@article{79ae1dc2649440e8b881cd43d9bc547d,
title = "Altered phobic reactions in frontotemporal dementia: A behavioural and neuroanatomical analysis",
abstract = "Introduction: Abnormal behavioural and physiological reactivity to emotional stimuli is a hallmark of frontotemporal dementia (FTD), particularly the behavioural variant (bvFTD). As part of this repertoire, altered phobic responses have been reported in some patients with FTD but are poorly characterised. Methods: We collected data (based on caregiver reports) concerning the prevalence and nature of any behavioural changes related to specific phobias in a cohort of patients representing canonical syndromes of FTD and Alzheimer's disease (AD), relative to healthy older controls. Neuroanatomical correlates of altered phobic reactivity were assessed using voxel-based morphometry. Results: 46 patients with bvFTD, 20 with semantic variant primary progressive aphasia, 25 with non-fluent variant primary progressive aphasia, 29 with AD and 55 healthy age-matched individuals participated. Changes in specific phobia were significantly more prevalent in the combined FTD cohort (15.4% of cases) and in the bvFTD group (17.4%) compared both to healthy controls (3.6%) and patients with AD (3.5%). Attenuation of phobic reactivity was reported for individuals in all participant groups, however new phobias developed only in the FTD cohort. Altered phobic reactivity was significantly associated with relative preservation of grey matter in left posterior middle temporal gyrus, right temporo-occipital junction and right anterior cingulate gyrus, brain regions previously implicated in contextual decoding, salience processing and reward valuation. Conclusion: Altered phobic reactivity is a relatively common issue in patients with FTD, particularly bvFTD. This novel paradigm of strong fear experience has broad implications: clinically, for diagnosis and patient well-being; and neurobiologically, for our understanding of the pathophysiology of aversive sensory signal processing in FTD and the neural mechanisms of fear more generally.",
keywords = "Alzheimer's disease, Emotion, Fear, Frontotemporal dementia, Neuroimaging, Specific phobia, VBM",
author = "Jimenez, {Daniel A.} and Bond, {Rebecca L.} and Requena-Komuro, {Mai Carmen} and Harri Sivasathiaseelan and Marshall, {Charles R.} and Russell, {Lucy L.} and Caroline Greaves and Moore, {Katrina M.} and Woollacott, {Ione OC} and Rachelle Shafei and Hardy, {Chris JD} and Rohrer, {Jonathan D.} and Warren, {Jason D.}",
note = "Funding Information: We are grateful to all participants for their involvement. We would like to thank Jennifer Nicholas and Amy MacDougall (of LSHTM) for their valuable advice on the statistical methods. The Dementia Research Centre is supported by Alzheimer{\textquoteright}s Research UK , the Brain Research Trust and the Wolfson Foundation . This work was funded by the Alzheimer{\textquoteright}s Society, Leonard Wolfson Experimental Neurology Centre , Medical Research Council UK , and the NIHR UCLH/UCL Biomedical Research Centre . DAJ is a recipient of a Scholarship from the Chilean Government (CONICYT PFCHA/Becas Chile/2017–76180041). CJDH is supported by a Pauline Ashley Action on Hearing Loss-Dunhill Medical Trust Fellowship (PA_23). RLB was funded by an MRC PhD studentships. MCRK holds a Wellcome Trust Four-Year PhD Studentship. CRM and HS were supported by Clinical Research Fellowships from the Leonard Wolfson Experimental Neurology Centre . KMM was supported by a grant from the Alzheimer's Society . IOCW was funded by an MRC Clinical Research Training Fellowship ( MR/M018288/1 ). JDR is supported by an MRC Clinician Scientist Fellowship ( MR/M008525/1 ) and has received funding from the NIHR Rare Disease Translational Research Collaboration ( BRC149/NS/MH ). No study funder or sponsor had any involvement in study design, data collection, analysis or interpretation, writing of the paper or decision to submit the article for publication. Funding Information: We are grateful to all participants for their involvement. We would like to thank Jennifer Nicholas and Amy MacDougall (of LSHTM) for their valuable advice on the statistical methods. The Dementia Research Centre is supported by Alzheimer's Research UK, the Brain Research Trust and the Wolfson Foundation. This work was funded by the Alzheimer's Society, Leonard Wolfson Experimental Neurology Centre, Medical Research Council UK, and the NIHR UCLH/UCL Biomedical Research Centre. DAJ is a recipient of a Scholarship from the Chilean Government (CONICYT PFCHA/Becas Chile/2017?76180041). CJDH is supported by a Pauline Ashley Action on Hearing Loss-Dunhill Medical Trust Fellowship (PA_23). RLB was funded by an MRC PhD studentships. MCRK holds a Wellcome Trust Four-Year PhD Studentship. CRM and HS were supported by Clinical Research Fellowships from the Leonard Wolfson Experimental Neurology Centre. KMM was supported by a grant from the Alzheimer's Society. IOCW was funded by an MRC Clinical Research Training Fellowship (MR/M018288/1). JDR is supported by an MRC Clinician Scientist Fellowship (MR/M008525/1) and has received funding from the NIHR Rare Disease Translational Research Collaboration (BRC149/NS/MH). No study funder or sponsor had any involvement in study design, data collection, analysis or interpretation, writing of the paper or decision to submit the article for publication. Publisher Copyright: {\textcopyright} 2020 The Author(s)",
year = "2020",
month = sep,
doi = "10.1016/j.cortex.2020.05.016",
language = "English (US)",
volume = "130",
pages = "100--110",
journal = "Cortex",
issn = "0010-9452",
publisher = "Masson SpA",
}