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Dement Geriatr Cogn Disord Extra 2016;6:194–204 DOI: 10.1159/000445870 Published online: May 26, 2016
© 2016 The Author(s) Published by S. Karger AG, Basel 1664–5464/16/0062–0194$39.50/0 www.karger.com/dee
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Original Research Article
Vestibular Impairment in Frontotemporal Dementia Syndrome Kiyotaka Nakamagoe a Kotarou Kadono a Tadachika Koganezawa b Mao Takiguchi a Makoto Terada a Fumiko Yamamoto a Tetsuya Moriyama a Kumi Yanagiha a Seitaro Nohara a Naoki Tozaka a Zenshi Miyake a Satoshi Aizawa a Kentaro Furusho c Akira Tamaoka a a Department
of Neurology, Division of Clinical Medicine, and b Department of Physiology, Division of Biomedical Science, Faculty of Medicine, University of Tsukuba, Tsukuba, and c Department of Neurology, Ryugasaki Saiseikai Hospital, Ryugasaki, Japan
Key Words Frontotemporal dementia · Vestibular function · Frontotemporal lobar degeneration · Visual suppression · Vestibular stimulation · Frontal eye field · Inferior parietal lobule · Caloric test Abstract Background: No studies to date have attempted to evaluate frontotemporal lobar degeneration from the perspective of the vestibular system. Objective: The present study examined vestibular function in patients with frontotemporal dementia (FTD) clinical syndrome and evaluated whether vestibular disorders are involved in the clinical symptoms due to FTD. Methods: Fourteen patients with FTD syndrome, as well as healthy elderly controls without dementia, were included in the present study. All subjects underwent vestibular function tests using electronystagmography, such as caloric tests and visual suppression (VS) tests, in which the induced caloric nystagmus was suppressed by visual stimuli. The association between clinical symptoms and vestibular function in the FTD syndrome group was further examined. Results: In the FTD syndrome group, caloric nystagmus was not necessarily suppressed during VS tests. Furthermore, VS was observed to be significantly impaired in FTD syndrome patients with gait disturbance as compared to those without such disturbance. Conclusion: The present study revealed that impairment of VS in patients with FTD results in an inability to regulate vestibular function by means of visual perception, regardless of multiple presumed neuropathological backgrounds. This could also be associated with gait disturbance in patients with FTD syndrome. © 2016 The Author(s) Published by S. Karger AG, Basel
Kiyotaka Nakamagoe University of Tsukuba Tennodai 1-1-1 Tsukuba, Ibaraki 305-8575 (Japan) E-Mail nakamagoek @ md.tsukuba.ac.jp
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Dement Geriatr Cogn Disord Extra 2016;6:194–204 DOI: 10.1159/000445870
© 2016 The Author(s). Published by S. Karger AG, Basel www.karger.com/dee
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome
Introduction
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Dement Geriatr Cogn Disord Extra 2016;6:194–204 DOI: 10.1159/000445870
© 2016 The Author(s). Published by S. Karger AG, Basel www.karger.com/dee
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome
Subjects and Methods
Subjects
ͳͶ ȋ ǡ ͺ ǡ Ǥͻ ά ͷǤ ȌǤ
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ȋαͲǤͶ͵ǡǦȌǤ Evaluation of Clinical Symptoms
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Dement Geriatr Cogn Disord Extra 2016;6:194–204 DOI: 10.1159/000445870
© 2016 The Author(s). Published by S. Karger AG, Basel www.karger.com/dee
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome
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Evaluation of Brain Lesions Using Cerebral Blood Flow Single-Photon Emission Computed Tomography Tests ͳʹ͵ Ǧ Ǧ
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ǡ Ǥ Statistical Analysis
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ͷΨǤ Results
Clinical Symptoms of Subjects with FTD Syndrome
ͳǤ ͶǤͺάǤͳǡ͵ǤͶάʹǤͻǤ ǡ
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Dement Geriatr Cogn Disord Extra 2016;6:194–204 © 2016 The Author(s). Published by S. Karger AG, Basel www.karger.com/dee
DOI: 10.1159/000445870
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome
Table 1.
ǡ Ȁ ǡ
Ǧ
ȋͳͲǦȌ ȋͳǦȌ
ȋαͳͶȌ
ȋαͳͶȌ
Ǥͻ ά ͷǤ Ȁͺ ʹͳǤͻ ά ͷǤͲ ͺǤͺ ά ͵Ǥ ͶǤͺ ά Ǥͳ ͵ǤͶ ά ʹǤͻ
ͻǤʹ ά ʹǤͺ Ȁͺ ʹͺǤ ά ͳǤʹ ͳͷǤͻ ά ͳǤ͵ Ȃ Ȃ
ͲǤͶ͵Ͷ Ȃ ͲǤͲͲͲͲͲͲȗȗ ͲǤͲͲͲͲͲͲȗȗ Ȃ Ȃ
ͳͲȋͳǤͶȌ ʹȋͳͶǤ͵Ȍ ͺȋͷǤͳȌ Ͷȋ͵͵Ǥ͵Ȍ ͷȋ͵ͷǤȌ ͲȋͲȌ ͳͲȋͳǤͶȌ ͵ȋʹͳǤͶȌ ȋͶʹǤͻȌ ͳͶȋͳͲͲǤͲȌ ͶȋʹͺǤȌ ͲȋͲȌ
Ȃ Ȃ Ȃ Ȃ Ȃ Ȃ Ȃ Ȃ Ȃ Ȃ Ȃ Ȃ
Ȃ Ȃ Ȃ Ȃ Ȃ Ȃ Ȃ Ȃ Ȃ Ȃ Ȃ Ȃ
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a
b
Fig. 1.
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Dement Geriatr Cogn Disord Extra 2016;6:194–204 DOI: 10.1159/000445870
© 2016 The Author(s). Published by S. Karger AG, Basel www.karger.com/dee
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome
Table 2.
ȋʹͺȌ Pre-VStest ǡ
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ǡȀ VStest ǡ
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ͷǤͷ ά ͳǤ ͷǤ ά ͳǤ
ͲǤͲͲͲͲͲʹȗȗ ͲǤͲͲͲͲͳȗȗ
ͷͻǤͶ ά ʹͳǤͷ ͳʹǤͶ ά Ǥʹ ͵ǤͲ ά ͳǤͳ
ͺʹǤͳ ά ͳǤ͵ ͳͷǤʹ ά ͵Ǥ ʹǤͷ ά ͲǤ
ͲǤͲͲͲͲͺȗȗ ͲǤͲ ͲǤͲ͵
͵Ǥʹ ά ͳǤͺ ͶǤͲ ά ʹǤͲ
ͳǤͻ ά ͲǤ ʹǤ͵ ά ͲǤͺ
ͲǤͲͲͲͶȗȗ ͲǤͲͲͲʹȗȗ
ͷǤͷ ά ʹͶǤͻ ͳͳǤͶ ά ͺǤͻ ʹǤͶ ά ͳǤ͵
ͶͷǤ ά ͻǤͲ ͷǤ ά ʹǤ ʹǤͳ ά ͲǤͻ
ͲǤͲͲͲʹȗȗ ͲǤͲͲʹȗȗ ͲǤ͵ͳͲ
ͶǤͺ ά ͶǤͲ
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Ǥ Caloric Test Results for Each Group
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Ǥ Relationship of Subjective Symptoms with SR in the FTD Group
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Dement Geriatr Cogn Disord Extra 2016;6:194–204 DOI: 10.1159/000445870
© 2016 The Author(s). Published by S. Karger AG, Basel www.karger.com/dee
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome
Table 3.
ȋαͳͶȌ
Ǧ
ȋͳͲǦȌ ȋͳǦȌ
ǡΨ
ͳǤͶ ά ͵ʹǤͲȋͳͲȀͳͶȌ Ȃ ͺǤͶ ά ʹ͵Ǥ͵ȋʹȀͳͶȌ ʹǤʹ ά ʹͻǤʹȋͺȀͳͶȌ ͳͲǤͳ ά ͵ͺǤȋͶȀͳͶȌ Ȃ ͷǤͳ ά ͵ǤͳȋͷȀͳͶȌ ͳͶǤͺ ά ʹͺǤͷȋͳͲȀͳͶȌ ȂͶͳǤͲ ά ͳͲǤȋ͵ȀͳͶȌ ȂͳͷǤ͵ ά ͵ʹǤͺȋȀͳͶȌ
ȂʹʹǤ͵ ά ʹʹǤʹȋͶȀͳͶȌ ͺǤͶ ά ͵ͷǤͻȋͳʹȀͳͶȌ ͳͳǤʹ ά ͶʹǤͶȋȀͳͶȌ ͶǤͶ ά ͵ͶǤͶȋͳͲȀͳͶȌ ͳʹǤʹ ά ͵͵ǤȋͻȀͳͶȌ ȂͳǤͲ ά ͶͳǤȋͶȀͳͶȌ ͳͺǤͻ ά ʹͷǤȋͳͳȀͳͶȌ ʹʹǤͲ ά ʹǤͻȋͺȀͳͶȌ
ͲǤͲʹͻȗ ͲǤͶͺʹ ͲǤ ͲǤͺͲͻ ͲǤͶͲ ͲǤʹͶͶ ͲǤͲͲͲʹȗȗ ͲǤͲͶͺȗ
άǡǤ ȗ
ȋ δ ͲǤͲͷǡ Ǧ ȌǤȗȗ
ȋδͲǤͲͳǡ ǦȌǤ
Discussion
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ȏͷǡʹȐǡ
ǦǤ
ǡ
E X T R A
Dement Geriatr Cogn Disord Extra 2016;6:194–204 DOI: 10.1159/000445870
© 2016 The Author(s). Published by S. Karger AG, Basel www.karger.com/dee
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome
a
b
c
Fig. 2.
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Ǣα
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ǡǤ
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Dement Geriatr Cogn Disord Extra 2016;6:194–204 DOI: 10.1159/000445870
© 2016 The Author(s). Published by S. Karger AG, Basel www.karger.com/dee
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome
Ǧȋ Ȍ
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ǡ ǡǡ
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Dement Geriatr Cogn Disord Extra 2016;6:194–204 © 2016 The Author(s). Published by S. Karger AG, Basel www.karger.com/dee
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Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome
Conclusion
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Ǥ Acknowledgments
ȋȌ ȋǤ ʹͶͲͻͲͳȌ
ǡǡǡ
Ǥ Disclosure Statement
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References Ԙ ͳ ǡǡǡǡǣ
Ͳͺǣ ͲͻȂʹ͵Ǥ ǤͳͻͺͷǢͳ Ԙ ʹ ǡ ǡ ǡ
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ǫ
ͳͻͻͺǢʹ Ԙ Ͷ ǡ ǡǡ ǡ ǡǡǡ ǡǡ ǡ ǣ ʹǣͳ ͷʹȂͳͷͺǤ
Ǧ
ǣǤʹͲͲ͵Ǣͳ Ԙ ͷ ǡ ǡǡǡǡ ǡ
ǡǡǡ ǣͳ ͺͷȂͳͻǤ ǣ
ǯǤ ʹͲͳͷǢͶ Ԙ
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ǡ ǡǣ
ǣ͵ ͳͺȂ͵ʹǤ ǤͳͻǢʹ Ԙ
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Ǥ
ʹǣʹ ͺͲȂʹͺͳǤ ͳͻͳǢͳ Ԙ ͺ òǡǣ
ȋʹȌ
ͷ͵ǣ͵ ͻʹȂ͵ͻǤ
ǤͳͻͺǢͳ Ԙ ͻ ǡ
ǡ
ǡǣ
͵ ͳǣͻ ȂͳͲͷǤ (Saimiri sciureus)ǤͳͻͶǢʹ ͳ Ͳ Ǧ ǡ ǣ
ȋȌ
Ǧ ͺͲǣͳ ȂͳͶǤ Ǧ
(Macaca fascicularis)Ǥ ͳͻͺͻǢʹ ͳ ͳ ò ǡǡ
ǣ
Ǧ ͵Ͳǣͷ ͵ȂͷͷǤ
(Macaca fascicularis)Ǥ ͳͻͻͲǢͶ ͳ ʹ ò ǡǡ
ǣǦ
(Macaca fasci ͵Ͳǣͷ ͷͻȂͷͺ͵Ǥ cularis)ǣ
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͵ͻǣͶ ʹͳȂͶ͵Ǥ
Ǥ ͳͻͻͶǢ͵ ͳ ͷ ǡ ǡ ǡǡǡ
ǡ ǡǡǡǡ ǡǡ ǡ ǣ ǣ
Ǧ ͳǣͳ ͷͶȂͳͷͷͶǤ
ǤͳͻͻͺǢͷ
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Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome
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ͺǣͳ ͺͲ͵ȂͳͺͲͻǤ ʹͲͲͳǢͷ ǣͷ Ȃͷͺ͵Ǥ ͳ ǣ ǣǤ
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ʹͲͲͷǢ ʹ Ͳ ǡ ǡǡ ǡ ǡǡ ǣ
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ʹͲͲǢʹ ʹ ͳ ǡ ǡ ǡ
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ͺǣͳ ͺͳȂͳͺʹ͵Ǥ ǤʹͲͳʹǢ ʹ ͵ ǡ ǡǡǡǡǡǡ ǡ ǣǦ
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ͳͻͺͺǢʹ ʹ ͷ ǡǡǡǡǡǡǣ
ͺǣͻ ȂͳͲͶǤ ǦǤ
ͳͻͻǢͺ ʹ ǡǡǣ
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Ͳͷǣͷ ͻȂͷͺͳǤ ͳͻͻǢͳ ʹ ǡǡǣ
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ͳͻͺͳǢ͵ ʹ ͺ ǡ ǡǡ ǡǣ
ǯ ǣͳ ʹ͵ͺȂͳʹͶͺǤ Ǧ
ǦͳͺǦ Ǥ
ͳͻͻͷǢ͵ ʹ ͻ ǡ
ǡ ǡǣ ǣ ǤʹͲͲͲǢ ͷ ͷǣͳ ʹͳȂͳʹǤ ͵ Ͳ ǡǣ
Ȁ
ǣ͵ ͻȂͶǤ Ǧ
ǤͳͻͻͳǢͳ ͵ ͳ ǡǡǡǣ
ͳǣͳ ͵͵Ȃͳ͵ͷͲǤ
Ǥ ͳͻͻͶǢ ͵ ʹ ǡǡ ǡ ǡ ǡǡǡǣͳͺ Ǧ ǣʹ ͵͵Ȃʹ͵ͻǤ ǣʹͻǤ
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ǡǡǡǡ ǡǡ ǡǡ
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ǯǣ ͷǣ͵ ͲͷͲȂ͵ͲͷͻǤ
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ǣͶ ʹ͵ȂͶ͵ͶǤ ǤʹͲͳʹǢͺ