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Generalized and Symptom-Specific Insight in Behavioral Variant Frontotemporal Dementia and Primary Progressive Aphasia

Received December 12, 2007; revised May 5 and July 12, 2008; accepted July 16, 2008. Dr. Banks is affiliated with the Department of Neurology and Neurosurgery at Montreal Neurological Institute and Hospital, Montreal, Quebec; Dr. Weintraub is affiliated with the Cognitive Neurology and Alzheimer’s Disease Center at Northwestern University, Feinberg School of Medicine, in Chicago. Address correspondence to Sarah Banks, Ph.D., Montreal Neurological Institute, Department of Neurology and Neurosurgery, 3801 University St., Montreal Quebec H3A 2B4 Canada; sarah.banks{at}mail.mcgill.ca (e-mail).

Behavioral variant frontotemporal dementia (FTD) and primary progressive aphasia (PPA) are related dementias with different presenting symptoms but with increasing symptom overlap as they progress. Loss of insight is associated with early behavioral variant FTD, but not PPA. This study used the Frontal Behavioral Inventory to compare patient and caregiver concepts of symptom presence and severity. Patients with behavioral variant FTD were found to have worse insight overall than PPA patients. However, the PPA group showed reduced insight into behavioral symptoms, and the behavioral variant FTD groups had intact insight into some language symptoms. Theoretical and clinical implications are discussed.

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