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In the fog: Neural correlates of psychiatric symptoms in mixed neurodegenerative and depressed populations

Abstract

This dissertation study examined the accuracy of early stage neurodegenerative disease patients’ psychiatric self-reports; compared patient groups to clinically normal age-matched controls on specific psychiatric symptoms; and examined the neural substrates of psychiatric symptoms. To determine whether patients could accurately self-report psychiatric symptoms, 59 participants-informant dyads (11 with possible or probable typical or atypical Alzheimer’s disease (AD), 13 behavioral variant frontotemporal dementia (bvFTD), 11 semantic variant primary progressive aphasia (svPPA), 13 late-life depressed patients (LLD), and 11 clinically normal controls (NC)) completed a comprehensive battery of psychiatric measures and participated in separate video-taped interviews about the participants’ psychiatric history and experiences of loss. Video observers rated participant interviews for signs of psychiatric phenomena, and the psychometric qualities of participant self-reports were analyzed. Once validated, participant self-report data of 38 additional participants (14 AD, 14 bvFTD, 3 svPPA, 5 LLD, and 2 NCs) were added to group comparison and imaging analyses; symptoms were compared to structural and functional magnetic resonance imaging data. Results showed that early stage neurodegenerative patients did accurately self-report psychiatric symptoms. svPPA and LLD patients rated themselves higher in depression than controls, and grief, negative affect, and mania were related to volumes of intrinsically connected networks observed in healthy adults. Implications for neurology and psychiatry research and clinical diagnoses and are discussed.

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