record of change. Hyperactivity was prevalent among bvFTD (58.5%) and semantic PPA (68.8%) subtypes while hypoactivity was less common in both subtypes (29.3% and 18.8%, respectively). The majority of patients with non-fluent PPA showed no record of change in motor activity (66.7%). The analysis of cortical thickness and subcortical volumes did not identify significant associations with motor activity levels. In conclusion, increased motor activity is highly prevalent among individuals with FTD, especially bvFTD and svPPA subtypes. These findings may inform prognosis and prediction of changes in motor activity, and allow planning for appropriate environmental and behavioural interventions. Future studies with prospective, standardized longitudinal collection of information regarding the type and level of change in motor activity, including wearable measures of actigraphy, may help to further delineate the onset and progression of abnormal motor behaviours and determine neuroanatomic associations in FTD.
运动活动的改变在额颞叶痴呆(FTD)患者中很常见。然而,为什么有些患者在疾病的早期阶段变得运动过度,而有些患者则运动不足,这仍然不清楚。本研究旨在检查运动活动水平与(1)FTD 临床亚型,以及(2)皮质厚度和皮质下体积之间的关系。从符合 FTD 三种主要临床亚型之一的共识标准的患者中回顾性地审查了 82 份图表:可能的 bvFTD、语义变异原发性进行性失语症(PPA)或非流利变异 PPA。参与者被分配到以下三个组之一:(1)运动过度,(2)运动不足,或(3)无运动活动变化记录。运动过度在 bvFTD(58.5%)和语义 PPA(68.8%)亚型中较为常见,而在这两种亚型中,运动不足的情况则较为少见(分别为 29.3%和 18.8%)。大多数非流利性 PPA 患者的运动活动无变化记录(66.7%)。皮质厚度和皮质下体积分析未发现与运动活动水平有显著关联。总之,FTD 患者的运动活动增加很常见,尤其是 bvFTD 和 svPPA 亚型。这些发现可能为运动活动变化的预后和预测提供信息,并允许对适当的环境和行为干预进行规划。未来的研究需要前瞻性地、标准化地收集关于运动活动类型和水平变化的信息,包括可穿戴的活动记录仪,这可能有助于进一步描绘异常运动行为的发病和进展,并确定 FTD 中的神经解剖关联。