Expert opinions on pharmacological symptomatic treatment of behavioral symptoms in frontotemporal dementia: A survey of the Neuropsychiatric International Consortium on Frontotemporal Dementia (NIC‐FTD)
Bibliographic record
Abstract
BACKGROUND AND PURPOSE: Behavioral variant frontotemporal dementia (bvFTD) is essentially characterized by progressive changes in personality and cognition. Clinically, bvFTD presents with often profound behavioral symptomatology. Despite the high burden of these symptoms for both patients and caregivers, there is no general consensus on an effective pharmacological symptomatic treatment. Interestingly, for multiple similar symptoms in primary psychiatric disorders, there is consensus on an effective pharmacological treatment. The aim of this study is to explore currently preferred clinical practices in the pharmacological treatment of specific core behavioral symptoms in bvFTD by world-leading clinical experts. METHODS: A digital survey was conducted among members of the Neuropsychiatric International Consortium on Frontotemporal Dementia, comprising neurologists, psychiatrists, and neuropsychiatrists. Respondents recommended pharmacological treatments targeting symptoms including disinhibition, apathy, loss of empathy, hyperorality, perseverative/compulsive behaviors, and positive psychotic symptoms. RESULTS: Of 48 respondents with a median experience of 11.5 years in treating bvFTD, disinhibition was most frequently targeted (58.4%), followed by perseverative/compulsive behaviors (46.5%). Recommended drug classes included atypical antipsychotics (35.1%), selective serotonin reuptake inhibitors (31.2%), antiepileptics (10.0%), serotonin antagonist and reuptake inhibitors (8.4%), benzodiazepines (4.0%), and others (11.4%). CONCLUSIONS: Our survey revealed diverse pharmacological treatment practices for behavioral symptoms in bvFTD, reflecting the expected radical heterogeneity in pharmacological treatment strategies. Notwithstanding this, results from this explorative survey could further inform future research directions, and thus in turn potentially aid in establishing more consensus on effective pharmacological management of bvFTD, while the field awaits the development of highly anticipated disease-modifying treatment(s).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".