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Decision making in frontotemporal dementia: neuropsychological and neuroimaging assessments
Shima Tavakolan Haghighi, Chiara Bertasini, Rozalda Picari, Giovanna Paolone. Frontiers in Neuroscience, 2025-07-31
Topic: Risk, prevention and care in population studies
Frontotemporal dementia (FTD) is a neurodegenerative disorder primarily affecting the frontal and temporal lobes, leading to significant impairments in executive function, social behavior, and emotional regulation. FTD is clinically categorized into two variants, the behavioral (bvFTD) and the primary progressive aphasia (PPA). The bvFTD is the most common form of FTD, and, in these patients, impaired decision-making is the most prominent and clinically relevant cognitive deficit, often manifesting early and preceding more global cognitive decline. This narrative review explores the neuropsychological and neurobiological basis of decision-making deficits in FTD, with a focus on tasks such as the Moral Behavior Inventory (MBI), Iowa Gambling Task (IGT), Executive and Social Cognition Battery (ESCB), Addenbrooke’s Cognitive Examination (ACE), and the Balloon Analog Risk Task (BART). Evidence from both case and cohort studies reveals that, although bvFTD patients have intact cognitive profiles, they show impaired performance on decision-making tasks, suggesting that these deficits may be an early and specific marker of the disease. In addition, according to neuroimaging studies, these impairments are associated with atrophy in a distributed network, including the ventromedial and orbitofrontal cortices, anterior cingulate, insula, and even cerebellar regions. Finally, impaired decision-making is a critical yet underrecognized marker for early detection and differentiation of FTD from other forms of dementia.
Key findings
- Frontotemporal dementia (FTD) is a neurodegenerative disorder primarily affecting the frontal and temporal lobes, leading to significant impairments in executive function, social behavior, and emotional regulation.
- Evidence from both case and cohort studies reveals that, although bvFTD patients have intact cognitive profiles, they show impaired performance on decision-making tasks, suggesting that these deficits may be an early and specific marker of the disease.
- In addition, according to neuroimaging studies, these impairments are associated with atrophy in a distributed network, including the ventromedial and orbitofrontal cortices, anterior cingulate, insula, and even cerebellar regions.
Why it matters
This narrative review explores decision-making deficits in frontotemporal dementia, noting that impaired performance on decision-making tasks may be an early and specific marker of the disease. It discusses neuropsychological and neuroimaging assessments but no treatment or cure.
Study details
- Study designcohort study
- Evidence strengthModerate
How this study scored 46/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Frontiers in Neuroscience) |
| Journal's citation record | 2 / 4 | Frontiers in Neuroscience: journal h-index 226 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 4 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 2.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Giovanna Paolone: h-index 22 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Verona: institution h-index 763 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40822240) |
| Free to read | 2 / 2 | Free to read |
| Total | 46 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.3389/fnins.2025.1632054
- PubMed: 40822240
- Original source →
- Free full text: Frontiers in Neuroscience →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Haghighi, S. T., Bertasini, C., Picari, R., & Paolone, G. (2025). Decision making in frontotemporal dementia: neuropsychological and neuroimaging assessments. Frontiers in Neuroscience. https://doi.org/10.3389/fnins.2025.1632054
Vancouver
Haghighi ST, Bertasini C, Picari R, Paolone G. Decision making in frontotemporal dementia: neuropsychological and neuroimaging assessments. Frontiers in Neuroscience. 2025. doi:10.3389/fnins.2025.1632054. PMID: 40822240.
BibTeX
@article{haghighi2025-40822240,
author = {Haghighi, Shima Tavakolan and Bertasini, Chiara and Picari, Rozalda and Paolone, Giovanna},
title = {{Decision making in frontotemporal dementia: neuropsychological and neuroimaging assessments}},
journal = {Frontiers in Neuroscience},
year = {2025},
doi = {10.3389/fnins.2025.1632054},
pmid = {40822240},
url = {https://doi.org/10.3389/fnins.2025.1632054}
}
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