Italian researchers gave 68 CBD patients and 57 PSP patients a test called the “Frontal Behavioral Inventory.” The “most frequent behavioral abnormalities present in both groups (>25%) were aspontaneity and logopenia.” [Logopenia = decreased speech output. Here’s a description from eMedicine: “Spontaneous speech can be sparse yet fluent in character, with preserved grammar (logopenia).]
Comparing the behavioral profiles of CBDers and PSPers, the researchers found that:
* apathy was more frequent in PSP;
* alien hand/apraxia was more frequent in CBD;
* “Aphasia (27.9%) and irritability (35.3%) were more frequent in CBDS compared to PSP, even if not statistically different.”
We’ll have to get the full article to understand why the researchers say that their study “further confirms the usefulness of the FBI scale.”
The abstract notes that scores on the FBI were relatively low in both patient groups. Low scores mean the behavior never occurs or is mild.
You can find a copy of this 24-page battery here (and I’ve copied the questions beneath the abstract below):
http://www.bic.mni.mcgill.ca/users/gaby … rs/FBI.pdf
It was developed by Canadian cognitive neurologist Andrew Kertesz, MD. Dr. Kertesz is an expert on the various types of frontotemporal dementias. He includes PSP and CBS as FTDs. He wrote a very good book called “The Banana Lady” that provides stories of various patients with FTDbv, PSP, and CBS.
Robin
International Psychogeriatrics. 2009 Mar 27:1-6. [Epub ahead of print]
Pattern of behavioral disturbances in corticobasal degeneration syndrome and progressive supranuclear palsy.
Borroni B, Alberici A, Agosti C, Cosseddu M, Padovani A.
Department of Neurology, University of Brescia, Italy.
Background: A careful characterization of behavioral abnormalities in corticobasal degeneration syndrome (CBDS) and progressive supranuclear palsy (PSP) by reliable tools is still lacking. Literature data provided evidence of the usefulness of the Frontal Behavioral Inventory (FBI) to operationalize such disturbances, particularly in the frontotemporal lobar degeneration spectrum. The study aimed to evaluate the frequency and pattern of presentation of behavioral disturbances in a large sample of CBDS and PSP patients by FBI.
Methods: Sixty-eight CBDS and 57 PSP patients entered the study and underwent a standardized clinical and neuropsychological battery, and a structural brain imaging study. Behavioral disturbances were carefully analyzed by FBI.
Results: FBI scores were relatively low in both groups, being 6.7 +/- 8.2 and 5.6 +/- 6.1 in CBDS and PSP, respectively. Comparison of the behavioral profile between CBDS and PSP patients showed significant differences in apathy were more frequent in the latter (57.9% vs. 33.8%, P = 0.007), and the presence of alien hand/apraxia more frequent in the former group 39.7% vs. 10.5%, P = 0.001).
Apathy correlated neither with age nor with motor disturbances as measured by UPDRS-III.
Overall, the most frequent behavioral abnormalities present in both groups (>25%) were aspontaneity and logopenia.
Aphasia (27.9%) and irritability (35.3%) were more frequent in CBDS compared to PSP, even if not statistically different.
Discussion: The present study has provided measures of behavioral disturbances in a population of PSP and CBDS patients, and further confirms the usefulness of the FBI scale.
PubMed ID#: 19323870 (see pubmed.gov for abstract only)
Excerpts from
FRONTAL BEHAVIORAL INVENTORY (FBI)
(c) Andrew Kertesz
0 (none / never)
1 (mild / occasional)
2 (moderate / often)
3 (severe / most of the time)
Negative Behavior Score: Total of 1 12: _____
Disinhibition Score: Total of 13-24 : _____
Total Score: _____
Negative Behavior Questions:
1. Apathy: Has s/he lost interest in friends or daily activities or is s/he interested in seeing people or doing things?
2. Aspontaneity: Does s/he start things on his/her own, or does s/he have to be asked?
3. Indifference, Emotional Flatness: Does s/he respond to occasions of joy or sadness as much as ever, or has s/he lost emotional responsiveness?
4. Inflexibility: Can s/he change his/her mind with reason or does s/he appear stubborn or rigid in thinking lately?
5. Personal Neglect: Does s/he take as much care of his/her personal hygiene and appearance as usual, or does s/he neglect to wash or change his/her underwear?
6. Disorganization: Can s/he plan and organize complex activity or is s/he easily distractible, impersistent, or unable to complete a job?
7. Inattention: Does s/he pay attention to what is going on or does s/he seem to lose track or not follow at all?
8. Loss of Insight: Is s/he aware of any problems or changes in behavior, or does s/he seem unaware of them or deny them when discussed?
9. Logopenia: Is s/he as talkative as before or has the amount of speech significantly decreased?
10. Semantic Dementia: Does s/he ask what words mean, has trouble comprehending words, and/or objects, or does s/he know the meaning of words?
11. Aphasia and Verbal Apraxia: Does s/he make language or pronunciation errors or has s/he developed stuttering or repeating sounds recently?
12. Alien Hand and/or Apraxia: Has s/he developed clumsiness, stiff hand, inability to use utensils or appliances, or does a hand interfere with the other, or behaves as if it did not belong, or can s/he use both hands as before?
Negative Behavior Score: Total of 1 12: _____
Disinhibition Questions:
13. Perseverations, Obsessions: Does s/he repeat or perseverate actions or remarks? Are there any obsessive routines or behaviors, or has s/he always been a creature of habit?
14. Irritability: Has s/he been irritable, short-tempered, or is s/he reacting to stress or frustration as s/he always had?
15. Excessive Jocularity: Has s/he been making jokes excessively or offensively or at the wrong time, or has s/he always had a jocular manner or a quirky sense of humor?
16. Impulsivity/Poor Judgment: Has s/he been using good judgment in decisions, spending or driving, or has s/he acted impulsively, irresponsibly, neglectfully or in poor judgment?
17. Hoarding: Has s/he started to hoard objects or money excessively or has her/his saving habits remained unchanged?
18. Inappropriateness: Has s/he kept social rules or has s/he said or done things outside what are acceptable? Has s/he been rude, or childish?
19. Restlessness/Roaming: Has s/he been pacing, walking, driving excessively or is the activity level normal?
20. Aggression: Has s/he shown aggression, or shouted at anyone or hurt anyone physically or is there no change in this respect?
21. Hyperorality: Has s/he been drinking or eating excessively anything in sight, or developing food fads, or even putting objects in his/her mouth, or has s/he always had a large appetite?
22. Hypersexuality: Has sexual behavior been unusual or excessive? This could include remarks or undressing, or is there no change in this respect?
23. Utilization Behavior: Does s/he seem to need to touch, feel, examine, or pick up objects within reach and sight, or can s/he keep his/her hands to him/herself?
24. Incontinence: Has s/he wet or soiled his or herself or does s/he have problems that can be explained by urinary infection or childbirth/prostate?
Disinhibition Score: Total of 13-24