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Behavioural Neurology
Volume 24, Issue 3, Pages 237-244
http://dx.doi.org/10.3233/BEN-2011-0335

False Reports from Patients with Frontotemporal Dementia: Delusions or Confabulations?

Mario F. Mendez, Ivan Andrew Fras, Sarah A. Kremen, and Po-Heng Tsai

Departments of Neurology and Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, The University of California at Los Angeles, V.A. Greater Los Angeles Healthcare Center, Los Angeles, CA, USA

Received 25 August 2011; Accepted 25 August 2011

Copyright © 2011 Hindawi Publishing Corporation and the authors. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Patients with behavioral variant frontotemporal dementia (bvFTD) can make false statements consistent with delusions or confabulations. It is unclear whether bvFTD is primarily associated with either delusions or with confabulations and whether they can be explained by the pathophysiology of this disease. In order to clarify this, we retrospectively surveyed the records of 48 patients with bvFTD for the presence of any false reports and identified four patients. Their false reports included continued interaction with a favorite but dead relation, fictitious marriages with movie stars, and two who claimed that their partner was having an affair. When confronted with the falsity of their statements, the patients conveyed a lack of certainty regarding their external or internal source but persisted in the constancy of their reports. On functional neuroimaging, the patients had predominant frontal involvement. This report found that patients with bvFTD can have both fantastic, wish fulfilling confabulations and typical content-specific delusions. We propose that both phenomena result from known disturbances of ventromedial prefrontal cortex in bvFTD, including deficits in source monitoring and in activating an automatic “doubt tag” for false reports.