Schizophrenia as a mimic of behavioral variant frontotemporal dementia

ABSTRACT

Recently, the diagnostic criteria for the behavioral variant of frontotemporal dementia were revised. Although these criteria offer a relatively high sensitivity, their specificity is yet unknown. We describe a 54-year-old woman fulfilling criteria for both late-onset schizophrenia and probable behavioral variant frontotemporal dementia. Following an initial presentation with psychosis, she developed progressive apathy, compulsiveness, and executive dysfunction. Moreover, bilateral frontotemporal hypometabolism was seen on [¹⁸F]fludeoxyglucose-positron emission tomography. A post-mortem diagnosis of schizophrenia was established, given the clinical picture combined with the pathological exclusion of a neurodegenerative cause. Our case suggests that patients with other brain disorders may meet the current diagnostic criteria for probable frontotemporal dementia. Further clinicopathological validation of these criteria is needed to determine their exact specificity.

KEYWORDS:

• Frontotemporal dementia
• schizophrenia
• FTDC criteria
• imaging
• neuropathology

Disclosure statement

Dr. Prins serves on the advisory board of Boehringer Ingelheim and Forum, and has provided consultancy services for Sanofi. He has been a speaker at symposia organised by Janssen and Novartis and receives research support from Alzheimer Nederland; Dr. Scheltens reports grants from GE Healthcare, grants from Merck, grants from Piramal Imaging, outside the submitted work; Dr. Pijnenburg reports grants from Dutch Brain Foundation, during the execution of the study; the other authors report no conflicts of interest. We report no other role of any funding source. The Dutch Brain Association had no role in the design of the study, in execution of the study, or in the publication of this article.

Additional information

Funding

Dr. Prins reports other from Forum pharmaceuticals, other from Boehringer Ingelheim, from Sanofi, outside the submitted work; Dr. Scheltens reports grants from GE Healthcare, grants from Merck, grants from Piramal Imaging, outside the submitted work; Dr. Pijnenburg reports grants from Dutch Brain Foundation, during the execution of the study.