Journal of the International Neuropsychological Society



Relationship between positive and negative symptoms and neuropsychological scores in frontotemporal dementia and Alzheimer's disease


KYLE BRAUER  BOONE  a1 c1, BRUCE L.  MILLER  a2, RANDOLPH  SWARTZ  a3, PO  LU  a1 and ALISON  LEE  a1
a1 Department of Psychiatry, Harbor-UCLA Medical Center, Torrance California
a2 Department of Neurology, University of California–San Francisco
a3 Department of Family Medicine, Harbor-UCLA Medical Center, Torrance California

Abstract

Patients with dementia, particularly those with frontotemporal dementia (FTD), are reported to display marked negative symptoms, including apathy, lack of initiative, and flattened affect, similar to those observed in schizophrenic patients. However, negative symptoms have yet to be formally quantified in an FTD population. Twenty-seven patients with FTD (11 primarily right-sided, 8 primarily left-sided, and 4 symmetric) and 7 patients with Alzheimer's disease were rated on the Scale for the Assessment of Negative Symptoms, the Positive and Negative Syndrome Scale, and the Emotional Blunting scale. The FTD patients registered significantly more negative symptoms than the Alzheimer's patients, averaging a threefold increase; groups did not significantly differ in positive symptoms. Negative symptom scale scores were negatively correlated with nonverbal executive skills (23–44% shared variance), verbal executive skills (up to 25% shared variance) and verbal memory (up to 20% shared variance), but were unrelated to measures of attention, verbal and nonverbal information processing, nonverbal memory, language, and constructional skill. In contrast, positive symptoms were positively correlated with constructional skill (19% shared variance) and attentional scores (15% shared variance). These findings add to the existing literature relating negative symptoms to anterior cerebral hypofunction, and suggest that positive symptoms, at least in this population, may be tied to increased posterior activation. (JINS, 2003, 9, 698–709.)

(Received January 12 2001)
(Revised July 8 2002)
(Accepted July 9 2002)


Key Words: Positive and negative symptoms; Frontotemporal dementia; Alzheimer's disease; Executive scores; Cognition.

Correspondence:
c1 Reprint requests to: Kyle Brauer Boone, Ph.D., ABPP-ABCN, Harbor-UCLA Medical Center, Department of Psychiatry, Box 495, 1000 W. Carson Street, Building F-9, Torrance, CA 90509-2910