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• W3201434961 abstract "Importance: The behavioral variant of Alzheimer disease (bvAD) is characterized by early and predominant behavioral deficits caused by AD pathology. This AD phenotype is insufficiently understood and lacks standardized clinical criteria, limiting reliability and reproducibility of diagnosis and scientific reporting. Objective: To perform a systematic review and meta-analysis of the bvAD literature, and use the outcomes to propose provisional research criteria for this syndrome. Data sources: A systematic literature search in PubMed/Medline and Web-of-Science databases (from inception through April 7th, 2021, performed in duplicate) led to the assessment of 83 studies, including 13 suitable for meta-analysis. Study selection: Studies reporting on behavioral, neuropsychological or neuroimaging features in bvAD, and, when available, providing comparisons with typical amnestic-predominant AD (tAD) or behavorial variant frontotemporal dementia (bvFTD). Data extraction and synthesis: We performed random-effects meta-analyses on group-level study results of clinical data, and systematically reviewed the neuroimaging literature. Main outcome and measures: Behavioral symptoms (neuropsychiatric symptoms and bvFTD core clinical criteria), cognitive function (global cognition, episodic memory and executive functioning) and neuroimaging features (structural MRI, [18F]FDG-PET, perfusion SPECT, amyloid-PET and tau-PET). Results: Data were collected for 591 patients with bvAD. There was moderate-to-substantial heterogeneity and moderate risk of bias across studies. bvAD showed more severe behavioral symptoms compared to tAD (standardized mean difference [SMD, 95% confidence interval]: 1.16[0.74-1.59], p<0.001), and a trend towards less severe behavioral symptoms compared to bvFTD (SMD:-0.22[-0.47-0.04], p=0.10). Meta-analyses of cognitive data indicated worse executive performance in bvAD versus tAD (SMD:-1.03[-1.74--0.32], p<0.01), but not compared to bvFTD (SMD:-0.61[-1.75-0.53], p=0.29). bvAD showed a trend towards worse memory performance compared to bvFTD (SMD:-1.31[-2.75-0.14], p=0.08), but did not differ from tAD (SMD:0.43[-0.46-1.33], p=0.34). The neuroimaging literature revealed two distinct bvAD neuroimaging-phenotypes: an AD-like posterior-predominant pattern and a bvFTD-like anterior-predominant pattern, with the former being more prevalent. Conclusions and relevance: Our data indicate that bvAD is clinically most similar to bvFTD, while it shares most pathophysiological features with tAD. Based on these insights, we propose provisional research criteria for bvAD aimed at improving the consistency and reliability of future research and aiding the clinical assessment of this AD phenotype." @default.
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• W3201434961 date "2021-09-13" @default.
• W3201434961 modified "2023-09-27" @default.
• W3201434961 title "Provisional research criteria for the behavioral variant of Alzheimer disease: A systematic review and meta-analysis" @default.
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• W3201434961 doi "https://doi.org/10.1101/2021.09.08.21263253" @default.
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