Characterizing Sexual Behavior in Frontotemporal Dementia

Article type: Research Article

Authors: Ahmed, Rebekah M.^{a; b; e; g; 1} | Kaizik, Cassandra^{a; 1} | Irish, Muireann^{a; d; e} | Mioshi, Eneida^f | Dermody, Nadene^{a; d} | Kiernan, Matthew C.^g | Piguet, Olivier^{a; c; e} | Hodges, John R.^{a; c; e; *}

Affiliations: [a] Neuroscience Research Australia, Sydney, Australia | [b] Prince of Wales Clinical School, The University of New South Wales, Sydney, Australia | [c] School of Medical Sciences, The University of New South Wales, Sydney, Australia | [d] School of Psychology, The University of New South Wales, Sydney, Australia | [e] ARC Centre of Excellence in Cognition and its Disorders, The University of New South Wales, Sydney, Australia | [f] Department of Psychiatry, University of Cambridge, Cambridge, UK | [g] Sydney Medical School, Brain & Mind Research Institute, University of Sydney, Australia

Correspondence: [*] Correspondence to:Professor John Hodges, Neuroscience Research Australia, Barker Street, Randwick NSW 2031, Australia. Tel.: +61 29399 1000; Fax: +61 2 9399 1047; E-mail: j.hodges@neura.edu.au

Note: [1] These authors contributed equally to this work.

Abstract: Background: Frontotemporal dementia (FTD) is characterized by a number of prominent behavioral changes. While FTD has been associated with the presence of aberrant or unusual sexual behaviors in a proportion of patients, few studies have formally investigated changes in sexual function in this disease. Objective: We aimed to systematically quantify changes in sexual behavior, including current symptoms and changes from prior diagnoses, in behavioral-variant (bvFTD) and semantic dementia (SD), compared to Alzheimer’s disease (AD). Methods: Carers of 49 dementia patients (21 bvFTD, 11 SD, 17 AD) were interviewed using the Sexual Behavior and Intimacy Questionnaire (SIQ), a survey designed to assess changes in sexual function across multiple domains including initiating, level of affection, and aberrant or unusual sexual behavior. Results: BvFTD patients show prominent hyposexual behavior including decreased affection, initiation, and response to advances by partners, and decreased frequency of sexual relations, compared to AD and to SD patients. The greatest changes in sexual behavior compared to pre-diagnoses were found in the bvFTD group with a 90–100% decrease in initiation, response, and frequency of sexual relations. Notably, aberrant or unusual sexual behavior was reported in a minority of bvFTD and SD patients and occurred in patients who also showed hyposexual behavior toward their partner. Conclusion: Overall loss of affection, reduced initiation of sexual activity, and responsiveness is an overwhelming feature of bvFTD. In contrast, aberrant or unusual sexual behavior is observed in the minority of bvFTD patients. The underlying pathophysiology of these changes likely reflects structural and functional changes in frontoinsular and limbic regions including the hypothalamus.

Keywords: Alzheimer’s disease, frontotemporal dementia, sexual function

DOI: 10.3233/JAD-150034

Journal: Journal of Alzheimer's Disease, vol. 46, no. 3, pp. 677-686, 2015