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Table 1 Clinical features distinguishing fvAD from bvFTD

From: Diagnosing the frontal variant of Alzheimer’s disease: a clinician’s yellow brick road

  Clinical Features supporting fvAD Clinical Features supporting bvFTD
Memory Early memory complaints Late memory complaints
Language Phonemic and semantic paraphasias Loss of socioemotional aspects of speech
Fluency Semantic > phonemic fluency impairment Phonemic > semantic fluency impairment
Behavioral Compulsive or perseverative behaviors are uncommon Collection or hoarding, and ritualistic and disinhibited behaviors (particularly involving food)
Personality Change Agitation and irritability Early apathy, disinhibition, loss of empathy
Thought Content Delusions (theft, infidelity, and paranoid) Mental rigidity
Body Habitus Weight loss associated with depression Weight gain associated with hyperphagia
Movement Disorder Myoclonus (often mischaracterized as tremor), late parkinsonism Early parkinsonism
Brain MRI pattern Symmetric atrophy (temporal > frontal, posterior corpus callosum, and perisylvian) Symmetric (~MAPT mutations) or asymmetric (~GRN mutations) frontotemporal atrophy
CSF findings CSF p-Tau/Aβ42 ratio (>0.21 ng/mL) CSF progranulin levels (<60 ng/mL)- not validated in clinical practice
Biomarkers APOE ε4 allele positive No relation to APOE allele