Recent Talks and Publications

For a full list of Dr. Pressman’s publications, please visit Colorado PROFILES or his NCBI Bibliography . 

Recommendations to distinguish behavioural variant frontotemporal dementia from psychiatric disorders

The behavioural variant of frontotemporal dementia (bvFTD) is a frequent cause of early-onset dementia. The diagnosis of bvFTD remains challenging because of the limited accuracy of neuroimaging in the early disease stages and the absence of molecular biomarkers, and therefore relies predominantly on clinical assessment. BvFTD shows significant symptomatic overlap with non-degenerative primary psychiatric disorders including major depressive disorder, bipolar disorder, schizophrenia, obsessive-compulsive disorder, autism spectrum disorders and even personality disorders. To date, ∼50% of patients with bvFTD receive a prior psychiatric diagnosis, and average diagnostic delay is up to 5-6 years from symptom onset. It is also not uncommon for patients with primary psychiatric disorders to be wrongly diagnosed with bvFTD. The Neuropsychiatric International Consortium for Frontotemporal Dementia was recently established to determine the current best clinical practice and set up an international collaboration to share a common dataset for future research. The goal of the present paper was to review the existing literature on the diagnosis of bvFTD and its differential diagnosis with primary psychiatric disorders to provide consensus recommendations on the clinical assessment.

Published in Brain: A Journal in Neurology. Link to full article here.

P-Hacking Lexical Richness Through Definitions of "Type" and "Token"

"P-hacking" is the repeated analysis of data until a statistically significant result is achieved. We show that p-hacking can also occur during data generation, sometimes unintentionally. We use the type-token ratio to demonstrate that differences in the definitions of "type" and "token" can produce significantly different results. Since these terms are rarely defined in the biomedical literature, the result is an inability to meaningfully interpret the body of literature that makes use of this measure.

Published in Studies in Health and Information Technologies. Link to full article here.

 Aprosodia and prosoplegia with right frontal neurodegeneration

Affective prosody and facial expression are essential components of human communication. Aprosodic syndromes are associated with focal right cerebral lesions that impair the affective-prosodic aspects of language, but are rarely identified because affective prosody is not routinely assessed by clinicians. Inability to produce emotional faces (affective prosoplegia) is a related and important aspect of affective communication has overlapping neuroanatomic substrates with affective prosody. We describe a patient with progressive aprosodia and prosoplegia who had right greater than left perisylvian and temporal atrophy with an anterior predominance. We discuss the importance of assessing affective prosody and facial expression to arrive at an accurate clinical diagnosis.

Published in Neurocase: The Neural Cases of Cognition. Link to full article here.

 Interpersonal prosodic correlation in frontotemporal dementia

Communication accommodation describes how individuals adjust their communicative style to that of their conversational partner. We predicted that interpersonal prosodic correlation related to pitch and timing would be decreased in behavioral variant frontotemporal dementia (bvFTD). We predicted that the interpersonal correlation in a timing measure and a pitch measure would be increased in right temporal FTD (rtFTD) due to sparing of the neural substrate for speech timing and pitch modulation but loss of social semantics. We found no significant effects in bvFTD, but conversations including rtFTD demonstrated higher interpersonal correlations in speech rate than healthy controls.

Published in ANNALS of Clinical and Transitional Neurology. Link to full article here.

Relative preservation of facial expression recognition in posterior cortical atrophy

Objective: To compare recognition of facial expression (FE) vs recognition of facial identity (FI) in posterior cortical atrophy (PCA), with the hypothesis that FE recognition would be relatively preserved in PCA.

Methods: In this observational study, FI and expression recognition tasks were performed by 194 participants in 4 groups, including 39 with Alzheimer disease (AD) (non-PCA), 49 with behavioral variant frontotemporal dementia (bvFTD), 15 with PCA, and 91 healthy controls. Between-group differences in test scores were compared.

Results: Patients with PCA performed worse than healthy controls in FI and emotion recognition tasks (p < 0.001 for all). Patients with PCA also performed worse than AD and bvFTD groups in FI recognition, with no difference in FE recognition.

Conclusions: Patients with PCA have relatively preserved FE recognition compared to FI recognition, as seen in affective blindsight.

Published in Neurology. Link to full article here.