Agitation as a neuropsychiatric symptom of frontotemporal dementia

Shunichiro Shinagawa

Department of Psychiatry, Jikei University School of Medicine

Frontotemporal dementia （FTD） is a neurodegenerative disorder, characterized by behavioral changes such as disinhibition, apathy, lack of empathy, stereotypic behavior, and changes in eating behavior, caused by focal degeneration of the frontal and anterior temporal lobes.　These behavioral changes are related to the dysfunction of the frontal lobe, but agitation is not included in the diagnostic criteria.　Studies using comprehensive neuropsychiatric rating scales revealed that agitation is not characteristic of FTD.　The agitation has two meanings, in the broad sense it means just aggression or restlessness （excessive movement）, in the narrow sense it is accompanied by anxiety or emotional distress.　Aggression in the broad sense also exists in FTD, caused by unique stereotypic behaviors or stimulus-bound behaviors, lack of empathy, which is not related to anxiety or emotional distress.　When assessing neuropsychiatric symptoms of dementia, it is important to consider not only superficial behaviors but also the pathophysiology behind them.　Note that management and care will vary greatly accordingly.

Address correspondence to Dr. Shunichiro Shinagawa, Department of Psychiatry, Jikei University School of Medicine （3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan）