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Late-onset frontotemporal dementia associated with progressive supranuclear palsy/argyrophilic grain disease/Alzheimer's disease pathology

Authors: G. A. Rippon a;  B. F. Boeve ab;  J. E. Parisi bc;  D. W. Dickson bd;  R. I. Ivnik be;  C. R. Jack bf;  M. Hutton bg;  M. Baker bg;  K. A. Josephs a;  D. S. Knopman ab; R. C. Petersen ab
Affiliations:   a Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
b Robert H. and Clarice Smith and Abigail Van Buren Alzheimer's Disease Research program of the Mayo Foundation,
c Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
d Neuropathology Laboratory, Mayo Clinic, Jacksonville, Florida, USA
e Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
f Department of Diagnostic Radiology, Mayo Clinic, Rochester, Minnesota, USA
g Neurogenetics Laboratory, Mayo Clinic, Jacksonville, Florida, USA
DOI: 10.1080/13554790590944753
Publication Frequency: 6 issues per year
Published in: journal Neurocase, Volume 11, Issue 3 June 2005 , pages 204 - 211
Formats available: HTML (English) : PDF (English)
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Abstract

Progressive supranuclear palsy (PSP) is typically manifested by vertical supranuclear gaze palsy, frequent falls early in the disease course, axial rigidity and poor response to levodopa. Prominent anterograde memory dysfunction with subsequent impairment in other cognitive domains is characteristic of Alzheimer's disease (AD). No clear clinical syndrome has been identified in argyrophilic grain disease (AGD). Frontotemporal dementia (FTD) is characterized by apathy, emotional blunting, disinhibition, and impairment in executive functioning despite relatively preserved memory and visuospatial abilities. Cognitive deficits are known to occur in PSP; however, overt clinical FTD without parkinsonism or supranuclear gaze palsy associated with PSP pathology has rarely been documented. We report an elderly patient with the typical clinical, neuropsychometric, and neuroimaging features of FTD who had autopsy findings most consistent with PSP plus AGD and AD in limbic structures. We suggest that PSP with or without coexisting AD and AGD be included in the differential diagnosis of patients presenting with FTD.
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