A-72: Distinguishing Neuropsychological Features of Progressive bvFTD and Phenocopy phFTD

Abstract

Objective: This review examines which clinical, neuropsychological, and neuroanatomical features most reliably distinguish phenocopy behavioral variant frontotemporal dementia (phFTD) from progressive behavioral variant frontotemporal dementia (bvFTD). The focus is on diagnostic differentiation in adults presenting with behavioral and personality changes consistent with frontotemporal dementia, with emphasis on cognitive performance, disease progression, and structural and functional neuroimaging findings. Method/Data Selection: A review was conducted using (PubMed, Google Scholar, PsycINFO) covering studies from 2000 to 2025. Terms included “phenocopy bvFTD,” “behavioral variant frontotemporal dementia,” and “non-progressive FTD.” Studies were included if they examined clinical presentation, performance, progression, and neuroimaging differences between phFTD and bvFTD. Approximately 10–15 peer-reviewed articles/reviews, were selected. Data extraction focused on behavioral symptoms, executive functioning, memory, social cognition, progression, and neuroimaging markers. Results/Data Synthesis: Findings indicate phFTD and bvFTD share similar behavioral symptoms (disinhibition/apathy), phFTD characterized by minimal disease progression, preserved executive functioning /episodic memory, and relatively intact activities of daily living. In contrast, bvFTD shows progressive cognitive decline in executive/social cognitive domains, alongside functional deterioration. Neuroanatomically, bvFTD is associated with frontal and anterior temporal atrophy, whereas phFTD demonstrates normal/subtle changes on structural MRI/functional imaging. Conclusions: Differentiating phFTD from bvFTD requires integrating clinical observation with neuropsychological assessment and neuroimaging. Stability over time and preserved cognition are key indicators of phFTD. Improved diagnostic accuracy has important implications for prognosis, treatment planning, and patient counseling. Future research should focus on identifying biomarkers and clarifying whether phFTD represents a non-neurodegenerative condition or a slowly progressive subtype within the frontotemporal dementia spectrum.