Frontotemporal dementia (FTD) consists of three main clinical syndromes: (1) frontal variant FTD presenting predominantly with behavioural abnormalities, (2) semantic dementia presenting with fluent aphasic deficits and (3) primary progressive aphasia presenting with non-fluent aphasic deficits.1 By definition, major behavioural abnormalities are not present in the initial stages of semantic dementia.1 However, we have observed that significant behavioural problems may occur in some patients with semantic dementia when both comprehension and verbal output deteriorate rapidly. These behavioural abnormalities appear to respond favourably to low-dose sertraline.

Methods

This study was approved by the Institutional Review Board of the University of Oklahoma in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

Four non-institutionalised patients, two women and two men, who received care at the Center for Memory Loss and Dementia (CMLD) at the University of Oklahoma Health Sciences Center were diagnosed as having semantic dementia between 15 July 2004 and 30 December 2006. All patients fulfilled clinical criteria for FTD1 and had a complete diagnostic evaluations for dementia, including neuropsychological testing, Clinical Dementia Rating Scale (CDR), Mini-Mental State Examination (MMSE) and the Neuropsychiatric Inventory Questionnaire (NPI-Q).2 Brain MRI and PET studies in all four patients showed significant left temporal and, to a lesser degree, left …