Thalamic stroke mimicking frontotemporal dementia: a case report

Background: The behavioral variant of frontotemporal dementia (bvFTD) is characterized by changes of personality, social behavior and cognition and relies on a neurodegenerative process. However, vascular lesions affecting subcortical structures may result in a clinical syndrome resembling bvFTD. Objective: To describe a case of thalamic stroke resulting in frontal dementia. Case report: A 58-year-old man was referred to our hospital because of behavioral and cognitive changes formerly diagnosed as bvFTD. In 2010, he suddenly presented loss of consciousness and in the next days he developed amnesia, apathy and personality changes. Toxicological exams, CSF analysis and CT scan were normal at admission. Neuropsychological tests showed an impairment of executive functions and amnesia. He was referred to our Center in 2011. Behavioral disturbances and cognitive dysfunctions were already improved since the onset, and at six-month follow-up neuropsychological test showed a further recovery of cognitive functions. Brain MRI showed a left thalamic infarct. Conclusions: The sudden onset and the improvement of clinical signs suggest a vascular origin of the syndrome. The FTD-like picture is attributable to a disruption of the fronto-subcortical circuits at the level of the striatum or the anterior thalamic peduncle. Vascular dementia should be considered in differential diagnosis of bvFTD

Tumor diagnosis preceding Alzheimer's disease onset: is there a link between cancer and Alzheimer's disease?

Studies reporting an inverse association between Alzheimer's disease (AD) and cancer are scant. Available data are mostly based on ancillary findings of mortality data or obtained from studies evaluating frequency of neoplasms in AD patients independently if they occurred before or after AD. Moreover, some studies estimated frequencies of neoplasms in demented individuals, who were not necessarily AD patients. We estimated frequency of tumors preceding the onset of AD in AD patients and compared it to that of age- and gender-matched AD-free individuals. Occurrence of tumors preceding AD onset was assessed through a semi-structured questionnaire. Tumors were categorized as benign, malignant, or of uncertain classification and as endocrine-related or not. Odds ratios (OR), used as measure of the association between the two diseases, were adjusted for tumor categories and known risk factors for AD and tumors. We included 126 AD patients and 252 matched controls. Tumor frequency before AD onset was 18.2% among cases and 24.2% among controls. There was a suggestive trend of an overall inverse association between the two diseases (adjusted OR 0.6; 95% CI 0.4-1.1; p = 0.11). Risk for neoplasms was significantly reduced only for women (adjusted OR, 0.5; 95% CI 0.3-0.9; p = 0.03) and for endocrine related tumors (adjusted OR, 0.5; 95% CI 0.2-1; p = 0.04). Our study confirms the inverse association reported in previous epidemiological studies. Though our findings might be explained by processes playing an opposite role in tumors development and neurodegeneration, they are also suggestive for a possible role of estrogen

DYSAUTONOMIC DYSFUNCTION IN PARKINSON’DISEASE BY SCOPA-AUT SCALE

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