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PostScript
LETTER
Simple motor stereotypies are not specific features of behavioural frontotemporal dementia Stereotypies and repetitive behaviours are among the core features for the diagnosis of the behavioural variant frontotemporal dementia (bvFTD).1 A positive rating in this behavioural domain occurs if the patient manifests one of the following features: simple repetitive movements, verbal stereotypies or complex compulsive or ritualistic behaviours.1 Stereotypies are involuntary non-goal-directed repetitive movement patterns, distractible and temporary suppressible, resulting in simple motor or verbal actions (elementary stereotypies), or in more complex series of movements (complex stereotypies).2 To systematically assess stereotypies and repetitive behaviours, two questionnaires are available: the Stereotypy Rating Inventory (SRI)3 and the Stereotypic and Ritualistic Behaviour (SRB)4 subscale. In the SRI questionnaire, elementary and complex stereotypies are investigated together without a distinction between simple and more complex motor stereotypies. In the SRB subscale, instead, simple motor stereotypies are not considered. In this study, we partially revised the SRB subscale with the aim (a) to add one item that specifically investigates simple motor stereotypies and (b) to enlarge the spectrum of simple verbal stereotypies. This SRB-revised subscale was therefore applied to 31 patients receiving a diagnosis of bvFTD according to recently proposed international criteria1 and compared with 57 patients with a diagnosis of Alzheimer’s disease (AD) based on NINCDS-ADRDA criteria, with the aim of defining frequency and characteristics of stereotyped and repetitive behaviours for a better application of the bvFTD diagnostic criteria. Patients were selected among those referred to the outpatient memory clinic at the Department of Neurosciences in Padua (Italy) between January 2012 and June 2013. Neurological examination in search of extrapyramidal and motor neuron disease signs and routine blood tests was performed in all patients. The degree of global cognitive impairment was assessed through the Mini Mental State Examination (MMSE) test. Behavioural disorders were assessed with the Neuropsychiatric Inventory (NPI) questionnaire. J Neurol Neurosurg Psychiatry August 2014 Vol 85 No 8
The SRB-revised subscale created ad hoc for this study evaluates frequency and severity scores for the following nine subitems: simple motor stereotypies, verbal stereotypies, verbal perseverations, clock watching, counting, hoarding, routines/ rituals, fixed leisure activities and recurrent eating behaviours. When compared with the original tool, the SRB-revised subscale had one added item investigating simple motor stereotypies, which included enquiries on purposeless repetitive movements such as clapping of hands, rubbing of knees, touching something or someone, rocking back and forth, stamping of feet, etc. Moreover, the item assessing verbal stereotypies was expanded beyond the use of a stock phrase, to also encompass the use of repeated sounds, single words and musical refrains. Examples of questions for each item of the SRB-revised subscale are summarised in the online supplementary appendix. The patient groups were matched for disease duration (mean years=bvFTD: 3.5 ±2.4; AD: 3.6±2.1; p=0.73) and gender (M/F: bvFTD=13/18; AD=21/36; p=0.64). Patients with bvFTD were younger than AD (mean age=bvFTD: 72 ±8 years, range 49–85; AD: 79.9 ±7.1 years, range 61–93; p
PostScript
LETTER
Simple motor stereotypies are not specific features of behavioural frontotemporal dementia Stereotypies and repetitive behaviours are among the core features for the diagnosis of the behavioural variant frontotemporal dementia (bvFTD).1 A positive rating in this behavioural domain occurs if the patient manifests one of the following features: simple repetitive movements, verbal stereotypies or complex compulsive or ritualistic behaviours.1 Stereotypies are involuntary non-goal-directed repetitive movement patterns, distractible and temporary suppressible, resulting in simple motor or verbal actions (elementary stereotypies), or in more complex series of movements (complex stereotypies).2 To systematically assess stereotypies and repetitive behaviours, two questionnaires are available: the Stereotypy Rating Inventory (SRI)3 and the Stereotypic and Ritualistic Behaviour (SRB)4 subscale. In the SRI questionnaire, elementary and complex stereotypies are investigated together without a distinction between simple and more complex motor stereotypies. In the SRB subscale, instead, simple motor stereotypies are not considered. In this study, we partially revised the SRB subscale with the aim (a) to add one item that specifically investigates simple motor stereotypies and (b) to enlarge the spectrum of simple verbal stereotypies. This SRB-revised subscale was therefore applied to 31 patients receiving a diagnosis of bvFTD according to recently proposed international criteria1 and compared with 57 patients with a diagnosis of Alzheimer’s disease (AD) based on NINCDS-ADRDA criteria, with the aim of defining frequency and characteristics of stereotyped and repetitive behaviours for a better application of the bvFTD diagnostic criteria. Patients were selected among those referred to the outpatient memory clinic at the Department of Neurosciences in Padua (Italy) between January 2012 and June 2013. Neurological examination in search of extrapyramidal and motor neuron disease signs and routine blood tests was performed in all patients. The degree of global cognitive impairment was assessed through the Mini Mental State Examination (MMSE) test. Behavioural disorders were assessed with the Neuropsychiatric Inventory (NPI) questionnaire. J Neurol Neurosurg Psychiatry August 2014 Vol 85 No 8
The SRB-revised subscale created ad hoc for this study evaluates frequency and severity scores for the following nine subitems: simple motor stereotypies, verbal stereotypies, verbal perseverations, clock watching, counting, hoarding, routines/ rituals, fixed leisure activities and recurrent eating behaviours. When compared with the original tool, the SRB-revised subscale had one added item investigating simple motor stereotypies, which included enquiries on purposeless repetitive movements such as clapping of hands, rubbing of knees, touching something or someone, rocking back and forth, stamping of feet, etc. Moreover, the item assessing verbal stereotypies was expanded beyond the use of a stock phrase, to also encompass the use of repeated sounds, single words and musical refrains. Examples of questions for each item of the SRB-revised subscale are summarised in the online supplementary appendix. The patient groups were matched for disease duration (mean years=bvFTD: 3.5 ±2.4; AD: 3.6±2.1; p=0.73) and gender (M/F: bvFTD=13/18; AD=21/36; p=0.64). Patients with bvFTD were younger than AD (mean age=bvFTD: 72 ±8 years, range 49–85; AD: 79.9 ±7.1 years, range 61–93; p
