Author ORCID Identifier
Document Type
Article
Publication Date
9-7-2016
Abstract
Objectives: Although bipolar disorder has been understood classically as a cyclic disease with full recovery between mood episodes, in the last decade, evidence has accumulated supporting progressive features. The clinical picture of advanced or end-stage bipolar disorder is heterogeneous with possible deficits in cognition and behavior, as illustrated by our case series. Cases: From our neuropsychiatric outpatient clinic, we describe four cases with bipolar disorder gradually developing a clinical syndrome, including apathy, disinhibition, loss of empathy, stereotypical behavior, and compulsiveness, fulfilling the criteria for possible behavioral variant frontotemporal dementia. All cases were diagnosed with bipolar 1 disorder at least 10 years before the onset of the current symptoms, which were not due to recent mood episodes or switches of medication. In all cases, 3-7 years of follow-up yielded no progression. Repeated neuroimaging was within normal limits. Cerebrospinal fluid biomarker studies were not supportive of underlying neurodegenerative pathology. C9orf72 mutation status was negative in all cases. Conclusion: Symptoms fitting the criteria for possible behavioral variant frontotemporal dementia may be present in end-stage of bipolar disorder. An alternative neurodegenerative nature seems unlikely based on repeated normal neuroimaging and the absence of clinical progression. Functional involvement of the frontal-subcortical networks might play a role.
Keywords
benign phenocopy syndrome, bipolar disorder, BvFTD, older, staging
Language
English
Publication Title
Neuropsychiatric Disease and Treatment
Rights
© The Author(s) 2016. This is an open access article under the CC BY-NC license (https://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Recommended Citation
Dols A, Krudop W, Moeller C, Shulman K, Sajatovic M, Pijnenburg Y. Late life bipolar disorder evolving into frontotemporal dementia mimic. Neuropsychiatr Dis Treat. 2016;12:2207-2212 https://doi.org/10.2147/NDT.S99229
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