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March 2016

Uncovering Neuroanatomical Networks Responsible for Abnormal Eating Behavior in Frontotemporal Dementia

Author Affiliations
  • 1Department of Radiology, Mayo Clinic, Rochester, Minnesota
JAMA Neurol. 2016;73(3):267-268. doi:10.1001/jamaneurol.2015.4496

Magnetic resonance imaging (MRI) is a powerful tool that allows us to not only assess atrophic patterns associated with disease but to start to unravel the complex associations between regional tissue loss and specific clinical symptoms. Patterns of atrophy associated with frontotemporal dementia (FTD) and its clinical variants have been well described and studies have begun to demonstrate that different behavioral symptoms observed across the FTD spectrum have different anatomical loci.1-6 Changes in one’s eating behavior is a behavioral feature that is particularly hard to measure and, hence, to study accurately with neuroimaging. This could involve the tendency to overeat or cram food in the mouth, indiscriminate eating, oral exploration of inanimate objects, increased selectivity in food choices, or a preference for sweet foods.7 These behaviors are typically best captured with caregiver questionnaires since a loss of insight results in an underestimation of the presence and severity of the behaviors by the patient. These questionnaires are not perfect, however, and are limited by problems with overestimation or underestimation. In addition, the reduced quantitative scale often inherent to these questionnaires (eg, 4-point scale of normal, mild, moderate, severe) can also make neuroimaging analyses difficult.

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