Visual rating scales of atrophy differentiate sporadic behavioral variant frontotemporal dementia from primary psychiatric disorder: DIPPA study
Sporadic behavioral variant frontotemporal dementia (bvFTD) is often misdiagnosed as late-onset primary psychiatric disorder (PPD) due to overlapping symptoms and lack of disease-specific biomarkers. This multicenter pilot study aimed to identify brain atrophy patterns using visual rating scales (VRS) that distinguish between groups, and to compare VRS performance with standard clinical assessment. Magnetic resonance images from bvFTD and PPD patients across five centers were retrospectively reviewed. One rater, blinded for the clinical diagnosis, applied eight VRS. Group differences were assessed, the most predictive scales were identified and combined into a composite score, and the predictivity compared. 297 bvFTD and 92 PPD patients were analysed. All VRS yielded higher atrophy in bvFTD than in PPD patients. The Orbitofrontal, the Anterior-Temporal, and the Fronto-Insula scales were the strongest discriminators, and their composite score outperformed any individual scale. VRS may provide useful diagnostic support for distinguishing bvFTD from PPD.
Authors
- Ishana Rue (ORCID: https://orcid.org/0000-0002-8954-1078)
- O A Piguet
- Andrea Arighi (ORCID: https://orcid.org/0000-0003-2865-3970)
- Giorgio Fumagalli (ORCID: https://orcid.org/0000-0003-0687-7199)
- Chiara Fornari
- Zac Chatterton (ORCID: https://orcid.org/0000-0002-6683-1400)
- G G HALLIDAY
- Lina Riedl (ORCID: https://orcid.org/0000-0002-0658-5332)
- Janine Diehl‐Schmid (ORCID: https://orcid.org/0000-0002-7745-1382)
- Fenoglio Cm
- Yal Pijnenburg
- Ramon Landin-Romero
- Daniela Galimberti
- Sophie Matis
- Sterre C. M. de Boer
- Simon Ducharme
Institutions
- Montreal Neurological Institute and Hospital (CA)
- The University of Sydney (AU)
- University of Milan (IT)
- University of Trento (IT)
- Douglas Mental Health University Institute (CA)
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- Amsterdam Neuroscience (NL)
- Inn-Salzach-Klinikum (DE)
- Center for Neuroscience and Cognitive Systems (IT)
- Amsterdam University Medical Centers (NL)
- Ferrari (Italy) (IT)
- McGill University (CA)
- Technical University of Munich (DE)
Publication Details
- Journal
- Journal of Neural Transmission
- Published
- 2026-07-02
- DOI
- https://doi.org/10.1007/s00702-026-03223-y
- Primary Topic
- Dementia and Cognitive Impairment Research
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- EU Joint Programme – Neurodegenerative Disease Research
- Ministero della Salute
- Università degli Studi di Trento
- Alzheimer Nederland
- Medical Research Council
- National Health and Medical Research Council