Psychosis in Frontotemporal Dementia

Article type: Research Article

Authors: Shinagawa, Shunichiro^{a; b; *} | Nakajima, Shinichiro^{c; d; e; f} | Plitman, Eric^{e; g} | Graff-Guerrero, Ariel^{d; e; f} | Mimura, Masaru^c | Nakayama, Kazuhiko^b | Miller, Bruce L.^a

Affiliations: [a] Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA | [b] Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan | [c] Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan | [d] Geriatric Mental Health Program, Centre for Addiction and Mental Health, Toronto, ON, Canada | [e] Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada | [f] Department of Psychiatry, University of Toronto, Toronto, Canada | [g] Institute of Medical Science, University of Toronto, Toronto, Canada

Correspondence: [*] Correspondence to: Shunichiro Shinagawa, MD, PhD, Department of Psychiatry, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. Tel.: +81 334331111; Fax: +81 334370228; E-mail: shinagawa@jikei.ac.jp.

Abstract: Frontotemporal dementia (FTD) is a neurodegenerative disorder, associated with a progressive decline in behavior caused by focal degeneration of the frontal lobes. Psychosis was an underestimated symptom of FTD, however, recent genetic research has revealed a high prevalence of psychosis in certain genetic groups. The primary objective of this work is to review the literature on psychosis in FTD and to propose directions for future research, with reference to findings on psychosis in schizophrenia. A search was performed using PubMed, MEDLINE, and EMBASE. Search terms included “frontotemporal dementia”, “psychosis”, “schizophreni*”, “psychotic symptoms”, “hallucinations”, and “delusions”, and it identified 122 articles. Results revealed: 1) prevalence is approximately 10%, 2) TDP-43 type B and FUS pathologies might have relatively high frequency of psychosis, 3) psychosis in FTD is higher with genetic mutations of C9ORF72 and GRN, 4) imaging researches did not achieve conclusive results, and 5) no treatment for psychosis in FTD is currently available. A limitation of this systematic review is that it includes a small number of studies specifically examining psychosis in FTD. It is suggested that a possible overlap exists between FTD and schizophrenia. This potential overlap indicates a vulnerability to psychosis due to brain systems and pathways shared by these disorders.

Keywords: Frontotemporal dementia, gene mutation, neuropathology, psychosis, schizophrenia

DOI: 10.3233/JAD-140312

Journal: Journal of Alzheimer's Disease, vol. 42, no. 2, pp. 485-499, 2014