Extrapyramidal signs, primitive reflexes and incontinence in fronto-temporal dementia

Extrapyramidal signs, primitive reflexes and incontinence in fronto-temporal dementia

P. Häussermann, et al. "Extrapyramidal signs, primitive reflexes and incontinence in fronto-temporal dementia." European Journal of Neurology 14.8 (2007): 860-864.Academic Search Premier. EBSCO. Web. 14 Sept. 2011.

             I chose this article “Extrapyramidal signs, primitive reflexes and incontinence in fronto-temporal dementia” because I thought it would be interesting to see how some reflexes affect dementia.  The purpose of this study was to examine the prevalence of the prescience of  extra pyramidal signs (EPMS), primitive reflexes, and incontinence in patients with fronto-temporal dementia (FTD). They also aimed to investigate prevalence of EPMS as it correlates with other determining variables. They tested 31 patients that displayed FTD, off their medication, by using a diagnostic evaluation. A neurological exam using the Mini-Mental-State-Exam (MMSE) for cognition, the Unified Parkinson’s Disease Rating Scale (UPDRS) for motor function, neuropsychiatric symptoms were evaluated using the Frontal Behavior Inventory (FBI), and the overall severity of the disease was examined using the Clinical Dementia Rating (CDR).  They used Spearman’s correlation coefficient to analyze the data. They found dementia severity was mild in 24 patients and moderate in 7 patients. The frequency of EPMS was most prevalent in akinesis and parkinsonian gait or posture, but urinary incontinence was only found in about one fourth of the studied patients. They also found an association between UPDRS scores, overall age, and onset age, but no relationship to any other demographic factors. EPMS mainly akinesia, Parkinsonian gait or posture do occur in most patients with moderate to mild stages of FTD, but the likelihood of a tremor reflex is rare. UPDRS scores are not correlated with disease duration or symptoms assessed by the MMSE and the FBI. They did not do follow up assessments which is a limitation to their study. They did find an overlap in Fronto-Temporal Dementia (FTD), Progressive Supranuclear Palsy (PSP), and Corticobasal Degeneration (CBD). This means that some patients of the patients with FTD will be more likely to develop PSP or CBD. They looked more in-depth to the urinary incontinence and how this notion can be cured using medicine. Overall they found prevalence of EPMS support the diagnosis of FTD, more precisely high prevalence of akinesia  in FTD patients. The motor problems were mild in most cases as well as tremors and primitive reflexes symptoms were rare.  

http://onlinelibrary.wiley.com/doi/10.1111/j.1468-1331.2007.01773.x/full