Alzheimer's & dementia (Amsterdam, Netherlands) · 2026
Autonomic dysfunction and hypothalamic atrophy in frontotemporal dementia and primary psychiatric disorders.
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Timar Yannick S S, van Engelen Marie-Paule Emilie, Venkatraghavan Vikram, Billot Benjamin, Fieldhouse Jay Lydia Petronella, Van't Hooft Jochum J, de Boer Sterre C M, Koevoets Chris S, Hartog Luc W, Groot Collin, Oudega Mardien L, Vijverberg Jort Everard G B, van der Flier Wiesje M, Barkhof Frederik, Pijnenburg Yolande A L
Аннотация
INTRODUCTION: Evidence suggests that autonomic symptoms in frontotemporal dementia (FTD) may relate to hypothalamic pathology. We investigated (1) autonomic symptoms in FTD, primary psychiatric disorders (PPD), and controls; (2) hypothalamic volumes; and (3) their associations.
METHODS: Autonomic Symptoms Questionnaire (ASQ) data were collected from FTD (n = 31), PPD (n = 30), and controls (n = 30). MRI data from these and additional participants (FTD n = 259, PPD n = 44, controls n = 62) were analyzed using a deep learning approach.
RESULTS: FTD and PPD groups reported more cardiovascular symptoms than controls (p = 0.020; p = 0.049). FTD patients showed greater thermodysregulation (vs. PPD p = 0.026; vs. controls p = 0.012) and altered pain perception (FTD 13%, PPD 2%, controls 1%; p < 0.001). FTD showed smaller hypothalamic subregions, except the left inferior-tubular area. In FTD, autonomic symptoms correlated with subregional hypothalamic volumes.
DISCUSSION: FTD patients exhibit increased autonomic symptoms across several domains compared to PPD and controls; moreover, FTD is associated with smaller regional hypothalamic volume.
METHODS: Autonomic Symptoms Questionnaire (ASQ) data were collected from FTD (n = 31), PPD (n = 30), and controls (n = 30). MRI data from these and additional participants (FTD n = 259, PPD n = 44, controls n = 62) were analyzed using a deep learning approach.
RESULTS: FTD and PPD groups reported more cardiovascular symptoms than controls (p = 0.020; p = 0.049). FTD patients showed greater thermodysregulation (vs. PPD p = 0.026; vs. controls p = 0.012) and altered pain perception (FTD 13%, PPD 2%, controls 1%; p < 0.001). FTD showed smaller hypothalamic subregions, except the left inferior-tubular area. In FTD, autonomic symptoms correlated with subregional hypothalamic volumes.
DISCUSSION: FTD patients exhibit increased autonomic symptoms across several domains compared to PPD and controls; moreover, FTD is associated with smaller regional hypothalamic volume.