Patients with frontotemporal dementia (FTD) often
present with an asymmetric left or right-sided anterior
cerebral perfusion abnormality that is associated with
differential behavioral symptoms. However, whether patients
with primarily right versus left FTD also have
unique neuropsychological characteristics has not been
previously investigated. Comparisons of 11 patients with
right-sided FTD and 11 with left FTD indicated that the
2 patient groups showed relatively distinct cognitive profiles.
Patients with right FTD exhibited relatively worse performance
on PIQ than VIQ, and on select nonverbal executive tasks
relative to their verbal analogs (e.g., design fluency
< word generation; Picture Arrangement < word sequencing).
In contrast, patients with left FTD showed the opposite
pattern. In addition, the 2 patient groups differed on
several absolute test scores; patients with right FTD demonstrated
more errors and perseverative responses, and worse percent
conceptual level responses, on the Wisconsin Card Sorting
Test, while the left FTD patients obtained significantly
worse scores on the Boston Naming Test, and Stroop word
reading and color naming. Verbal and nonverbal memory,
mental speed, visual perceptual–constructional skill,
and IQ subtest scaled scores did not significantly differ
between groups. These data indicate that FTD should not
be viewed as a unitary disorder, and that neuropsychological
testing holds promise for the differential diagnosis of
right versus left FTD. (JINS, 1999, 5,
616–622.)