Altered Time Awareness in Dementia
Our awareness of time, specifically of longer intervals spanning hours, days, months, and years, is critical for ensuring our sense of self-continuity. Disrupted time awareness over such intervals is a clinical feature in a number of frontotemporal dementia syndromes and Alzheimer's disease, bu...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-04-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.00291/full |
| _version_ | 1818328561457561600 |
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| author | Maï-Carmen Requena-Komuro Charles R. Marshall Charles R. Marshall Rebecca L. Bond Lucy L. Russell Caroline Greaves Katrina M. Moore Jennifer L. Agustus Elia Benhamou Harri Sivasathiaseelan Chris J. D. Hardy Jonathan D. Rohrer Jason D. Warren |
| author_facet | Maï-Carmen Requena-Komuro Charles R. Marshall Charles R. Marshall Rebecca L. Bond Lucy L. Russell Caroline Greaves Katrina M. Moore Jennifer L. Agustus Elia Benhamou Harri Sivasathiaseelan Chris J. D. Hardy Jonathan D. Rohrer Jason D. Warren |
| author_sort | Maï-Carmen Requena-Komuro |
| collection | DOAJ |
| description | Our awareness of time, specifically of longer intervals spanning hours, days, months, and years, is critical for ensuring our sense of self-continuity. Disrupted time awareness over such intervals is a clinical feature in a number of frontotemporal dementia syndromes and Alzheimer's disease, but has not been studied and compared systematically in these diseases. We used a semi-structured caregiver survey to capture time-related behavioral alterations in 71 patients representing all major sporadic and genetic syndromes of frontotemporal dementia, in comparison to 28 patients with typical Alzheimer's disease and nine with logopenic aphasia, and 32 healthy older individuals. Survey items pertained to apparent difficulties ordering past personal events or estimating time intervals between events, temporal rigidity and clockwatching, and propensity to relive past events. We used a logistic regression model including diagnosis, age, gender, and disease severity as regressors to compare the proportions of individuals exhibiting each temporal awareness symptom between diagnostic groups. Gray matter associations of altered time awareness were assessed using voxel-based morphometry. All patient groups were significantly more prone to exhibit temporal awareness symptoms than healthy older individuals. Clinical syndromic signatures were identified. While patients with typical and logopenic Alzheimer's disease most frequently exhibited disturbed event ordering or interval estimation, patients with semantic dementia were most prone to temporal rigidity and clockwatching and those with behavioral variant frontotemporal dementia commonly exhibited all these temporal symptoms as well as a propensity to relive past events. On voxel-based morphometry, the tendency to relive past events was associated with relative preservation of a distributed left-sided temporo-parietal gray matter network including hippocampus. These findings reveal a rich and complex picture of disturbed temporal awareness in major dementia syndromes, with stratification of frontotemporal dementia syndromes from Alzheimer's disease. This is the first study to assess symptoms of altered temporal awareness across frontotemporal dementia syndromes and provides a motivation for future work directed to the development of validated clinical questionnaires, analysis of underlying neurobiological mechanisms and design of interventions. |
| first_indexed | 2024-12-13T12:34:07Z |
| format | Article |
| id | doaj.art-c4209ced52a0419db5b06f014d24df76 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-13T12:34:07Z |
| publishDate | 2020-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-c4209ced52a0419db5b06f014d24df762022-12-21T23:45:56ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-04-011110.3389/fneur.2020.00291519633Altered Time Awareness in DementiaMaï-Carmen Requena-Komuro0Charles R. Marshall1Charles R. Marshall2Rebecca L. Bond3Lucy L. Russell4Caroline Greaves5Katrina M. Moore6Jennifer L. Agustus7Elia Benhamou8Harri Sivasathiaseelan9Chris J. D. Hardy10Jonathan D. Rohrer11Jason D. Warren12Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United KingdomDementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United KingdomPreventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United KingdomDementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United KingdomDementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United KingdomDementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United KingdomDementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United KingdomDementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United KingdomDementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United KingdomDementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United KingdomDementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United KingdomDementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United KingdomDementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United KingdomOur awareness of time, specifically of longer intervals spanning hours, days, months, and years, is critical for ensuring our sense of self-continuity. Disrupted time awareness over such intervals is a clinical feature in a number of frontotemporal dementia syndromes and Alzheimer's disease, but has not been studied and compared systematically in these diseases. We used a semi-structured caregiver survey to capture time-related behavioral alterations in 71 patients representing all major sporadic and genetic syndromes of frontotemporal dementia, in comparison to 28 patients with typical Alzheimer's disease and nine with logopenic aphasia, and 32 healthy older individuals. Survey items pertained to apparent difficulties ordering past personal events or estimating time intervals between events, temporal rigidity and clockwatching, and propensity to relive past events. We used a logistic regression model including diagnosis, age, gender, and disease severity as regressors to compare the proportions of individuals exhibiting each temporal awareness symptom between diagnostic groups. Gray matter associations of altered time awareness were assessed using voxel-based morphometry. All patient groups were significantly more prone to exhibit temporal awareness symptoms than healthy older individuals. Clinical syndromic signatures were identified. While patients with typical and logopenic Alzheimer's disease most frequently exhibited disturbed event ordering or interval estimation, patients with semantic dementia were most prone to temporal rigidity and clockwatching and those with behavioral variant frontotemporal dementia commonly exhibited all these temporal symptoms as well as a propensity to relive past events. On voxel-based morphometry, the tendency to relive past events was associated with relative preservation of a distributed left-sided temporo-parietal gray matter network including hippocampus. These findings reveal a rich and complex picture of disturbed temporal awareness in major dementia syndromes, with stratification of frontotemporal dementia syndromes from Alzheimer's disease. This is the first study to assess symptoms of altered temporal awareness across frontotemporal dementia syndromes and provides a motivation for future work directed to the development of validated clinical questionnaires, analysis of underlying neurobiological mechanisms and design of interventions.https://www.frontiersin.org/article/10.3389/fneur.2020.00291/fulltime perceptionclockwatchingAlzheimer's diseasefrontotemporal dementiaprimary progressive aphasiasemantic dementia |
| spellingShingle | Maï-Carmen Requena-Komuro Charles R. Marshall Charles R. Marshall Rebecca L. Bond Lucy L. Russell Caroline Greaves Katrina M. Moore Jennifer L. Agustus Elia Benhamou Harri Sivasathiaseelan Chris J. D. Hardy Jonathan D. Rohrer Jason D. Warren Altered Time Awareness in Dementia Frontiers in Neurology time perception clockwatching Alzheimer's disease frontotemporal dementia primary progressive aphasia semantic dementia |
| title | Altered Time Awareness in Dementia |
| title_full | Altered Time Awareness in Dementia |
| title_fullStr | Altered Time Awareness in Dementia |
| title_full_unstemmed | Altered Time Awareness in Dementia |
| title_short | Altered Time Awareness in Dementia |
| title_sort | altered time awareness in dementia |
| topic | time perception clockwatching Alzheimer's disease frontotemporal dementia primary progressive aphasia semantic dementia |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.00291/full |
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