VentRa: distinguishing frontotemporal dementia from psychiatric disorders

Abstract

The volume of the lateral ventricles are reliable and sensitive indicators of brain atrophy and disease progression in behavioral variant frontotemporal dementia. Here we validate our previously developed automated tool using ventricular features (known as VentRa) for the classification of behavioral variant frontotemporal dementia vs a mixed cohort of neurodegenerative, vascular, and psychiatric disorders from a clinically representative independent dataset.

Lateral ventricles were segmented for 1110 subjects - 14 behavioral variant frontotemporal dementia, 30 other Frontotemporal Dementia, 70 Lewy Body Disease, 898 Alzheimer Disease, 62 Vascular Brain Injury and 36 Primary Psychiatric Disorder from the publicly accessible National Alzheimer’s Coordinating Center dataset to assess the performance of VentRa.

Using ventricular features to discriminate behavioral variant frontotemporal dementia subjects from primary psychiatric disorders, VentRa achieved an accuracy of 84%, 71% sensitivity and 89% specificity. VentRa was able to identify behavioral variant frontotemporal dementia from a mixed age-matched cohort (i.e., other Frontotemporal Dementia, Lewy Body Disease, Alzheimer Disease, Vascular Brain Injury and Primary Psychiatric Disorders) and to correctly classify other disorders as ‘not compatible with behavioral variant frontotemporal dementia’ with a specificity of 83%. The specificity against each of the other individual cohorts were 80% for other Frontotemporal Dementia, 83% for Lewy Body Disease, 83% for Alzheimer Disease, 84% for Vascular Brain Injury and 89% for Primary Psychiatric Disorders.

VentRa is a robust and generalizable tool with potential usefulness for improving the diagnostic certainty of behavioral variant frontotemporal dementia, particularly for the differential diagnosis with Primary Psychiatric Disorders.