DIETARY-CHANGES, COMPULSIONS AND SEXUAL-BEHAVIOR IN FRONTOTEMPORAL DEGENERATION

The occurrence of weight gain, sweet and carbohydrate craving, hyposex uality, and compulsions in frontal lobe dementia (FLD) compared to Alz heimer's disease (AD) was evaluated. FLD is a progressive dementia wit h a high rate of misdiagnosis and therefore better diagnostic criteria for FLD are needed. Fourteen patients meeting research criteria for A D were compared to 14 with suspected FLD. All had cerebral perfusion m easured with xenon-133 and imaged with HMPAO using brain-dedicated SPE CT. The FLD group showed frontotemporal and AD posterior temporopariet al hypoperfusion. The primary caregivers were queried regarding weight gain, sweet/carbohydrate preference, sexual drive, and compulsions. D ifferences were compared with Fisher's exact test. The following was f ound in FLD versus AD: Weight gain in FLD patients amounted to 64% (AD 7%), carbohydrate craving was 79% (vs. 0%) and compulsive behavior 64 % (vs. 14%). The differences for these symptoms were statistically sig nificant, whereas for the symptoms increased sexual drive (8 vs. 8%) a nd reduced sexual drive (54 vs. 23%) no significant difference could b e found. In FLD the first symptoms were often dietary changes or hypos exuality. Compulsions were more bizarre and severely disabling in FLD than in AD. Dietary changes, hyposexuality, and disabling compulsions are prominent early symptoms in FLD but not AD. The cause of these sym ptoms may be due to both frontal and subcortical serotonin loss and dy sfunction of the anterior temporal lobes.