Cognitive and Behavioral Control in FTD

描述（由申请方提供）：本项目的总体目标是确定行为变异型额颞叶痴呆（bvFTD）患者表现出的行为调节严重缺陷的认知、神经解剖学和生理学基础。bvFTD和其他额叶疾病患者通常表现为重度行为功能障碍，尽管在注意力、工作记忆、问题解决和执行功能的标准临床指标上表现相对完整。一个主要的问题是这些行为在多大程度上反映了认知缺陷（例如，认知控制、错误意识、错误纠正），或者它们是否反映了奖励和惩罚过程中的主要潜在缺陷。我们计划研究50例轻度bvFTD患者、50例人口统计学和痴呆严重程度匹配的阿尔茨海默病患者和50例正常对照。我们将通过评估冲突监控、错误检测和错误纠正来研究行为调节的认知成分，并通过采用奖励处理范式来评估动机成分。行为研究将与功能性MRI结合进行，以研究介导这些行为的大脑系统。我们的研究结果有望阐明为什么这些患者无法抑制不适当的行为，并为新的干预措施提供指导。 公共卫生相关性：无法控制冲动和抑制不适当的行为对额叶疾病患者有毁灭性的影响。该项目的首要目标是研究行为变异性额颞叶痴呆患者，以更好地了解这些适应不良行为的认知和神经基础。对公共卫生的潜在贡献在于希望更好地了解介导行为失控的神经系统将导致护理的改善。

DESCRIPTION (provided by applicant): The overarching goal of this project is to determine the cognitive, neuroanatomic and physiological underpinnings of the profound deficits in behavioral regulation exhibited by patients with behavioral variant frontotemporal dementia (bvFTD). Patients with bvFTD and other frontal lobe disorders often present with severe behavioral dysfunction despite relatively intact performance on standard clinical measures of attention, working memory, problem solving, and executive function. A primary question is to what degree these behaviors reflect deficits in cognition (e.g., cognitive control, awareness of errors, error correction), or whether they reflect a primary underlying deficit in the processing of reward and punishment. We propose to study 50 patients with mild bvFTD, 50 Alzheimer's disease patients matched for demographics and dementia severity, and 50 normal controls. We will study the cognitive components of behavioral regulation by assessing conflict monitoring, error detection, and error correction, and we will evaluate the motivational components by employing reward processing paradigms. Behavioral studies will be carried out in conjunction with functional MRI to study the brain systems that mediate these behaviors. Our results will hopefully shed light on why these patients fail to inhibit inappropriate actions and offer guidance toward new interventions. PUBLIC HEALTH RELEVANCE: The Inability to control impulses and inhibit inappropriate behavior has a devastating impact on patients with frontal lobe disorders. The overarching goal of this project is to study patients with behavioral-variant frontotemporal dementia to better understand the cognitive and neurological underpinnings of these maladaptive behaviors. The potential contribution to public health lies in the hope that a better understanding of the neural systems that mediate behavioral dyscontrol will lead to improvements in care.