The Benson Complex Figure Test detects deficits in visuoconstruction and visual memory in symptomatic familial frontotemporal dementia: A GENFI study

• Published in: Journal of the neurological sciences Vol. 446; p. 120590
• Main Authors: Jiskoot, Lize C., Russell, Lucy L., Peakman, Georgia, Convery, Rhian S., Greaves, Caroline V., Bocchetta, Martina, Poos, Jackie M., Seelaar, Harro, Giannini, Lucia A.A., van Swieten, John C., van Minkelen, Rick, Pijnenburg, Yolande A.L., Rowe, James B., Borroni, Barbara, Galimberti, Daniela, Masellis, Mario, Tartaglia, Carmela, Finger, Elizabeth, Butler, Chris R., Graff, Caroline, Laforce, Robert, Sanchez-Valle, Raquel, de Mendonça, Alexandre, Moreno, Fermin, Synofzik, Matthis, Vandenberghe, Rik, Ducharme, Simon, le Ber, Isabelle, Levin, Johannes, Otto, Markus, Pasquier, Florence, Santana, Isabel, Cash, David M., Thomas, David, Rohrer, Jonathan D.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15-03-2023; Elsevier
• Subjects: Atrophy - complications; C9orf72 Protein - genetics; Cognition; Cross-Sectional Studies; Frontotemporal Dementia; Genetic; Humans; Life Sciences; Marker; Medicin och hälsovetenskap; Mutation; Neurons and Cognition; Neuropsychological Tests; Neuropsychology; Presymptomatic; tau Proteins - genetics; Genetic; Presymptomatic; Cognition; Neuropsychology; Marker; Frontotemporal dementia
• ISSN: 0022-510X; 1878-5883; 1878-5883
• DOI: 10.1016/j.jns.2023.120590

Sensitive cognitive markers are still needed for frontotemporal dementia (FTD). The Benson Complex Figure Test (BCFT) is an interesting candidate test, as it assesses visuospatial, visual memory, and executive abilities, allowing the detection of multiple mechanisms of cognitive impairment. To investigate differences in BCFT Copy, Recall and Recognition in presymptomatic and symptomatic FTD mutation carriers, and to explore its cognitive and neuroimaging correlates.
We included cross-sectional data from 332 presymptomatic and 136 symptomatic mutation carriers (GRN, MAPT or C9orf72 mutations), and 290 controls in the GENFI consortium. We examined gene-specific differences between mutation carriers (stratified by CDR® NACC-FTLD score) and controls using Quade's / Pearson Χ2 tests. We investigated associations with neuropsychological test scores and grey matter volume using partial correlations and multiple regression models respectively.
No significant differences were found between groups at CDR® NACC-FTLD 0–0.5. Symptomatic GRN and C9orf72 mutation carriers had lower Copy scores at CDR® NACC-FTLD ≥2. All three groups had lower Recall scores at CDR® NACC-FTLD ≥2, with MAPT mutation carriers starting at CDR® NACC-FTLD ≥1. All three groups had lower Recognition scores at CDR® NACC FTLD ≥2. Performance correlated with tests for visuoconstruction, memory, and executive function. Copy scores correlated with frontal-subcortical grey matter atrophy, while Recall scores correlated with temporal lobe atrophy.
In the symptomatic stage, the BCFT identifies differential mechanisms of cognitive impairment depending on the genetic mutation, corroborated by gene-specific cognitive and neuroimaging correlates. Our findings suggest that impaired performance on the BCFT occurs relatively late in the genetic FTD disease process. Therefore its potential as cognitive biomarker for upcoming clinical trials in presymptomatic to early-stage FTD is most likely limited.
•The BCFT is an interesting candidate test for familial FTD.•It identified gene-specific impairment mechanisms and its neuroimaging correlates.•Impaired BCFT performance occurs relatively late in the FTD disease process.•Therefore its potential as cognitive test for trials in the early stage is limited.