Clinical Swallowing Profile of Patients with Frontotemporal Dementia

Objective: To document the characteristics of dysphagia in FTD and therefore the link between the different phenotypes of FTD and swallowing profiles. Background: Fronto-temporal dementia (FTD) is characterized by a wide range of clinical manifestation from language to behavioral disorders. Recent discover of C9ORF72 as a causative gene both in sporadic and familial forms of FTD and ALS, has determined a focus on motor neuron dysfunctions across the clinical manifestations of FTD. Very few studies described swallowing function in FTD although dysphagia increases significantly morbidity and mortality. Design/Methods: Patients were referred for assessment of swallowing function from the center (of neurodegenerative diseases at Cardinal Panico Hospital, based in Tricase (University of Bari) Southern Italy. Consent was obtained with a research protocol that included patient and family consent, and was approved by the institutional review board. All patients underwent a Fiberoptic Endoscopic Evaluation of Swallowing (FEES) to assess the oropharyngeal stage of swallowing; severity of dysphagia was determined according to the Pooling score scale and Penetration Aspiration Scale (PAS). Results: While the majority of patients (78%; 18/23) showed subtle alteration of swallowing dynamic (premature spillage, incomplete bolus clearance), a relevant degree of dysphagia was identified in 7/23 patients (30%). Specifically, in the bv-FTD subgroup, 6/9 (66%) patients were found to have moderate to severe dysphagia according to pooling score scale and PAS; 1/8 patient with non-fluent progressive aphasia (12.5%) (in the subgroup of language disorders) and 2/6 (33%) of the patients in the motor neuron phenotype presented mild dysphagia. Conclusions: Dysphagia was more frequently found in bv-FTD population, with signs of aspiration pneumonia and choking. Patients who presented compulsive eating behavior were predominantly affected by swallowing problems. Our findings empathize the importance of instrumental assessment of swallowing function to identify early signs of dysphagia such as aspiration and common prevent clinical complications. Disclosure: Dr. Iacolucci has nothing to disclose. Dr. Battista has nothing to disclose. Dr. Barone has nothing to disclose. Dr. Vitulli has nothing to disclose. Dr. Longo has nothing to disclose. Dr. Castrovillari has nothing to disclose. Dr. Capozzo has nothing to disclose. Dr. Tortelli has nothing to disclose. Dr. Logroscino has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Eli Lilly.