E X T R A Dement Geriatr Cogn Disord Extra 2016;6:194–204

DOI: 10.1159/000445870 © 2016 The Author(s)

Published online: May 26, 2016 Published by S. Karger AG, Basel
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Original Research Article

Vestibular Impairment in
Frontotemporal Dementia Syndrome
Kiyotaka Nakamagoe a Kotarou Kadono a Tadachika Koganezawa b
Mao Takiguchi a Makoto Terada a Fumiko Yamamoto a
Tetsuya Moriyama a Kumi Yanagiha a Seitaro Nohara a Naoki Tozaka a
Zenshi Miyake a Satoshi Aizawa a Kentaro Furusho c Akira Tamaoka a
a Department of Neurology, Division of Clinical Medicine, and b Department of Physiology,
Division of Biomedical Science, Faculty of Medicine, University of Tsukuba, Tsukuba, and
c
Department of Neurology, Ryugasaki Saiseikai Hospital, Ryugasaki, Japan

Key Words
Frontotemporal dementia · Vestibular function · Frontotemporal lobar degeneration · Visual
suppression · Vestibular stimulation · Frontal eye field · Inferior parietal lobule · Caloric test

Abstract
Background: No studies to date have attempted to evaluate frontotemporal lobar degen-
eration from the perspective of the vestibular system. Objective: The present study examined
vestibular function in patients with frontotemporal dementia (FTD) clinical syndrome and
evaluated whether vestibular disorders are involved in the clinical symptoms due to FTD.
Methods: Fourteen patients with FTD syndrome, as well as healthy elderly controls without
dementia, were included in the present study. All subjects underwent vestibular function tests
using electronystagmography, such as caloric tests and visual suppression (VS) tests, in which
the induced caloric nystagmus was suppressed by visual stimuli. The association between
clinical symptoms and vestibular function in the FTD syndrome group was further examined.
Results: In the FTD syndrome group, caloric nystagmus was not necessarily suppressed dur-
ing VS tests. Furthermore, VS was observed to be significantly impaired in FTD syndrome pa-
tients with gait disturbance as compared to those without such disturbance. Conclusion: The
present study revealed that impairment of VS in patients with FTD results in an inability to
regulate vestibular function by means of visual perception, regardless of multiple presumed
neuropathological backgrounds. This could also be associated with gait disturbance in pa-
tients with FTD syndrome. © 2016 The Author(s)
Published by S. Karger AG, Basel

Kiyotaka Nakamagoe
University of Tsukuba
Tennodai 1-1-1
Tsukuba, Ibaraki 305-8575 (Japan)
E-Mail nakamagoek @ md.tsukuba.ac.jp
 E X T R A Dement Geriatr Cogn Disord Extra 2016;6:194–204 195
DOI: 10.1159/000445870 © 2016 The Author(s). Published by S. Karger AG, Basel
www.karger.com/dee
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome

Introduction

 –Šƒ•Ž‘‰„‡‡„‡Ž‹‡˜‡†–Šƒ––Š‡…‡”‡„‡ŽŽ——•‡•‡—”ƒŽ…‹”…—‹–•‹–Š‡˜‡•–‹„—Žƒ”•›•–‡
–‘’”‘…‡••˜‹•—ƒŽ‹’—–‹ˆ‘”ƒ–‹‘ˆ”‘–Š‡‡›‡ƒ†–Š‡”‡‰—Žƒ–‡•–Š‡„”ƒ‹•–‡˜‡•–‹„—Žƒ”
—…Ž‡—•Ǥ ‘™‡˜‡”ǡ •‡˜‡”ƒŽ •–—†‹‡• Šƒ˜‡ …‘–‡†‡† –Šƒ– –Š‡ …‡”‡„”ƒŽ …‘”–‡š ƒ› „‡ ƒ ‡›
’Žƒ›‡”‹–Š‡‡—”ƒŽ…‹”…—‹–•‹–Š‡˜‡•–‹„—Žƒ”•›•–‡ȏͳȂͷȐǤ”‡˜‹‘—•ƒ‹ƒŽ‡š’‡”‹‡–•
Šƒ˜‡†‡‘•–”ƒ–‡†–Šƒ–—Ž–‹’Ž‡˜‡•–‹„—Žƒ”…‘”–‡šƒ”‡ƒ•ƒ”‡•…ƒ––‡”‡†‘˜‡”–Š‡’ƒ”‹‡–ƒŽƒ†
–‡’‘”ƒŽ Ž‘„‡• ȏ ͸ȂͳʹȐǤ  ƒ††‹–‹‘ǡ ’”‡˜‹‘—• •–—†‹‡• –Šƒ– —•‡† ˆ—…–‹‘ƒŽ ƒ‰‡–‹… ”‡•‘Ǧ
ƒ…‡‹ƒ‰‹‰ƒ†’‘•‹–”‘‡‹••‹‘–‘‘‰”ƒ’Š›–‘‹˜‡•–‹‰ƒ–‡˜‡•–‹„—Žƒ”ƒˆˆ‡”‡–’ƒ–Š™ƒ›•
„›‡ƒ•‘ˆ˜‡•–‹„—Žƒ”•–‹—Žƒ–‹‘Šƒ˜‡•Š‘™–Šƒ––Š‡˜‡•–‹„—Žƒ”…‘”–‡šƒ”‡ƒƒŽ•‘•‡‡•–‘
„‡’”‡•‡–‹–Š‡Š—ƒ„”ƒ‹ȏͳǡʹǡͶȐǤƒ††‹–‹‘ǡ‡š’‡”‹‡–•‘‘‡›•Šƒ˜‡†‡‘Ǧ
•–”ƒ–‡†‘–‘Ž›–Šƒ––Š‡˜‡•–‹„—Žƒ”…‘”–‡š”‡…‡‹˜‡•’”‘Œ‡…–‹‘•ˆ”‘–Š‡ƒˆˆ‡”‡–ˆ‹„‡”•‘”‹‰Ǧ
‹ƒ–‹‰ˆ”‘–Š‡˜‡•–‹„—Žƒ”—…Ž‡‹‘„‘–Š•‹†‡•ǡ„—–ƒŽ•‘–Šƒ–‡ˆˆ‡”‡–ˆ‹„‡”•‘”‹‰‹ƒ–‹‰ˆ”‘
–Š‡˜‡•–‹„—Žƒ”…‘”–‡š†‹”‡…–Ž›’”‘Œ‡…––‘–Š‡˜‡•–‹„—Žƒ”—…Ž‡‹ȏͳ͵ǡͳͶȐǤ–Š‡”•–—†‹‡•Šƒ˜‡
•—‰‰‡•–‡† –Šƒ– –Š‡ ˆ”‘–ƒŽ ƒ† –‡’‘”ƒŽ Ž‘„‡ ”‡‰‹‘• ȋ‹…Ž—†‹‰ –Š‡ ˆ”‘–ƒŽ ‡›‡ ˆ‹‡Ž†ǡ –Š‡
–‡’‘”ƒŽ’‘Ž‡ǡ–Š‡‹ˆ‡”‹‘”–‡’‘”ƒŽ‰›”—•ǡƒ†–Š‡ˆ—•‹ˆ‘”‰›”—•Ȍƒ†–Š‡‡†‹ƒŽ’ƒ”‹‡–‘Ǧ
‘……‹’‹–ƒŽ˜‹•—ƒŽƒ”‡ƒƒ›‡š‡”–ƒ‹Š‹„‹–‘”›‡ˆˆ‡…–‘–Š‡˜‡•–‹„—Žƒ”…‘”–‡š˜‹ƒ˜‹•—ƒŽ‹ˆ‘”Ǧ
ƒ–‹‘ ȏ ͳǡ ʹǡ ͶȐǤ  ‡‰ƒ–‹˜‡ …‘””‡Žƒ–‹‘ ‹• •‡‡ „‡–™‡‡ ƒ…–‹˜ƒ–‹‘ ‘ˆ –Š‡ ˜‹•—ƒŽ …‘”–‹…ƒŽ
”‡‰‹‘•ƒ†ƒ…–‹˜ƒ–‹‘‘ˆ–Š‡˜‡•–‹„—Žƒ”…‘”–‡šȏͳǡʹǡͶȐǤ

 ‡ ’”‡˜‹‘—•Ž› ”‡’‘”–‡† –Šƒ– ŽœŠ‡‹‡”ǯ• †‹•‡ƒ•‡Ǧ”‡Žƒ–‡† ’ƒ–Š‘Ž‘‰› ‹ –Š‡ …‡”‡„”ƒŽ
…‘”–‡š…ƒ…ƒ—•‡‹’ƒ‹”‡–‘ˆ˜‡•–‹„—Žƒ”ˆ—…–‹‘™Š‹…Šǡ‹–—”ǡŽ‡ƒ†•–‘‹’ƒ‹”‡†˜‹•—ƒŽ
…‘–”‘ŽȏͷȐǤƒ‹‰‹–‘ƒ……‘—––Š‡ƒ„‘˜‡Ǧ‡–‹‘‡†ˆ‹†‹‰•ǡ–Š‡’”‡•‡–•–—†›’”‘’‘•‡•
ƒŠ›’‘–Š‡•‹•ƒ„‘—–ƒ•›•–‡‹™Š‹…Š–Š‡…‡”‡„”ƒŽ…‘”–‡š—•‡•˜‹•—ƒŽ‹ˆ‘”ƒ–‹‘–‘…‘–”‘Ž
˜‡•–‹„—Žƒ” ‡—”ƒŽ …‹”…—‹–• ‹ ŽœŠ‡‹‡”ǯ• †‹•‡ƒ•‡ ’ƒ–‹‡–•Ǥ ‡ ‡šƒ‹‡† ™Š‡–Š‡” –Š‹• Š›Ǧ
’‘–Š‡•‹•Š‘Ž†•–”—‡ˆ‘”ˆ”‘–‘–‡’‘”ƒŽ†‡‡–‹ƒȋ Ȍ•›†”‘‡’ƒ–‹‡–•™Š‹Ž‡‘Ž‡•‹‘
™ƒ•ˆ‘—†‹–Š‡…‡”‡„‡ŽŽ—Ǥ

  •›†”‘‡ ‹• ƒ …Ž‹‹…ƒŽ †‹ƒ‰‘•‹• ƒ† ƒ †‹•‡ƒ•‡ …Šƒ”ƒ…–‡”‹œ‡† „› •›’–‘• –Šƒ–
‹…Ž—†‡Žƒ…‘ˆ…‘•…‹‘—•‡••‘ˆ–Š‡†‹•‡ƒ•‡ǡ†‹•‹Š‹„‹–‹‘ǡ…Šƒ”ƒ…–‡”…Šƒ‰‡•ǡ†›•’Šƒ•‹ƒǡƒ†
—•‘…‹ƒŽ„‡Šƒ˜‹‘”ȏͳͷȂͳ͹ȐǤ •›†”‘‡…‘–”ƒ•–•…Ž‹‹…ƒŽŽ›™‹–ŠŽœŠ‡‹‡”ǯ•†‹•‡ƒ•‡Ǣƒ•ƒ
…Ž‹‹…ƒŽ…‘…‡’–ǡ‹–”‡ˆ‡”•–‘ƒ•›†”‘‡‘ˆ‘ǦŽœŠ‡‹‡”†‡‰‡‡”ƒ–‹‘’”‡•‡–‹‰ƒ–”‘’Š›
ƒ† ˆ—…–‹‘ƒŽ †‹•‘”†‡” ƒ‹Ž› ‘ˆ –Š‡ ˆ”‘–ƒŽ ƒ† –‡’‘”ƒŽ Ž‘„‡•Ǥ ‘‰ ’ƒ–‹‡–• ™‹–Š
†‡‡–‹ƒǡ–Š‡’”‡˜ƒŽ‡…‡‘ˆˆ”‘–‘–‡’‘”ƒŽŽ‘„ƒ”†‡‰‡‡”ƒ–‹‘”ƒ•ƒˆ–‡”–Šƒ–‘ˆŽœŠ‡‹Ǧ
‡”ǯ•†‹•‡ƒ•‡ƒ†‡™›„‘†›†‹•‡ƒ•‡Ǥ‘‰–Š‘•‡ƒ‰‡†͸ͷ›‡ƒ”•ƒ†›‘—‰‡”ǡ‹–•’”‡˜ƒǦ
Ž‡…‡‹•‘™–‘„‡‘ƒ’ƒ”™‹–Š–Šƒ–‘ˆŽœŠ‡‹‡”ǯ•†‹•‡ƒ•‡ȏͳͺȐǤ
 ƒ› •–—†‹‡• ‘ˆ ‡›‡ ‘˜‡‡–• ˆ‘…—• ‘ •ƒ……ƒ†‡ †‹•‘”†‡”•Ǣ –Š‡•‡ ‘˜‡‡–• Šƒ˜‡
„‡‡•Š‘™–‘„‡ƒ”‡•—Ž–‘ˆˆ”‘–ƒŽŽ‘„‡†‹•‘”†‡”•ǡ•—…Šƒ•ˆ”‘–ƒŽ‡›‡ˆ‹‡Ž††‹•‘”†‡”ȏͳͻȂʹʹȐǤ
Š‡ ˆ”‘–ƒŽ ‡›‡ ˆ‹‡Ž† ‹• ƒ ”‡‰‹‘ ‘ˆ ƒŒ‘” Ž‡•‹‘ ‹  •›†”‘‡Ǥ  –Š‡ ‘–Š‡” Šƒ†ǡ ‘
•–—†‹‡• –‘ †ƒ–‡ Šƒ˜‡ ƒ––‡’–‡† –‘ ‡˜ƒŽ—ƒ–‡  •›†”‘‡ ˆ”‘ –Š‡ ’‡”•’‡…–‹˜‡ ‘ˆ –Š‡
˜‡•–‹„—Žƒ”•›•–‡Ǥ
 ‡•–‹„—Žƒ”•–‹—Žƒ–‹‘™ƒ•—•‡†‹’ƒ–‹‡–•™‹–ŠŽ‡•‹‘•‹˜‘Ž˜‹‰ƒ‹Ž›–Š‡…‡”‡„”ƒŽ
…‘”–‡š–‘‡šƒ‹‡Š‘™•—…Š•–‹—Žƒ–‹‘ƒ›ƒˆˆ‡…––Š‡˜‹•—ƒŽ•—’’”‡••‹‘ȋȌ‘ˆ˜‡•–‹„—Žƒ”
›•–ƒ‰—•ǤŠ‹•ƒŽŽ‘™‡†—•–‘†‹•”‡‰ƒ”†–Š‡’‘••‹„Ž‡‡ˆˆ‡…–•‘ˆ…‡”‡„‡ŽŽƒ”†‡ˆ‹…‹–•ǡ–Š—•…Žƒ”Ǧ
‹ˆ›‹‰ –Š‡ ‡…Šƒ‹• –Š”‘—‰Š ™Š‹…Š –Š‡ …‡”‡„”ƒŽ …‘”–‡š …‘–”‘Ž• –Š‡ ˜‡•–‹„—Žƒ” ‡—”ƒŽ
…‹”…—‹–•Ǥ
 Š‡ƒ‹‘ˆ–Š‹••–—†›™ƒ•–‘†‡–‡”‹‡™Š‡–Š‡”˜‡•–‹„—Žƒ”‹’ƒ‹”‡–‹•’”‡•‡–‹ 
…Ž‹‹…ƒŽ•›†”‘‡ƒ†ǡ‹ˆ‹–‹•’”‡•‡–ǡ–‘‡šƒ‹‡‹–•”‡Žƒ–‹‘•Š‹’–‘…Ž‹‹…ƒŽ•›’–‘•Ǥ
 E X T R A Dement Geriatr Cogn Disord Extra 2016;6:194–204 196
DOI: 10.1159/000445870 © 2016 The Author(s). Published by S. Karger AG, Basel
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Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome

Subjects and Methods

Subjects

 Š‡ •–—†› •—„Œ‡…–• ™‡”‡ ͳͶ  •›†”‘‡ ’ƒ–‹‡–• ȋ͸ ‡ǡ ͺ ™‘‡ǡ ƒ‰‡ ͸͹Ǥͻ ά ͷǤ͹
›‡ƒ”•ȌǤƒ–‹‡–•‹–Š‡ ‰”‘—’™‡”‡†‹ƒ‰‘•‡†‹ƒ……‘”†ƒ…‡™‹–Š–Š‡—†Ǧƒ…Š‡•–‡”
…”‹–‡”‹ƒȏʹ͵ȐǤ

 Š‡ ‰”‘—’™ƒ•…‘’ƒ”‡†–‘ƒ…‘–”‘Ž‰”‘—’…‘’”‹•‹‰ͳͶ‡Ž†‡”Ž›’‡‘’Ž‡™‹–Š‘—–
†‡‡–‹ƒȋ͸‡ǡͺ™‘‡ǡƒ‰‡͸ͻǤʹάʹǤͺ›‡ƒ”•ȌǤ‡ƒŽ–Š›˜‘Ž—–ƒ”›•—„Œ‡…–•™‡”‡”‡…”—‹–‡†
ƒ†‰‹˜‡ƒ‹–‡”˜‹‡™ƒ†ƒ‡†‹…ƒŽ‡šƒ‹ƒ–‹‘Ǣ–Š‡…‘–”‘Ž‰”‘—’™ƒ•ˆ‘”‡†ˆ”‘–Š‘•‡
™Š‘•…‘”‡†ʹͶ‘”Š‹‰Š‡”‘–Š‡‹‹Ǧ‡–ƒŽ–ƒ–‡šƒ‹ƒ–‹‘ȋȌȏʹͶȐǤŠ‡…‘–”‘Ž
•—„Œ‡…–• ™‡”‡ ‡šƒ‹‡† ‡—”‘Ž‘‰‹…ƒŽŽ› –‘ …‘ˆ‹” –Š‡ ƒ„•‡…‡ ‘ˆ Ž‹„ —•…Ž‡ ™‡ƒ‡••ǡ
‡š–”ƒ’›”ƒ‹†ƒŽ •›’–‘•ǡ †‡‡’ •‡•‹„‹Ž‹–› †‹•–—”„ƒ…‡• ‘” ‘–Š‡” •‡•‘”› †‹•‘”†‡”•ǡ ƒ†
…‡”‡„‡ŽŽƒ”ƒ–ƒš‹ƒ‘”‘–Š‡”‡—”‘Ž‘‰‹…ƒŽƒ„‘”ƒŽ‹–‹‡•Ǥ

 ŽŽ •—„Œ‡…–• ™‡”‡ ‰‹˜‡ ‘–‘Žƒ”›‰‘Ž‘‰‹…ƒŽ ‡šƒ‹ƒ–‹‘•Ǥ —„Œ‡…–• ™‹–Š †‹•‡ƒ•‡ ‘ˆ –Š‡
‘—–‡”‘”‹††Ž‡‡ƒ”™‡”‡‡š…Ž—†‡†ˆ”‘–Š‡•–—†›ǡƒ•™‡”‡•—„Œ‡…–•™Š‘™‡”‡–ƒ‹‰†”—‰•
–Šƒ–‹ˆŽ—‡…‡˜‡•–‹„—Žƒ”ˆ—…–‹‘Ǥˆ‘”‡†…‘•‡–™ƒ•‘„–ƒ‹‡†ˆ”‘ƒŽŽ•—„Œ‡…–•‹ƒ……‘”Ǧ
†ƒ…‡™‹–Š–Š‡”—Ž‡•‘ˆ–Š‡‡–Š‹…•…‘‹––‡‡‘ˆ–Š‡‹˜‡”•‹–›‘ˆ•——„ƒ‘•’‹–ƒŽǤ

 Š‡”‡™ƒ•‘•‹‰‹ˆ‹…ƒ–†‹ˆˆ‡”‡…‡‹‡ƒƒ‰‡„‡–™‡‡–Š‡ ‰”‘—’ƒ†–Š‡…‘–”‘Ž
‰”‘—’ȋ’αͲǤͶ͵ǡƒǦŠ‹–‡›–‡•–ȌǤ

Evaluation of Clinical Symptoms


 Š‡ˆ‘ŽŽ‘™‹‰…Ž‹‹…ƒŽ•›’–‘•™‡”‡‡˜ƒŽ—ƒ–‡†„›‡—”‘Ž‘‰‹…ƒŽ‡šƒ‹ƒ–‹‘ǣȋͳȌˆ”‘–ƒŽ
Ž‘„‡ ƒ‹ˆ‡•–ƒ–‹‘•ǡ ȋʹȌ —’™ƒ”† ‘” †‘™™ƒ”† ‰ƒœ‡ ’ƒŽ•›ǡ ȋ͵Ȍ ‘–‘” ‡—”‘ †‹•‘”†‡”ǡ ȋͶȌ
…‡”‡„‡ŽŽƒ”ƒ–ƒš‹ƒǡȋͷȌ’ƒ”‹•‘‹•ǡȋ͸Ȍ‰ƒ‹–†‹•–—”„ƒ…‡ȋͳͲǦ‡–‡”‰ƒ‹–Ȍǡƒ†ȋ͹Ȍ‹ƒ„‹Ž‹–›–‘
™ƒŽ ȋͳǦ‡–‡” ‰ƒ‹–ȌǤ ‡ †‡ˆ‹‡† ‰ƒ‹– †‹•–—”„ƒ…‡ ȋͳͲǦ‡–‡” ‰ƒ‹–Ȍ ƒ• –Š‡ ‹ƒ„‹Ž‹–› –‘ ™ƒŽ
…‘–‹—‘—•Ž›ˆ‘”ͳͲ‘”‘”‡—ƒ‹†‡†Ǥ‡†‡ˆ‹‡†‹ƒ„‹Ž‹–›–‘™ƒŽƒ•–Š‡‹ƒ„‹Ž‹–›–‘™ƒŽ
…‘–‹—‘—•Ž›ˆ‘”ͳ‘”‘”‡—ƒ‹†‡†ǤŠ‡–‡•–•ˆ‘”‰ƒ‹–†‹•–—”„ƒ…‡ƒ†‹ƒ„‹Ž‹–›–‘™ƒŽ
™‡”‡…ƒ””‹‡†‘—–ƒ……‘”†‹‰–‘–Š‡ͳͲǦ‡–‡”™ƒŽ‹‰–‡•–ƒ†–Š‡ͳǦ‡–‡”™ƒŽ‹‰–‡•–ǡ”‡•’‡…Ǧ
–‹˜‡Ž›Ǥ

Equilibrium Function Test


 Š‡ …ƒŽ‘”‹… –‡•– ‹• ƒ ‡ˆˆ‡…–‹˜‡ –‡•– ‘ˆ ˜‡•–‹„—Žƒ” ˆ—…–‹‘Ǥ Š‡ ˜‡•–‹„—Žƒ” •‡‹…‹”…—Žƒ”
…ƒƒŽ•ƒ”‡•‡•‹–‹˜‡–‘ƒ……‡Ž‡”ƒ–‘”›•–‹—Žƒ–‹‘†—‡–‘”‘–ƒ–‹‘‘ˆ–Š‡Š‡ƒ†ǡ™Š‹…Š…ƒ—•‡•ƒ
ˆŽ‘™‹–Š‡‡†‘Ž›’ŠǤ…ƒŽ‘”‹…•–‹—Ž—•…ƒƒŽ•‘…ƒ—•‡ƒ…‘˜‡…–‹˜‡ˆŽ‘™‹–Š‡‡†‘Ž›’Š
†—‡–‘ƒ†‹ˆˆ‡”‡…‡‹–‡’‡”ƒ–—”‡Ǣ–Š‹••–‹—Žƒ–‡•–Š‡•‡•‘”›Šƒ‹”…‡ŽŽ•ǡ…ƒ—•‹‰›•–ƒ‰—•Ǥ
Š‡…ƒŽ‘”‹…–‡•–‹•ƒ˜‡•–‹„—Žƒ”•–‹—Žƒ–‹‘–‡•–‹™Š‹…ŠƒˆŽ‘™‹–Š‡‡†‘Ž›’Š‹•’—”’‘•‡Ž›
’”‘˜‘‡†„›‹””‹‰ƒ–‹‰ƒ‹”‘”™ƒ–‡”ƒ–ƒ–‡’‡”ƒ–—”‡†‹ˆˆ‡”‡–ˆ”‘–Šƒ–‘ˆ–Š‡„‘†›‹–‘–Š‡
‡š–‡”ƒŽ ƒ—†‹–‘”› …ƒƒŽǤ Š‹• ‹†—…‡• ›•–ƒ‰—•ǡ ƒŽŽ‘™‹‰ –Š‡ ”‡ƒ…–‹‘ ‘ˆ –Š‡ ˜‡•–‹„—Žƒ”
•›•–‡ǯ•‡—”ƒŽ’ƒ–Š™ƒ›•–‘„‡•‡‡Ǥ›•–ƒ‰—•‹†—…‡†‹–Š‹•™ƒ›‹•…ƒŽŽ‡†…ƒŽ‘”‹…›•Ǧ
–ƒ‰—•ǡ ™Š‹Ž‡ –Š‡ •—’’”‡••‹‘ ‘ˆ …ƒŽ‘”‹… ›•–ƒ‰—• †—‡ –‘ ˜‹•—ƒŽ ˆ‹šƒ–‹‘ ‹• …ƒŽŽ‡† ˜‹•—ƒŽ
•—’’”‡••‹‘Ǥ‹’ƒ‹”‡–‹•‘™–‘„‡…ƒ—•‡†„›†‹•‘”†‡”•‘–‘Ž›‘ˆ–Š‡…‡”‡„‡ŽŽ—
ƒ†„”ƒ‹•–‡ǡ„—–ƒŽ•‘‘ˆ–Š‡…‡”‡„”ƒŽ…‘”–‡šȏʹͷȂʹ͹ȐǤŠ‡Ž‡˜‡Ž‘ˆ‹•‡ƒ•—”‡†ƒ•ƒ‡“—‹Ǧ
Ž‹„”‹—ˆ—…–‹‘–‡•–ǡ™Š‹…Š‹•Š‡Ž’ˆ—Ž‹†‹ƒ‰‘•‹‰…‡–”ƒŽ‡”˜‘—••›•–‡†‹•‘”†‡”•Ǥ

 ›‡‘˜‡‡–™ƒ•”‡…‘”†‡†„›ƒ––ƒ…Š‹‰‡Ž‡…–”‘†‡•‹Š‘”‹œ‘–ƒŽƒ†˜‡”–‹…ƒŽ†‹”‡…–‹‘•
–‘ –Š‡ ‡›‡Ž‹†Ǥ Š‡ ‘”‹‰‹ƒŽ ™ƒ˜‡ˆ‘” ȋ–‹‡ …‘•–ƒ– α ͵ •Ȍ ƒ† ˜‡Ž‘…‹–› ™ƒ˜‡ˆ‘” ȋ–‹‡
…‘•–ƒ–αͲǤͲ͵•Ȍ‘ˆ‡›‡‘˜‡‡–•‹‡ƒ…Š†‹”‡…–‹‘™‡”‡”‡…‘”†‡†—•‹‰ƒ‡Ž‡…–”‘›•–ƒ‰Ǧ
‘‰”ƒ’Š ƒ† ƒ †ƒ–ƒ …‘ŽŽ‡…–‹‘ ƒ† ƒƒŽ›•‹• †‡˜‹…‡ ™‹–Š ƒ •ƒ’Ž‹‰ ˆ”‡“—‡…› ‘ˆ ͳ œ
ȋ‘™‡”ƒ„Ǣ•–”—‡–•–›Ǥ–†Ǥǡƒ•–Ž‡‹ŽŽǡ—•–”ƒŽ‹ƒȌǤ

 Š‡…ƒŽ‘”‹…–‡•–™ƒ•…ƒ””‹‡†‘—–™‹–Š–Š‡•—„Œ‡…–‹–Š‡•—’‹‡’‘•‹–‹‘™‹–Š–Š‡Š‡ƒ†
”ƒ‹•‡†͵Ͳ郐†™‡ƒ”‹‰‰‘‰‰Ž‡•ˆ‹––‡†™‹–Šƒ‹ˆ”ƒ”‡†…ƒ‡”ƒȋ ‹”•–ǡ‘›‘ǡ ƒ’ƒȌǤ—”‹‰
 E X T R A Dement Geriatr Cogn Disord Extra 2016;6:194–204 197
DOI: 10.1159/000445870 © 2016 The Author(s). Published by S. Karger AG, Basel
www.karger.com/dee
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome

–Š‡–‡•–ǡ–Š‡‘’‡‘”•Š—–•–ƒ–—•‘ˆ–Š‡‡›‡•™ƒ•‘‹–‘”‡†˜‹•—ƒŽŽ›ǡƒ†–Š‡‡Ž‡…–”‘›•–ƒ‰Ǧ
‘‰”ƒ™ƒ•”‡…‘”†‡†ǤŠ‡…ƒŽ‘”‹…•–‹—Ž—•–‘‹†—…‡›•–ƒ‰—•™ƒ•†‡Ž‹˜‡”‡†„›‹””‹‰ƒ–‹‰
™‹–Š…‘‘Žƒ‹”ƒ–ʹͶι ˆ‘”ͳ‹ˆ”‘–Š‡‡š–‡”ƒŽƒ—†‹–‘”›…ƒƒŽ–‘–Š‡‡ƒ”†”—ǡ—•‹‰ƒƒ‹”
 

…ƒŽ‘”‹…†‡˜‹…‡ȋ ‹”•–ȌǤ ‘”–›•‡…‘†•ƒˆ–‡”–Š‡‡†‘ˆ–Š‡•–‹—Ž—•ǡ–Š‡–‡•–™ƒ•…ƒ””‹‡†‘—–

™‹–Š˜‹•—ƒŽˆ‹šƒ–‹‘„›‰ƒœ‹‰ƒ–ƒ–ƒ”‰‡–ˆ‘”ͳͲ•ǤŠ‡›•–ƒ‰—•‹†—…‡†™ƒ•ƒƒŽ›œ‡†ǡƒ†
–Š‡’ƒ”ƒ‡–‡”•‘ˆˆ”‡“—‡…›ǡƒ’Ž‹–—†‡ȋ•Ž‘™ƒ†“—‹…’Šƒ•‡Ȍǡƒ†‡ƒ˜‡Ž‘…‹–›ȋ•Ž‘™ƒ†
“—‹…’Šƒ•‡Ȍ™‡”‡‹˜‡•–‹‰ƒ–‡†Ǥ‡ƒ˜ƒŽ—‡•‘ˆ‡ƒ…Š’ƒ”ƒ‡–‡”™‡”‡…ƒŽ…—Žƒ–‡†ˆ‘”–Š‡ͳͲ•
„‡ˆ‘”‡–Š‡–‡•–ƒ†–Š‡ͳͲ•†—”‹‰–Š‡–‡•–Ǣ–Š‡•‡™‡”‡•‡’ƒ”ƒ–‡†‹–‘„‡ˆ‘”‡–Š‡–‡•–
ƒ††—”‹‰–Š‡–‡•–ˆ‘”ƒƒŽ›•‹•Ǥ

 Š‡•—’’”‡••‹‘”ƒ–‡ȋȌ‘ˆ•Ž‘™Ǧ’Šƒ•‡˜‡Ž‘…‹–›†—”‹‰–Š‡–‡•–™ƒ•‡š’”‡••‡†ƒ•ƒ
’‡”…‡–ƒ‰‡—•‹‰–Š‡ˆ‘ŽŽ‘™‹‰‡“—ƒ–‹‘ǣαͳͲͲέȋ„Ȃ†ȌȀȋ„Ȍǡ™Š‡”‡„‹•
–Š‡•Ž‘™Ǧ’Šƒ•‡˜‡Ž‘…‹–›„‡ˆ‘”‡–Š‡–‡•–ƒ††‹•–Š‡•Ž‘™Ǧ’Šƒ•‡˜‡Ž‘…‹–›†—”‹‰–Š‡
–‡•–ǤŠ‡ˆ‘”‡ƒ…Š•—„Œ‡…–™ƒ•…ƒŽ…—Žƒ–‡†—•‹‰–Š‹•‡“—ƒ–‹‘Ǣ–Š‡‡ƒ˜ƒŽ—‡ˆ‘”‡ƒ…Š
‰”‘—’™ƒ••—„•‡“—‡–Ž›…ƒŽ…—Žƒ–‡†Ǥ

 Š‡˜‡Ž‘…‹–›‘ˆ–Š‡•Ž‘™’Šƒ•‡‹•‘”ƒŽŽ›Ž‘™‡”†—”‹‰–Š‡–‡•––Šƒ„‡ˆ‘”‡–Š‡
–‡•–ǤŠ‡‹•—•—ƒŽŽ›ƒ’‘•‹–‹˜‡˜ƒŽ—‡ǢŠ‘™‡˜‡”ǡ™Š‡”‡–Š‡•Ž‘™Ǧ’Šƒ•‡˜‡Ž‘…‹–›™ƒ•‰”‡ƒ–‡”
†—”‹‰–Š‡–‡•––Šƒ„‡ˆ‘”‡–Š‡–‡•–ǡ”‡‰ƒ”†‹‰ƒ‹…”‡ƒ•‡‹…ƒŽ‘”‹…›•–ƒ‰—•ǡ–Š‡
˜ƒŽ—‡™ƒ•‡‰ƒ–‹˜‡Ǥ

Evaluation of Brain Lesions Using Cerebral Blood Flow Single-Photon Emission Computed
Tomography Tests
ͳʹ͵ Ǧ •‹‰Ž‡Ǧ’Š‘–‘ ‡‹••‹‘ …‘’—–‡† –‘‘‰”ƒ’Š› ȋȌ „”ƒ‹ ‹ƒ‰‹‰ ™ƒ•
…ƒ””‹‡†‘—––‘‡˜ƒŽ—ƒ–‡…‡”‡„”ƒŽˆ—…–‹‘ƒ•ƒ†‹ƒ‰‘•–‹…ƒ‹†‹–Š‡ ‰”‘—’Ǥ‘‘‰”ƒ’Š‹…
•–ƒ–‹•–‹…ƒŽƒƒŽ›•‹•ȋ‹••’ͷȀ‹••’‘‘Ǣ‹Š‘‡†‹ǦŠ›•‹…•‘Ǥǡ–†Ǥǡ‘›‘ǡ ƒ’ƒȌ™ƒ•’‡”ˆ‘”‡†
‘–Š‡‹ƒ‰‡•ǡƒ†•…‘”‡‹ƒ‰‡•™‡”‡‡˜ƒŽ—ƒ–‡†„›…‘’ƒ”‹‰–Š‡™‹–Š–Š‡‘”ƒŽ
†ƒ–ƒ„ƒ•‡‘ˆ–Š‡‹˜‡”•‹–›‘ˆ•——„ƒȏʹͺȐǤŠ‡†ƒ–ƒ„ƒ•‡‘ˆ–Š‡‹˜‡”•‹–›‘ˆ•——„ƒ…‘Ǧ
’”‹•‡•ʹ͵…ƒ•‡•ƒ‰‡†͸͸Ȃ͹ͻ›‡ƒ”•Ǥ•…‘”‡˰ʹ  ǤͲ™ƒ•Œ—†‰‡†–‘„‡ƒ•‹‰‹ˆ‹…ƒ–†‹ˆˆ‡”‡…‡Ǥ

 •–ƒ–‹•–‹…ƒŽ‹ƒ‰‡ƒƒŽ›•‹•‘ˆ–Š‡…‡”‡„”ƒŽ„Ž‘‘†ˆŽ‘™™ƒ•—•‡†–‘‹˜‡•–‹‰ƒ–‡–Š‡
”‡†—…–‹‘ ‹ „Ž‘‘† ˆŽ‘™ ‹ –Š‡ ˆ”‘–‘–‡’‘”ƒŽ Ž‘„‡•ǡ „—– ‘– –Š‡ …‡”‡„‡ŽŽ—ǡ ‹ –Š‡ 
•›†”‘‡‰”‘—’Ǥ

Statistical Analysis

 Š‡†ƒ–ƒ‘„–ƒ‹‡†™‡”‡–‡•–‡†•–ƒ–‹•–‹…ƒŽŽ›™‹–Š–Š‡ƒǦŠ‹–‡›–‡•–ǡ—•‹‰•–ƒ–‹•–‹…•
•‘ˆ–™ƒ”‡ȋ–ƒ–‹•–‹…•„ƒ•‡•‘ˆ–™ƒ”‡Ǣǡ‡™‘”ǡǤǤǡȌǤŠ‡Ž‡˜‡Žˆ‘”ƒ•–ƒ–‹•Ǧ
–‹…ƒŽŽ›•‹‰‹ˆ‹…ƒ–†‹ˆˆ‡”‡…‡™ƒ•ͷΨǤ

Results

Clinical Symptoms of Subjects with FTD Syndrome


 Š‡…Ž‹‹…ƒŽ…Šƒ”ƒ…–‡”‹•–‹…•‘ˆ–Š‡ •›†”‘‡’ƒ–‹‡–•ƒ”‡…‘’‹Ž‡†‹–ƒ„Ž‡ͳǤŠ‡
‡ƒƒ‰‡ƒ–‘•‡–™ƒ•͸ͶǤͺά͹Ǥͳ›‡ƒ”•ǡƒ†–Š‡‡ƒ†‹•‡ƒ•‡†—”ƒ–‹‘™ƒ•͵ǤͶάʹǤͻ›‡ƒ”•Ǥ
–Š‡  ‰”‘—’ǡ –Š‡ ‡ƒ  •…‘”‡ ™ƒ• ʹͳǤͻ ά ͷǤͲǡ ƒ† –Š‡ ‡ƒ ”‘–ƒŽ ••‡••‡–
ƒ––‡”›ȏʹͻȐ •…‘”‡™ƒ•ͺǤͺά͵Ǥ͸Ǥƒ† ”‘–ƒŽ••‡••‡–ƒ––‡”›•…‘”‡•™‡”‡„‘–Š
•‹‰‹ˆ‹…ƒ–Ž› Ž‘™‡” ‹ –Š‡  ‰”‘—’ –Šƒ ‹ –Š‡ Š‡ƒŽ–Š› …‘–”‘Ž ‰”‘—’ ȋ’ δ ͲǤͲͷǡ ƒǦ
Š‹–‡›–‡•–Ȍȋ–ƒ„Ž‡ͳȌǤ

 Š‡‘•–…‘‘•›’–‘™ƒ•…Šƒ”ƒ…–‡”…Šƒ‰‡ǡ™Š‹…Š™ƒ•’”‡•‡–‹ƒŽŽͳͶ…ƒ•‡•ǡ
™Š‹Ž‡’‡”•‡˜‡”ƒ–‹‘™ƒ•ˆ‘—†‹ͳͲ…ƒ•‡•ǡ‘ǦˆŽ—‡–ƒ’Šƒ•‹ƒ‹ʹ…ƒ•‡•ǡ˜‡”–‹…ƒŽ‰ƒœ‡’ƒŽ•›
‹ͺ…ƒ•‡•ǡ—’’‡”‘–‘”‡—”‘†‹•‘”†‡”‹Ͷ…ƒ•‡•ǡŽ‘™‡”‘–‘”‡—”‘†‹•‘”†‡”‹ͷ…ƒ•‡•ǡ
ƒ†’ƒ”‹•‘‹•‹ͳͲ…ƒ•‡•Ǥ
 E X T R A Dement Geriatr Cogn Disord Extra 2016;6:194–204 198
DOI: 10.1159/000445870 © 2016 The Author(s). Published by S. Karger AG, Basel
www.karger.com/dee
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome

Table 1.Ž‹‹…ƒŽ…Šƒ”ƒ…–‡”‹•–‹…•‘ˆ–Š‡–™‘‰”‘—’•

•›†”‘‡ ‘–”‘Ž ’˜ƒŽ—‡

ȋαͳͶȌ ȋαͳͶȌ

‰‡ǡ›‡ƒ”• ͸͹Ǥͻ ά ͷǤ͹

  ͸ͻǤʹ ά ʹǤͺ
  ͲǤͶ͵Ͷ
ƒŽ‡•Ȁˆ‡ƒŽ‡• ͸Ȁͺ ͸Ȁͺ Ȃ
 ʹͳǤͻ ά ͷǤͲ
  ʹͺǤ͸ ά ͳǤʹ
  ͲǤͲͲͲͲͲͲ͹ȗȗ
”‘–ƒŽ••‡••‡–ƒ––‡”› ͺǤͺ ά ͵Ǥ͸
  ͳͷǤͻ ά ͳǤ͵
  ͲǤͲͲͲͲͲͲ͹ȗȗ
‰‡ƒ–‘•‡–ǡ›‡ƒ”• ͸ͶǤͺ ά ͹Ǥͳ
  Ȃ Ȃ
‡ƒ”•ƒˆˆ‡…–‡† ͵ǤͶ ά ʹǤͻ
  Ȃ Ȃ
Ž‹‹…ƒŽ•›’–‘•
‡”•‡˜‡”ƒ–‹‘ ͳͲȋ͹ͳǤͶȌ Ȃ Ȃ
‘ǦˆŽ—‡–ƒ’Šƒ•‹ƒ ʹȋͳͶǤ͵Ȍ Ȃ Ȃ
‡”–‹…ƒŽ‰ƒœ‡’ƒŽ•› ͺȋͷ͹ǤͳȌ Ȃ Ȃ
’’‡”‘–‘”‡—”‘†‹•‘”†‡” Ͷȋ͵͵Ǥ͵Ȍ Ȃ Ȃ
‘™‡”‘–‘”‡—”‘†‹•‘”†‡” ͷȋ͵ͷǤ͹Ȍ Ȃ Ȃ
‡”‡„‡ŽŽƒ”ƒ–ƒš‹ƒ ͲȋͲȌ Ȃ Ȃ
ƒ”‹•‘‹• ͳͲȋ͹ͳǤͶȌ Ȃ Ȃ

ƒ‹–†‹•–—”„ƒ…‡ȋͳͲǦ‡–‡”‰ƒ‹–Ȍ ͵ȋʹͳǤͶȌ Ȃ Ȃ
ƒ„‹Ž‹–›–‘™ƒŽȋͳǦ‡–‡”‰ƒ‹–Ȍ ͸ȋͶʹǤͻȌ Ȃ Ȃ

 ‡…”‡ƒ•‡†„Ž‘‘†ˆŽ‘™‹–Š‡ˆ”‘–‘–‡’‘”ƒŽŽ‘„‡ ͳͶȋͳͲͲǤͲȌ Ȃ Ȃ
‡…”‡ƒ•‡†„Ž‘‘†ˆŽ‘™‹–Š‡‹ˆ‡”‹‘”’ƒ”‹‡–ƒŽŽ‘„—Ž‡ ͶȋʹͺǤ͸Ȍ Ȃ Ȃ
‡…”‡ƒ•‡†„Ž‘‘†ˆŽ‘™‹–Š‡…‡”‡„‡ŽŽ— ͲȋͲȌ Ȃ Ȃ

 ‹‰—”‡•ƒ”‡’”‡•‡–‡†ƒ•‡ƒ•ά•–ƒ†ƒ”††‡˜‹ƒ–‹‘•ǡȀ‘”ȋΨȌǤ
ȗȗ–‡”‰”‘—’…‘’ƒ”‹•‘™‹–Š–Š‡…‘–”‘Ž‰”‘—’ȋ’δͲǤͲͳǡƒǦŠ‹–‡›–‡•–ȌǤ

a b

Fig. 1.šƒ’Ž‡•‘ˆ…ƒŽ‘”‹…–‡•–•Ǥ‡•—Ž–•‘ˆ•–‹—Žƒ–‹‘‘ˆ–Š‡Ž‡ˆ–‡ƒ”™‹–Š…‘‘Žƒ‹”ƒ–ʹͶι ƒ”‡’”‡•‡–‡†ǤŠ‡

 

—’’‡”’ƒ‡Ž•Š‘™•Š‘”‹œ‘–ƒŽ‡›‡‘˜‡‡–ǡ–Š‡Ž‘™‡”’ƒ‡Ž•Š‘™•˜‡Ž‘…‹–›Ǥ””‘™Š‡ƒ†•‹†‹…ƒ–‡…ƒŽ…—Ǧ
Žƒ–‡†˜ƒŽ—‡•‘ˆ͹ͺΨȋaǢ ƒŠ‡ƒŽ–Š›͹ͶǦ›‡ƒ”Ǧ‘Ž†ƒŽ‡•—„Œ‡…–Ȍƒ†͵ͺΨȋbǢ ƒ͸ͺǦ›‡ƒ”Ǧ‘Ž† •›†”‘‡
•—„Œ‡…–ȌǤ
 E X T R A Dement Geriatr Cogn Disord Extra 2016;6:194–204 199
DOI: 10.1159/000445870 © 2016 The Author(s). Published by S. Karger AG, Basel
www.karger.com/dee
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome

Table 2.ƒŽ‘”‹…›•–ƒ‰—•–‡•–

•›†”‘‡ ‘–”‘Ž ’˜ƒŽ—‡

ȋʹͺ‡ƒ”•Ȍ ȋʹͺ‡ƒ”•Ȍ

Pre-VStest
’Ž‹–—†‡ǡ†‡‰”‡‡•
—‹…’Šƒ•‡ ͵Ǥͳ ά ͳǤ͹ ͷǤͷ ά ͳǤ͸ ͲǤͲͲͲͲͲʹȗȗ
Ž‘™’Šƒ•‡ ͵Ǥ͵ ά ͳǤͺ ͷǤ͸ ά ͳǤ͹ ͲǤͲͲͲͲͳȗȗ
‡Ž‘…‹–›ǡ†‡‰”‡‡•Ȁ•
—‹…’Šƒ•‡ ͷͻǤͶ ά ʹͳǤͷ ͺʹǤͳ ά ͳ͹Ǥ͵ ͲǤͲͲͲͲͺȗȗ
Ž‘™’Šƒ•‡ ͳʹǤͶ ά ͹Ǥʹ ͳͷǤʹ ά ͵Ǥ͹ ͲǤͲ͹͸
›•–ƒ‰—•ˆ”‡“—‡…›ǡȀ• ͵ǤͲ ά ͳǤͳ ʹǤͷ ά ͲǤ͹ ͲǤͲ͸͵
VStest
’Ž‹–—†‡ǡ†‡‰”‡‡•
—‹…’Šƒ•‡ ͵Ǥʹ ά ͳǤͺ ͳǤͻ ά ͲǤ͸ ͲǤͲͲͲͶȗȗ
Ž‘™’Šƒ•‡ ͶǤͲ ά ʹǤͲ ʹǤ͵ ά ͲǤͺ ͲǤͲͲͲʹȗȗ
‡Ž‘…‹–›ǡ†‡‰”‡‡•Ȁ•
—‹…’Šƒ•‡ ͸ͷǤͷ ά ʹͶǤͻ ͶͷǤ͸ ά ͻǤͲ ͲǤͲͲͲʹȗȗ
Ž‘™’Šƒ•‡ ͳͳǤͶ ά ͺǤͻ ͷǤ͹ ά ʹǤ͸ ͲǤͲͲʹȗȗ
›•–ƒ‰—•ˆ”‡“—‡…›ǡȀ• ʹǤͶ ά ͳǤ͵ ʹǤͳ ά ͲǤͻ ͲǤ͵ͳͲ
ǡΨ ͶǤͺ ά Ͷ͸ǤͲ ͸͵Ǥͳ ά ͳʹǤʹ ͲǤͲͲͲͲͲͲͲ͵ȗȗ

‹‰—”‡•ƒ”‡’”‡•‡–‡†ƒ•‡ƒ•ά•–ƒ†ƒ”††‡˜‹ƒ–‹‘•Ǥ
ȗȗ’δͲǤͲͳƒ•…‘’ƒ”‡†–‘Š‡ƒŽ–Š›…‘–”‘Ž•ǢƒǦŠ‹–‡›–‡•–Ǥ

 ƒ›„‡„”‘ƒ†Ž›…Žƒ••‹ˆ‹‡†‹–‘–Š”‡‡•—„–›’‡•ǣ„‡Šƒ˜‹‘”ƒŽ˜ƒ”‹ƒ– ǡ’”‘‰”‡••‹˜‡
‘ǦˆŽ—‡–ƒ’Šƒ•‹ƒǡƒ†•‡ƒ–‹…†‡‡–‹ƒȏͳͷǡͳ͸ȐǤŠ‡”‡ƒ”‡ƒŽ•‘‘Ǧ–›’‹…ƒŽ…ƒ•‡•–Šƒ–†‘
‘–…‘””‡•’‘†–‘ƒ›‘ˆ–Š‡•‡…Ž‹‹…ƒŽˆ‘”•Ǥ–Š‡’”‡•‡–•–—†›ǡ–Š‡”‡™‡”‡ͳʹ…ƒ•‡•‘ˆ
„‡Šƒ˜‹‘”ƒŽ˜ƒ”‹ƒ– ƒ†ʹ…ƒ•‡•‘ˆ’”‘‰”‡••‹˜‡‘ǦˆŽ—‡–ƒ’Šƒ•‹ƒǢ‘‡‘ˆ–Š‡•—„Œ‡…–•
Šƒ†•‡ƒ–‹…†‡‡–‹ƒǤ

Caloric Test Results for Each Group


 ƒŽ‘”‹…–‡•–•™‡”‡…ƒ””‹‡†‘—–‘ͳͶ’‡‘’Ž‡ȋʹͺ‡ƒ”•Ȍ‹–Š‡ ‰”‘—’ƒ†‘ͳͶ’‡‘’Ž‡
ȋʹͺ‡ƒ”•Ȍ‹–Š‡…‘–”‘Ž‰”‘—’ȋˆ‹‰ǤͳȌǤ‡ˆ‘”‡–Š‡–‡•–ǡ“—‹…Ǧ’Šƒ•‡ƒ’Ž‹–—†‡ǡ•Ž‘™Ǧ’Šƒ•‡
ƒ’Ž‹–—†‡ǡƒ†“—‹…Ǧ’Šƒ•‡˜‡Ž‘…‹–›™‡”‡•‹‰‹ˆ‹…ƒ–Ž›Ž‘™‡”‹–Š‡ ‰”‘—’–Šƒ‹–Š‡
…‘–”‘Ž‰”‘—’Ǥ—”‹‰–Š‡–‡•–ǡ„‘–Š–Š‡ƒ’Ž‹–—†‡ƒ†–Š‡˜‡Ž‘…‹–›‘ˆ–Š‡“—‹…ƒ†•Ž‘™
’Šƒ•‡•™‡”‡•‹‰‹ˆ‹…ƒ–Ž›Š‹‰Š‡”‹–Š‡ ‰”‘—’–Šƒ‹–Š‡…‘–”‘Ž‰”‘—’ȋ–ƒ„Ž‡ʹȌǤŠ‡
‡ƒ  ˜ƒŽ—‡ ™ƒ• •‹‰‹ˆ‹…ƒ–Ž› Ž‘™‡” ‹ –Š‡  ‰”‘—’ –Šƒ ‹ –Š‡ …‘–”‘Ž ‰”‘—’Ǥ ††‹Ǧ
–‹‘ƒŽŽ›ǡˆ‹†‹‰•‘ˆ‹…”‡ƒ•‡†›•–ƒ‰—•™‡”‡’”‡•‡–†—”‹‰–Š‡–‡•–‹‘”‡–ŠƒŠƒŽˆ
ȋͷ͹ǤͳΨȌ‘ˆ–Š‡•—„Œ‡…–•Ǥ

Relationship of Subjective Symptoms with SR in the FTD Group


 Š‡‡ƒ˜ƒŽ—‡•‘ˆ’ƒ–‹‡–•‹–Š‡ ‰”‘—’™‹–Š†‹ˆˆ‡”‡–…Ž‹‹…ƒŽ•›’–‘•™‡”‡
…‘’ƒ”‡† ȋ–ƒ„Ž‡ ͵ȌǤ Š‡  ˜ƒŽ—‡ ™ƒ• •‹‰‹ˆ‹…ƒ–Ž› Ž‘™‡” ‹ ’ƒ–‹‡–• ™‹–Š ’‡”•‡˜‡”ƒ–‹‘ǡ
’ƒ–‹‡–•™‹–Š‰ƒ‹–†‹•–—”„ƒ…‡ǡƒ†’ƒ–‹‡–•—ƒ„Ž‡–‘™ƒŽǤŠ‡•Š‘™‡†‘”‡Žƒ–‹‘•Š‹’
™‹–Š ‘ǦˆŽ—‡– ƒ’Šƒ•‹ƒǡ ˜‡”–‹…ƒŽ ‰ƒœ‡ ’ƒŽ•›ǡ —’’‡” ‘–‘” ‡—”‘ †‹•‘”†‡”ǡ Ž‘™‡” ‘–‘”
‡—”‘†‹•‘”†‡”ǡ‘”’ƒ”‹•‘‹•Ǥ
 E X T R A Dement Geriatr Cogn Disord Extra 2016;6:194–204 200
DOI: 10.1159/000445870 © 2016 The Author(s). Published by S. Karger AG, Basel
www.karger.com/dee
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome

Table 3.‡Žƒ–‹‘•Š‹’‘ˆ–Š‡–‘‡—”‘Ž‘‰‹…ƒŽ•‹‰•‹–Š‡ ‰”‘—’ȋαͳͶȌ

Ž‹‹…ƒŽ•›’–‘•  ǡΨ ’˜ƒŽ—‡

•›†”‘‡™‹–Š •›†”‘‡™‹–Š‘—–
‡—”‘Ž‘‰‹…ƒŽ•‹‰• ‡—”‘Ž‘‰‹…ƒŽ•‹‰•

‡”•‡˜‡”ƒ–‹‘ ͳ͹ǤͶ ά ͵ʹǤͲȋͳͲȀͳͶȌ

  ȂʹʹǤ͵ ά ʹʹǤʹȋͶȀͳͶȌ
  ͲǤͲʹͻȗ
‘ǦˆŽ—‡–ƒ’Šƒ•‹ƒ Ȃ ͺǤͶ ά ʹ͵Ǥ͵ȋʹȀͳͶȌ
    ͺǤͶ ά ͵ͷǤͻȋͳʹȀͳͶȌ
    ͲǤͶͺʹ
‡”–‹…ƒŽ‰ƒœ‡’ƒŽ•›  ʹǤʹ ά ʹͻǤʹȋͺȀͳͶȌ
   ͳͳǤʹ ά ͶʹǤͶȋ͸ȀͳͶȌ
  ͲǤ͸͸͹
’’‡”‘–‘”‡—”‘†‹•‘”†‡” ͳͲǤͳ ά ͵ͺǤ͹ȋͶȀͳͶȌ
  ͶǤͶ ά ͵ͶǤͶȋͳͲȀͳͶȌ
    ͲǤͺͲͻ
‘™‡”‘–‘”‡—”‘†‹•‘”†‡” Ȃ ͷǤͳ ά ͵͸ǤͳȋͷȀͳͶȌ
    ͳʹǤʹ ά ͵͵Ǥ͸ȋͻȀͳͶȌ
  ͲǤͶͲ͸
ƒ”‹•‘‹• ͳͶǤͺ ά ʹͺǤͷȋͳͲȀͳͶȌ
  Ȃͳ͸ǤͲ ά ͶͳǤ͹ȋͶȀͳͶȌ
  ͲǤʹͶͶ

ƒ‹–†‹•–—”„ƒ…‡ȋͳͲǦ‡–‡”‰ƒ‹–Ȍ ȂͶͳǤͲ ά ͳͲǤ͸ȋ͵ȀͳͶȌ

  ͳͺǤͻ ά ʹͷǤ͸ȋͳͳȀͳͶȌ
  ͲǤͲͲͲʹȗȗ
ƒ„‹Ž‹–›–‘™ƒŽȋͳǦ‡–‡”‰ƒ‹–Ȍ ȂͳͷǤ͵ ά ͵ʹǤͺȋ͸ȀͳͶȌ
  ʹʹǤͲ ά ʹ͸ǤͻȋͺȀͳͶȌ
  ͲǤͲͶͺȗ

‹‰—”‡•ƒ”‡’”‡•‡–‡†ƒ•‡ƒ•ά•–ƒ†ƒ”††‡˜‹ƒ–‹‘•ǡ™‹–Š—„‡”‘ˆ’ƒ–‹‡–•‹’ƒ”‡–Š‡•‡•Ǥ
ȗ –‡”‰”‘—’ …‘’ƒ”‹•‘ „ƒ•‡† ‘ –Š‡ ’”‡•‡…‡ ‘” ƒ„•‡…‡ ‘ˆ •‹‰• ƒ† •›’–‘• ȋ’ δ ͲǤͲͷǡ ƒǦ
Š‹–‡›–‡•–ȌǤȗȗ–‡”‰”‘—’…‘’ƒ”‹•‘„ƒ•‡†‘–Š‡’”‡•‡…‡‘”ƒ„•‡…‡‘ˆ•‹‰•ƒ†•›’–‘•ȋ’δͲǤͲͳǡ
ƒǦŠ‹–‡›–‡•–ȌǤ

Discussion


 Ž–Š‘—‰Š •›†”‘‡Šƒ•˜ƒ”‹‘—•…Ž‹‹…ƒŽ•›’–‘•™‹–Š—Ž–‹’Ž‡’”‡•—‡†‡—”‘Ǧ
’ƒ–Š‘Ž‘‰‹…ƒŽ„ƒ…‰”‘—†•ǡƒŽƒ”‰‡—„‡”‘ˆ…ƒ•‡•™‹–Š •›†”‘‡Šƒ†‹’ƒ‹”‡†ƒ„‹Ž‹–›
–‘ •—’’”‡•• …ƒŽ‘”‹… ›•–ƒ‰—• „› ˜‹•—ƒŽ ˆ‹šƒ–‹‘Ǥ —”–Š‡”‘”‡ǡ  ‹’ƒ‹”‡– •Š‘™‡† ƒ
•‹‰‹ˆ‹…ƒ– ”‡Žƒ–‹‘•Š‹’ –‘ –Š‡ ‹ƒ„‹Ž‹–› –‘ ™ƒŽ ‹  •›†”‘‡Ǥ ƒ•‡† ‘ –Š‡ ’”‡˜‹‘—•
ˆ‹†‹‰•ƒ•‘—–Ž‹‡†ƒ„‘˜‡ǡ–Š‡‡…Šƒ‹•–Š”‘—‰Š™Š‹…Š‹’ƒ‹”‡–ƒ’’‡ƒ”•‹…‘”–‹…ƒŽ
†›•ˆ—…–‹‘™ƒ••’‡…—Žƒ–‡†–‘„‡ƒ•’”‡•‡–‡†‹ˆ‹‰—”‡ʹȏ ͳǡʹǡͶǡͷǡ͵Ͳǡ͵ͳȐǤ

 ‹‰—”‡ʹƒ•Š‘™•Š›’‘–Š‡•‹œ‡†˜‡•–‹„—Ž‘Ǧ‘…—Žƒ””‡ˆŽ‡š‡—”ƒŽ’ƒ–Š™ƒ›•ƒˆ–‡”•–‹—Žƒ–‹‘
‘ˆ–Š‡Š‘”‹œ‘–ƒŽ•‡‹…‹”…—Žƒ”…ƒƒŽ‹Š‡ƒŽ–Š›‹†‹˜‹†—ƒŽ•Ǥ–‹—Žƒ–‹‘‘ˆ–Š‡Š‘”‹œ‘–ƒŽ•‡‹Ǧ
…‹”…—Žƒ”…ƒƒŽ„›…‘Ž†ƒ‹”…ƒ—•‡•–Š‡‹Š‹„‹–‘”›‡—”‘•‹–Š‡˜‡•–‹„—Žƒ”—…Ž‡—•–‘†‡…”‡ƒ•‡
–Š‡‹”‹Š‹„‹–‹‘‘ˆƒ…–‹˜‹–›‹–Š‡ƒ„†—…‡•—…Ž‡—•ȋȌǤ–Š‡‘–Š‡”Šƒ†ǡ–Š‡ƒ…–‹˜‹–›‘ˆ–Š‡
‘…—Ž‘‘–‘”—…Ž‡—•ȋȌ‹’•‹Žƒ–‡”ƒŽ–‘–Š‡˜‡•–‹„—Žƒ”Ǧ•–‹—Žƒ–‡†•‹†‡†‘‡•‘–…Šƒ‰‡Ǥ•ƒ
”‡•—Ž–ǡ‘Ž›–Š‡–‘—•‘ˆ–Š‡ƒ„†—…–‘”—•…Ž‡•‹…”‡ƒ•‡•ǡ™Š‹…Š…ƒ—•‡•–Š‡–‘…‘–”ƒ…–ǡ–Š—•
’”‘†—…‹‰–Š‡•Ž‘™’Šƒ•‡‘ˆ…ƒŽ‘”‹…›•–ƒ‰—•Ǥ

 ‹‰—”‡ʹ„•Š‘™•–Š‡Š›’‘–Š‡•‹œ‡†”‘—–‡‘ˆ‹Š‡ƒŽ–Š›‹†‹˜‹†—ƒŽ•Ǥ—”‹‰ƒ–‡•–ǡ
˜‹•‹‘Ǧ”‡Žƒ–‡† ”‡‰‹‘•ǡ ‹…Ž—†‹‰ –Š‡ …‡”‡„‡ŽŽ— ƒ† –Š‡ ˆ”‘–ƒŽ ‡›‡ ˆ‹‡Ž† ‹ –Š‡ …‡”‡„”ƒŽ
…‘”–‡šǡ ”‡…‡‹˜‡ ˜‹•—ƒŽ •–‹—Žƒ–‹‘Ǥ Ž‘……—Žƒ” —”‹Œ‡ …‡ŽŽ• …‘–”ƒŽƒ–‡”ƒŽ –‘ –Š‡ ˜‡•–‹„—Žƒ”Ǧ
•–‹—Žƒ–‡†•‹†‡ƒ”‡ƒ…–‹˜ƒ–‡†„›˜‹•—ƒŽ•–‹—Žƒ–‹‘ǡ‡š‡”–‹‰ƒ‹…”‡ƒ•‡†‹Š‹„‹–‘”›‡ˆˆ‡…–‘
–Š‡‹Š‹„‹–‘”›‡—”‘•‹–Š‡˜‡•–‹„—Žƒ”—…Ž‡—•Ǥ•ƒ”‡•—Ž–ǡ‹Š‹„‹–‘”›‡—”‘ƒŽƒ…–‹˜‹–›‹
–Š‡˜‡•–‹„—Žƒ”—…Ž‡—•„‡…‘‡•†‹•”—’–‡†ǡ‡š‡”–‹‰Ž‡••‘ˆƒ‹Š‹„‹–‘”›‡ˆˆ‡…–‘–Š‡‡š…‹–Ǧ
ƒ–‘”›‡—”‘•‹–Š‡ƒ„†—…‡•—…Ž‡—•…‘–”ƒŽƒ–‡”ƒŽ–‘–Š‡˜‡•–‹„—Žƒ”Ǧ•–‹—Žƒ–‡†•‹†‡ȋȌǤ
Š‡”‡ˆ‘”‡ǡ–Š‡‡š…‹–ƒ–‘”›‡—”‘•‹–Š‡ƒ„†—…‡•—…Ž‡—•…‘–”ƒŽƒ–‡”ƒŽ–‘–Š‡˜‡•–‹„—Žƒ”Ǧ
•–‹—Žƒ–‡†•‹†‡ȋȌ„‡…‘‡ƒ…–‹˜ƒ–‡†ǡ‡š‡”–‹‰ƒ‰”‡ƒ–‡”‡š…‹–ƒ–‘”›‡ˆˆ‡…–‘–Š‡‡š–”ƒ‘…—Žƒ”
‘–‘”—…Ž‡‹‘–Š‡˜‡•–‹„—Žƒ”Ǧ•–‹—Žƒ–‡†•‹†‡ȋȌǡ™Š‹…Š‹…”‡ƒ•‡•–Š‡–‘—•‘ˆ–Š‡ƒ††—…–‘”
—•…Ž‡•‘–Š‡˜‡•–‹„—Žƒ”Ǧ•–‹—Žƒ–‡†•‹†‡Ǥƒ•‡†‘’”‡˜‹‘—•…Ž‹‹…ƒŽˆ‹†‹‰•ˆ‘”Ž‡•‹‘•‘
–Š‡‹ˆ‡”‹‘”’ƒ”‹‡–ƒŽŽ‘„—Ž‡ȏͷǡʹ͸Ȑǡ‹–…ƒ„‡ƒ••—‡†–Šƒ–˜‹•—ƒŽ•–‹—Žƒ–‹‘‹‰Š–…ƒ—•‡–Š‡
˜‡•–‹„—Žƒ” …‘”–‡š –‘ ‡š‡”– ƒ ‡š…‹–ƒ–‘”› ‡ˆˆ‡…– ‘ –Š‡ ‹Š‹„‹–‘”› ‡—”‘• ‹ –Š‡ ˜‡•–‹„—Žƒ”
—…Ž‡—•‹’•‹Žƒ–‡”ƒŽ–‘–Š‡˜‡•–‹„—Žƒ”Ǧ•–‹—Žƒ–‡†•‹†‡ǤŠ‡‹Š‹„‹–‘”›‡—”‘•‹–Š‡˜‡•–‹„—Žƒ”
—…Ž‡—•ƒ”‡–Š‡”‡ˆ‘”‡ƒ…–‹˜ƒ–‡†ǡ‡š‡”–‹‰ƒ‰”‡ƒ–‡”‹Š‹„‹–‘”›‡ˆˆ‡…–‘–Š‡‡š–”ƒ‘…—Žƒ”‘–‘”
 E X T R A Dement Geriatr Cogn Disord Extra 2016;6:194–204 201
DOI: 10.1159/000445870 © 2016 The Author(s). Published by S. Karger AG, Basel
www.karger.com/dee
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome

Fig. 2. ›’‘–Š‡•‹œ‡†‡…Šƒ‹•‘ˆ–Š‡†‹•‘”†‡”‘ˆ‹ •›†”‘‡Ǥa ‡•–‹„—Ž‘Ǧ‘…—Žƒ””‡ˆŽ‡š‡—”ƒŽ

’ƒ–Š™ƒ›•ƒˆ–‡”•–‹—Žƒ–‹‘‘ˆ–Š‡Š‘”‹œ‘–ƒŽ•‡‹…‹”…—Žƒ”…ƒƒŽ‹Š‡ƒŽ–Š›‹†‹˜‹†—ƒŽ•Ǥb›’‘–Š‡•‹œ‡†”‘—–‡
‘ˆ‹Š‡ƒŽ–Š›‹†‹˜‹†—ƒŽ•Ǥc ›’‘–Š‡•‹œ‡†‡…Šƒ‹•‘ˆ†‹•‘”†‡”‹ •›†”‘‡Ǥα…—Ž‘‘–‘”
—…Ž‡—•ǢჄ†—…‡•—…Ž‡—•Ǣα—”‹Œ‡…‡ŽŽǤŠ‹–‡…‹”…Ž‡••Š‘™‡š…‹–ƒ–‘”›‡—”‘•ǡ„Žƒ……‹”…Ž‡••Š‘™
‹Š‹„‹–‘”›‡—”‘•ǤŽ—••‹‰••–ƒ†ˆ‘”‡š…‹–ƒ–‹‘ǡ‹—••‹‰•ˆ‘”‹Š‹„‹–‹‘ǤŠ‡•‹œ‡‘ˆ’Ž—•ƒ†‹—••‹‰•
”‡ˆŽ‡…–•–Š‡†‡‰”‡‡‘ˆƒ…–‹˜‹–›Ǥ
 E X T R A Dement Geriatr Cogn Disord Extra 2016;6:194–204 202
DOI: 10.1159/000445870 © 2016 The Author(s). Published by S. Karger AG, Basel
www.karger.com/dee
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome

—…Ž‡‹‹’•‹Žƒ–‡”ƒŽ–‘–Š‡˜‡•–‹„—Žƒ”Ǧ•–‹—Žƒ–‡†•‹†‡ȋȌƒ†’‘–‡–‹ƒŽŽ›†‡…”‡ƒ•‹‰–Š‡–‘—•
‘ˆ–Š‡ƒ„†—…–‘”—•…Ž‡•‘–Š‡•–‹—Žƒ–‡†•‹†‡Ǥ˜‹‡™‘ˆ–Š‡‹ˆ‘”ƒ–‹‘…‹–‡†ƒ„‘˜‡ǡ™Š‡
…‘’ƒ”‡† ™‹–Š ˆ ‹‰—”‡ ʹƒǡ ‹– ‹• ‡˜‹†‡– –Šƒ– –Š‡ †‡…”‡ƒ•‡† –‘—• ‘ˆ –Š‡ ƒ„†—…–‘” —•…Ž‡•
†‡”‹˜‡†ˆ”‘”‡‰—Žƒ–‘”›ˆ—…–‹‘•’‡”ˆ‘”‡†„›–Š‡…‡”‡„”—ƒ†–Š‡†‡…”‡ƒ•‡†–‘—•‘ˆ–Š‡
ƒ††—…–‘”—•…Ž‡•†‡”‹˜‡†ˆ”‘”‡‰—Žƒ–‘”›ˆ—…–‹‘•’‡”ˆ‘”‡†„›–Š‡…‡”‡„‡ŽŽ—Ž‡ƒ†–‘ƒ
”‡†—…‡††‹ˆˆ‡”‡…‡„‡–™‡‡–Š‡–‘—•‘ˆ–Š‡ƒ„†—…–‘”ƒ†ƒ††—…–‘”—•…Ž‡•ǤŠ‹•ǡ‹–—”ǡ
’‘–‡–‹ƒŽŽ›†‡…”‡ƒ•‡•–Š‡•Ž‘™Ǧ’Šƒ•‡˜‡Ž‘…‹–›‘ˆ…ƒŽ‘”‹…›•–ƒ‰—•ǡ–Š—•‹Š‹„‹–‹‰˜‡•–‹„—Žƒ”
›•–ƒ‰—•ǤŠ‹•’Š‡‘‡‘‹•…ƒŽŽ‡†˜‹•—ƒŽ•—’’”‡••‹‘Ǥ

 ƒ•‡†‘’”‡˜‹‘—•…Ž‹‹…ƒŽˆ‹†‹‰•ȏͷǡʹ͸Ȑǡ™‡•’‡…—Žƒ–‡–Šƒ–†ƒƒ‰‡–‘„‘–Š–Š‡˜‹•—ƒŽ
…‘”–‹…ƒŽ”‡‰‹‘•ƒ†˜‡•–‹„—Žƒ”…‘”–‡š‹‰Š–‹†—…‡‹’ƒ‹”‡–‘ˆ…ƒŽ‘”‹…›•–ƒ‰—•‹
 ’ƒ–‹‡–•Ǥ  ’ƒ–‹‡–• …‘—Ž† Šƒ˜‡ ‘– ‘Ž› ˆ”‘–‘–‡’‘”ƒŽ Ž‡•‹‘• „—– ƒŽ•‘ ’ƒ”‹‡–ƒŽ
Ž‡•‹‘•ǡ •—…Š ƒ• ‹ –Š‡ ‹ˆ‡”‹‘” ’ƒ”‹‡–ƒŽ Ž‘„—Ž‡ ȏ ͵ʹȂ͵ͶȐǤ „‘—– ͵ͲΨ ‘ˆ  ’ƒ–‹‡–• Šƒ†
†‡…”‡ƒ•‡†„Ž‘‘†ˆŽ‘™‹–Š‡‹ˆ‡”‹‘”’ƒ”‹‡–ƒŽŽ‘„—Ž‡‹–Š‡’”‡•‡–•–—†›ǤŠ‡”‡‹•‘”‡’‘”–
–Šƒ–‘Ž›ˆ”‘–ƒŽŽ‘„‡Ž‡•‹‘•‹†—…‡‹’ƒ‹”‡†ƒ„‹Ž‹–›–‘•—’’”‡••…ƒŽ‘”‹…›•–ƒ‰—•„›˜‹•—ƒŽ
ˆ‹šƒ–‹‘Ǥ–Š‡‘–Š‡”Šƒ†ǡˆ”‘–ƒŽŽ‘„‡Ž‡•‹‘•…‘„‹‡†™‹–Š’ƒ”‹‡–ƒŽŽ‘„‡Ž‡•‹‘•ǡ•—…Šƒ•
‹–Š‡‹ˆ‡”‹‘”’ƒ”‹‡–ƒŽŽ‘„—Ž‡ǡ…‘—Ž†‹†—…‡‹’ƒ‹”‡–ȏʹ͸ȐǤ

 ‹‰—”‡ʹ…•Š‘™•–Š‡Š›’‘–Š‡•‹œ‡†‡…Šƒ‹•‘ˆ‹’ƒ‹”‡–‹ •›†”‘‡Ǥ
•›†”‘‡’ƒ–‹‡–•ǡ†‡‰‡‡”ƒ–‹‘ƒˆˆ‡…–•‘–‘Ž›˜‹•—ƒŽ…‘”–‹…ƒŽ”‡‰‹‘•ǡ•—…Šƒ•–Š‡ˆ”‘Ǧ
–ƒŽ‡›‡ˆ‹‡Ž†ǡ„—–ƒŽ•‘–Š‡˜‡•–‹„—Žƒ”…‘”–‡šǡ•—…Šƒ•–Š‡‹ˆ‡”‹‘”’ƒ”‹‡–ƒŽŽ‘„—Ž‡Ǥ•ƒ”‡•—Ž–ǡ
–Š‡‹Š‹„‹–‘”›‡—”‘•‹–Š‡˜‡•–‹„—Žƒ”—…Ž‡—•‹’•‹Žƒ–‡”ƒŽ–‘–Š‡˜‡•–‹„—Žƒ”Ǧ•–‹—Žƒ–‡†•‹†‡
”‡…‡‹˜‡Ž‡••‡š…‹–ƒ–‘”›‹’—–ˆ”‘–Š‡˜‡•–‹„—Žƒ”…‘”–‡šǤƒ•‡†‘’”‡˜‹‘—•…Ž‹‹…ƒŽˆ‹†‹‰•
ȏ ͷǡʹ͸Ȑǡ™‡•’‡…—Žƒ–‡–Šƒ––Š‡‹–‡”ƒ…–‹‘„‡–™‡‡–Š‡˜‹•—ƒŽ…‘”–‹…ƒŽ”‡‰‹‘•ƒ†–Š‡˜‡•–‹„—Žƒ”
…‘”–‡š‹•‹’‘”–ƒ–ˆ‘”–Š‡…‘–”‘Ž‘ˆ–Š‡˜‡•–‹„—Žƒ”—…Ž‡—•‹–Š‡„”ƒ‹•–‡ǤŠ‡…‘’ƒ”‹‰
™‹–Šˆ‹‰—”‡ʹ„ǡ‹–‹•‡˜‹†‡––Šƒ––Š‡‹Š‹„‹–‘”›‡—”‘•‹–Š‡˜‡•–‹„—Žƒ”—…Ž‡—•‹Š‹„‹––Š‡
‡š–”ƒ‘…—Žƒ”‘–‘”—…Ž‡‹Ž‡••‹’•‹Žƒ–‡”ƒŽŽ›–‘–Š‡˜‡•–‹„—Žƒ”Ǧ•–‹—Žƒ–‡†•‹†‡ȋȌǤŠ‹•ǡ‹–—”ǡ
ƒ…–‹˜ƒ–‡•–Š‡‡—”‘•‹–Š‡‡š–”ƒ‘…—Žƒ”‘–‘”—…Ž‡‹ȋȌǡ™Š‹…ŠŽ‡ƒ†•–‘‹…”‡ƒ•‡†–‘—•‘ˆ
–Š‡ƒ„†—…–‘”—•…Ž‡•‘–Š‡˜‡•–‹„—Žƒ”Ǧ•–‹—Žƒ–‡†•‹†‡Ǥ•ƒ…‘•‡“—‡…‡ǡ–Š‡†‹ˆˆ‡”‡…‡‹
—•…Ž‡–‘—•„‡–™‡‡–Š‡ƒ„†—…–‘”ƒ†ƒ††—…–‘”‹…”‡ƒ•‡•ǡ…ƒ—•‹‰–Š‡•Ž‘™Ǧ’Šƒ•‡˜‡Ž‘…‹–›
‘ˆ…ƒŽ‘”‹…›•–ƒ‰—•–‘‹…”‡ƒ•‡†—”‹‰ƒ–‡•–ǤŠ‹„‹–‹‘‘ˆ–Š‡•Ž‘™’Šƒ•‡‹•–Š‡”‡ˆ‘”‡
†‹•”—’–‡†ǡŽ‡ƒ†‹‰–‘–Š‡‘•‡–‘ˆ‹’ƒ‹”‡†Ǥ

 Š‡•Ž‘™’Šƒ•‡‘ˆ…ƒŽ‘”‹…›•–ƒ‰—•‹•‡›‡‘˜‡‡––Šƒ–‘……—”•ƒ•ƒ”‡•—Ž–‘ˆ–Š‡˜‡•–‹„Ǧ
—Ž‘Ǧ‘…—Žƒ””‡ˆŽ‡šǤˆ–Š‡ƒ…–‹˜‹–›‘ˆ–Š‡˜‡•–‹„—Žƒ”•‡‹…‹”…—Žƒ”…ƒƒŽ•‘‘‡•‹†‡…ƒ—•‡†„›…ƒŽ‘Ǧ
”‹…•–‹—Ž—•‘ˆ–Š‡Žƒ„›”‹–Š‹•‰”‡ƒ–‡”–Šƒ–Š‡ƒ…–‹˜‹–›‘–Š‡‘’’‘•‹–‡•‹†‡ǡ–Š‡”‡‹•ƒ•Ž‘™‡›‡
‘˜‡‡––‘™ƒ”†–Š‡‘’’‘•‹–‡•‹†‡Ǣ–Š‹•…‘””‡•’‘†•–‘–Š‡•Ž‘™’Šƒ•‡‘ˆ…ƒŽ‘”‹…›•–ƒ‰—•Ǥ
Š‡•Š‘”–‡•–’ƒ–Š™ƒ›‘ˆ–Š‡˜‡•–‹„—Ž‘Ǧ‘…—Žƒ””‡ˆŽ‡š‹•ƒ–Š”‡‡Ǧ‡—”‘”‡ˆŽ‡šƒ”……‘’”‹•‹‰–Š‡
˜‡•–‹„—Žƒ”‡”˜‡ǡ˜‡•–‹„—Žƒ”—…Ž‡—•‡—”‘•ǡƒ†‡š–”ƒ‘…—Žƒ”‘–‘”‡—”‘•Ǥ•‘†‹•‘”†‡”‘ˆ
•Ž‘™Ǧ’Šƒ•‡ ˜‡Ž‘…‹–› ™ƒ• ˆ‘—† ‹ –Š‡  ‰”‘—’ ‹ –Š‹• •–—†›ǡ ‹– ƒ› „‡ •—”‹•‡† –Šƒ– –Š‡
ˆ—…–‹‘‘ˆ–Š‡”‡ˆŽ‡šƒ”…‘ˆ–Š‡˜‡•–‹„—Ž‘Ǧ‘…—Žƒ””‡ˆŽ‡š‹•”‡Žƒ–‹˜‡Ž›’”‡•‡”˜‡†‹ •›†”‘‡Ǥ

 ƒ•‡† ‘ ’”‡˜‹‘—• ”‡’‘”–• ȏ ͷǡ ʹͷȂʹ͹Ȑǡ  ƒ† •Ž‘™Ǧ’Šƒ•‡ ˜‡Ž‘…‹–› ƒ”‡ –Š‘—‰Š– –‘ „‡
‹’‘”–ƒ–…ƒŽ‘”‹…˜‡•–‹„—Žƒ”’ƒ”ƒ‡–‡”•Ǥ–Š‡‘–Š‡”Šƒ†ǡ™‡–Š‹–Šƒ––Š‡‘–Š‡”’ƒ”ƒǦ
‡–‡”•ǡ•—…Šƒ•˜‡Ž‘…‹–›‘ˆ“—‹…’Šƒ•‡ƒ†ƒ’Ž‹–—†‡ǡƒ”‡‘–‹’‘”–ƒ–‹–Š‡’”‡•‡–•–—†›ǡ
™Š‹…Šƒ––‡’–‡†–‘‡˜ƒŽ—ƒ–‡˜‡•–‹„—Žƒ”‹’ƒ‹”‡–†—‡–‘…‘”–‹…ƒŽ†›•ˆ—…–‹‘Ǥ

 Š‡Ž‹‹–ƒ–‹‘•‘ˆ–Š‡’”‡•‡–•–—†›ƒ”‡ƒ•ˆ‘ŽŽ‘™•Ǥ ‹”•–ǡ–Š‡—„‡”‘ˆ…ƒ•‡••–—†‹‡†™ƒ•
‡š–”‡‡Ž›•ƒŽŽǤ‡…‘†ǡ‹–‹•†‹ˆˆ‹…—Ž––‘Œ—†‰‡–Š‡‡ˆˆ‡…–•‘ˆ˜‡•–‹„—Žƒ”†‹•‘”†‡”‘‰ƒ‹–†‹•–—”Ǧ
„ƒ…‡‹ •›†”‘‡Ǥ ƒ…–‘”•‘–Š‡”–Šƒ˜‡•–‹„—Žƒ”†‹•‘”†‡”ǡ•—…Šƒ•—•…Ž‡™‡ƒ‡••ƒ†
’ƒ”‹•‘‹•ǡŠƒ˜‡…‘’Ž‡š‡ˆˆ‡…–•ƒ†…ƒ‡ƒ•‹Ž›…ƒ—•‡„‹ƒ•ǤŠ‹”†ǡ™‡™‡”‡—ƒ„Ž‡–‘—•‡ƒ
‡—”‘’ƒ–Š‘Ž‘‰‹…ƒŽ ƒ’’”‘ƒ…Š –‘  •›†”‘‡ǡ •—…Š ƒ• Ǧ–ƒ—ǡ ǦͶ͵ ȋ Ǧ
„‹†‹‰ ’”‘–‡‹ ‘ˆ Ͷ͵ ƒȌǡ ƒ†  ȋˆ—•‹‘ ‹ •ƒ”…‘ƒȀ–”ƒ•Žƒ–‡† ‹ Ž‹’‘•ƒ”…‘ƒȌ ȏ ͵ͷȐǤ ‘
…Žƒ”‹ˆ›–Š‡…Ž‹‹…ƒŽ•‹‰‹ˆ‹…ƒ…‡ƒ†‡…Šƒ‹••‘ˆ˜‡•–‹„—Žƒ”†‹•‘”†‡”‹ •›†”‘‡ǡˆ—–—”‡
•–—†‹‡•ƒ”‡‡‡†‡†™‹–ŠŽƒ”‰‡”•ƒ’Ž‡•‹œ‡•–Šƒ–ǡƒ•ˆƒ”ƒ•’‘••‹„Ž‡ǡ…ƒ„‡‡šƒ‹‡†™‹–Š‘—–„‹ƒ•Ǥ
 E X T R A Dement Geriatr Cogn Disord Extra 2016;6:194–204 203
DOI: 10.1159/000445870 © 2016 The Author(s). Published by S. Karger AG, Basel
www.karger.com/dee
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome

Conclusion


 Š‡ˆ‹†‹‰•‘ˆ‘—”’”‡•‡–•–—†›ƒ”‡…‘•‹•–‡–™‹–Š–Š‡Š›’‘–Š‡•‹•–Šƒ––Š‡…‡”‡„”ƒŽ
…‘”–‡š—•‡•˜‹•—ƒŽ’‡”…‡’–‹‘–‘”‡‰—Žƒ–‡˜‡•–‹„—Žƒ”ˆ—…–‹‘–Š”‘—‰Š‡ˆˆ‡”‡–’ƒ–Š™ƒ›•ǤŠ‡
”‡‰—Žƒ–‹‘‘ˆ˜‡•–‹„—Žƒ”‡—”ƒŽ…‹”…—‹–•„›‡ƒ•‘ˆ˜‹•—ƒŽ‹’—–™ƒ•‘„•‡”˜‡†–‘„‡‹’ƒ‹”‡†
‹’ƒ–‹‡–•™‹–Š •›†”‘‡ǤŠ‡”‡•—Ž–ƒ–˜‡•–‹„—Žƒ”„ƒŽƒ…‡†‹•‘”†‡”ƒ›ǡ–Š—•ǡ„‡‘‡
ˆƒ…–‘”…ƒ—•‹‰‰ƒ‹–†‹•‘”†‡”•Ǥ˜‡•–‹„—Žƒ”„ƒŽƒ…‡†‹•‘”†‡”‹’ƒ–‹‡–•™‹–Š •›†”‘‡‹•
ƒ•‡”‹‘—•’”‘„Ž‡–Šƒ–…ƒŽ‡ƒ†–‘†‡…”‡ƒ•‡†“—ƒŽ‹–›‘ˆŽ‹ˆ‡ǤŽ—…‹†ƒ–‹‰–Š‡•‡”‹‡•‘ˆ’ƒ–Š™ƒ›•
‘”‹‰‹ƒ–‹‰ˆ”‘–Š‡…‡”‡„”ƒŽ…‘”–‡š–Šƒ–ƒ”‡‹˜‘Ž˜‡†‹–Š‡”‡‰—Žƒ–‹‘‘ˆ˜‡•–‹„—Žƒ”ˆ—…–‹‘
…ƒǡ –Š‡”‡ˆ‘”‡ǡ ’”‘˜‹†‡ —•‡ˆ—Ž ‹•‹‰Š–• ‹–‘ –Š‡ …Ž‹‹…ƒŽ ƒƒ‰‡‡– ‘ˆ ’ƒ–‹‡–• ™‹–Š 
•›†”‘‡Ǥ

Acknowledgments


 Š‹• •–—†› ™ƒ• ˆ—†‡† „› ƒ …‹‡–‹ˆ‹… ‡•‡ƒ”…Š ȋȌ ‰”ƒ– ȋ‘Ǥ ʹ͸Ͷ͸ͲͻͲͳȌ ˆ”‘ –Š‡
‹‹•–”›‘ˆ†—…ƒ–‹‘ǡ—Ž–—”‡ǡ’‘”–•ǡ…‹‡…‡ƒ†‡…Š‘Ž‘‰›‘ˆ ƒ’ƒǤ

Disclosure Statement


 Š‡ƒ—–Š‘”•†‡…Žƒ”‡‘…‘’‡–‹‰ˆ‹ƒ…‹ƒŽ‹–‡”‡•–•Ǥ


References
Ԙ ͳ ”‹„‡”‰ǡŽ•‡ǡ‘Žƒ†ǡƒ—Ž•‘ǡƒ••‡ǣ ‘…ƒŽ‹…”‡ƒ•‡‘ˆ„Ž‘‘†ˆŽ‘™‹–Š‡…‡”‡„”ƒŽ…‘”–‡š‘ˆ
ƒ†—”‹‰˜‡•–‹„—Žƒ”•–‹—Žƒ–‹‘Ǥ”ƒ‹ͳͻͺͷǢͳ  Ͳͺǣ͸
 ͲͻȂ͸ʹ͵Ǥ
 

Ԙ ʹ ”ƒ†– ǡ ƒ”–‡•–‡‹ ǡ ƒ‡ ǡ ‹‡–‡”‹…Š ǣ ‡…‹’”‘…ƒŽ ‹Š‹„‹–‘”› ˜‹•—ƒŽǦ˜‡•–‹„—Žƒ” ‹–‡”ƒ…–‹‘ǣ ˜‹•—ƒŽ
‘–‹‘•–‹—Žƒ–‹‘†‡ƒ…–‹˜ƒ–‡•–Š‡’ƒ”‹‡–‘Ǧ‹•—Žƒ”˜‡•–‹„—Žƒ”…‘”–‡šǤ”ƒ‹ͳͻͻͺǢͳ  ʹͳǣͳ
 ͹ͶͻȂͳ͹ͷͺǤ  

Ԙ ͵
—Ž†‹ǡ
”ò••‡” ǣ•–Š‡”‡ƒ˜‡•–‹„—Žƒ”…‘”–‡šǫ”‡†•‡—”‘•…‹ͳͻͻͺǢʹ  ͳǣʹ
 ͷͶȂʹͷͻǤ  

Ԙ Ͷ ƒ‹–‘ǡƒ–‡›ƒǡ‹”ƒ‘ǡ‘—‡ǡ —ƒ„‹‹ǡ‘›‘†ƒǡ‡‘ǡ•Š‹œ—ǡƒ‰ƒŠƒƒǡ ——›ƒƒǡ–‘ ǣ

‘”–‹…ƒŽ…‘””‡Žƒ–‡•‘ˆ˜‡•–‹„—Ž‘Ǧ‘…—Žƒ””‡ˆŽ‡š‘†—Žƒ–‹‘ǣƒ•–—†›Ǥ”ƒ‹ʹͲͲ͵Ǣͳ  ʹ͸ǣͳ
 ͷ͸ʹȂͳͷ͹ͺǤ  

Ԙ ͷ ƒƒƒ‰‘‡ǡ —Œ‹‹›ƒǡ‘‰ƒ‡œƒ™ƒǡƒ†‘‘ǡŠ‹‹œ—ǡ —Œ‹œ—ƒǡƒ‹‰—…Š‹ǡ‡‘ǡ‘œ‡ǡ

ƒƒ‘ƒǣ‡•–‹„—Žƒ”ˆ—…–‹‘‹’ƒ‹”‡–‹ŽœŠ‡‹‡”ǯ•†‹•‡ƒ•‡Ǥ ŽœŠ‡‹‡”•‹•ʹͲͳͷǢͶ  ͹ǣͳ
 ͺͷȂͳͻ͸Ǥ  

Ԙ ͸ ”‡†”‹…•‘ ǡ…Š‡‹†ǡ ‹‰‰‡ǡ‘”Š—„‡”ǣ‡•–‹„—Žƒ”‡”˜‡’”‘Œ‡…–‹‘–‘–Š‡…‡”‡„”ƒŽ…‘”–‡š‘ˆ–Š‡

”Š‡•—•‘‡›Ǥš’”ƒ‹‡•ͳͻ͸͸Ǣʹ  ǣ͵
 ͳͺȂ͵ʹ͹Ǥ
 

Ԙ ͹ …Š™ƒ”œǡ ”‡†”‹…•‘ ǣŠ‡•—•‘‡›˜‡•–‹„—Žƒ”…‘”–‡šǣƒ„‹‘†ƒŽ’”‹ƒ”›’”‘Œ‡…–‹‘ˆ‹‡Ž†Ǥ…‹‡…‡

ͳͻ͹ͳǢͳ
 ͹ʹǣʹ
  ͺͲȂʹͺͳǤ
Ԙ ͺ ò––‡”ǡ—‡––‡”ǣƒ”‹‡–ƒŽ…‘”–‡šȋʹ˜Ȍ‡—”‘ƒŽƒ…–‹˜‹–›‹–Š‡ƒŽ‡”–‘‡›†—”‹‰ƒ–—”ƒŽ˜‡•–‹„—Žƒ”
ƒ†‘’–‘‹‡–‹…•–‹—Žƒ–‹‘Ǥ”ƒ‹‡•ͳͻ͹ͺǢͳ  ͷ͵ǣ͵
 ͻʹȂ͵ͻ͹Ǥ
 

Ԙ ͻ †˜‹•–ǡ…Š™ƒ”œǡ ”‡†”‹…•‘ ǡƒ••Ž‡”ǣ”‘Œ‡…–‹‘‘ˆ–Š‡˜‡•–‹„—Žƒ”‡”˜‡–‘–Š‡ƒ”‡ƒ͵ƒƒ”ˆ‹‡Ž†

‹–Š‡•“—‹””‡Ž‘‡›(Saimiri sciureus)Ǥš’”ƒ‹‡•ͳͻ͹ͶǢʹ  ͳǣͻ
 ͹ȂͳͲͷǤ
 

ͳ Ͳ ƒ—‰‹‡”Ǧ
”‹ƒ—†ǡ‡–”‡ ǣƒ–‘‹……‘‡…–‹‘•‘ˆ‹ˆ‡”‹‘”’ƒ”‹‡–ƒŽ…‘”–‡šȋƒ”‡ƒ͹Ȍ™‹–Š•—„…‘”–‹…ƒŽ•–”—…Ǧ
–—”‡•”‡Žƒ–‡†–‘˜‡•–‹„—Ž‘Ǧ‘…—Žƒ”ˆ—…–‹‘‹ƒ‘‡›(Macaca fascicularis)Ǥ ‘’‡—”‘ŽͳͻͺͻǢʹ  ͺͲǣͳ
 ȂͳͶǤ  

ͳ ͳ
”ò••‡” ǡƒ—•‡ǡ…Š”‡‹–‡”ǣ‘…ƒŽ‹œƒ–‹‘ƒ†”‡•’‘•‡•‘ˆ‡—”‘‡•‹–Š‡’ƒ”‹‡–‘Ǧ‹•—Žƒ”˜‡•–‹„—Žƒ”
…‘”–‡š‘ˆƒ™ƒ‡‘‡›•(Macaca fascicularis)Ǥ Š›•‹‘ŽͳͻͻͲǢͶ  ͵Ͳǣͷ ͵͹Ȃͷͷ͹Ǥ
 

ͳ ʹ
”ò••‡” ǡƒ—•‡ǡ…Š”‡‹–‡”ǣ‡•–‹„—Žƒ”‡—”‘‡•‹–Š‡’ƒ”‹‡–‘Ǧ‹•—Žƒ”…‘”–‡š‘ˆ‘‡›•(Macaca fasci-
cularis)ǣ˜‹•—ƒŽƒ†‡…”‡…‡’–‘””‡•’‘•‡•Ǥ Š›•‹‘ŽͳͻͻͲǢͶ  ͵Ͳǣͷ ͷͻȂͷͺ͵Ǥ
 

ͳ ͵
—Ž†‹ǡ‹””‹‰ǡ
”ò••‡” ǣ‘‡…–‹‘•ˆ”‘–Š‡‡‘…‘”–‡š–‘–Š‡˜‡•–‹„—Žƒ”„”ƒ‹•–‡—…Ž‡‹‹–Š‡
…‘‘ƒ”‘•‡–Ǥ‡—”‘”‡’‘”–ͳͻͻ͵Ǣͷ  ǣͳ
 ͳ͵Ȃͳͳ͸Ǥ
 

ͳ Ͷ „ƒ”‹ƒ ǡ
”ò••‡”  ǡ
—Ž†‹ ǣ ‘”–‹…‘ˆ—‰ƒŽ …‘‡…–‹‘• „‡–™‡‡ –Š‡ …‡”‡„”ƒŽ …‘”–‡š ƒ† „”ƒ‹•–‡
˜‡•–‹„—Žƒ”—…Ž‡‹‹–Š‡ƒ…ƒ“—‡‘‡›Ǥ ‘’‡—”‘ŽͳͻͻͶǢ͵  ͵ͻǣͶ
 ʹͳȂͶ͵͹Ǥ
 

ͳ ͷ ‡ƒ”›ǡ‘™†‡ ǡ
—•–ƒˆ•‘ǡƒ••ƒ–ǡ–—••ǡŽƒ…ǡ ”‡‡†ƒǡ‡”–‡•œǡ‘„‡”–ǡŽ„‡”–ǡ
‘‘‡ǡ‹ŽŽ‡”ǡ—‹‰• ǡ‡•‘ ǣ ”‘–‘–‡’‘”ƒŽŽ‘„ƒ”†‡‰‡‡”ƒ–‹‘ǣƒ…‘•‡•—•‘…Ž‹‹…ƒŽ†‹ƒ‰Ǧ
‘•–‹……”‹–‡”‹ƒǤ‡—”‘Ž‘‰›ͳͻͻͺǢͷ  ͳǣͳ
  ͷͶ͸ȂͳͷͷͶǤ

 E X T R A Dement Geriatr Cogn Disord Extra 2016;6:194–204 204
DOI: 10.1159/000445870 © 2016 The Author(s). Published by S. Karger AG, Basel
www.karger.com/dee
Nakamagoe et al.: Vestibular Impairment in Frontotemporal Dementia Syndrome

ͳ
 ͸ …Šƒ
ǡŽ„‡”–ǡ
”‘••ƒǡ‹ŽŽ‡”ǡ‹…•‘ǡ”‘Œƒ‘™•‹ ǣŽ‹‹…ƒŽƒ†’ƒ–Š‘Ž‘‰‹…ƒŽ†‹ƒ‰‘•‹•
‘ˆˆ”‘–‘–‡’‘”ƒŽ†‡‡–‹ƒǣ”‡’‘”–‘ˆ–Š‡‘”
”‘—’‘ ”‘–‘–‡’‘”ƒŽ‡‡–‹ƒƒ†‹…ǯ•‹•‡ƒ•‡Ǥ”…Š
‡—”‘ŽʹͲͲͳǢͷ  ͺǣͳ
  ͺͲ͵ȂͳͺͲͻǤ


 ͹
”‘••ƒǣ ”‘–‘–‡’‘”ƒŽ†‡‡–‹ƒǣƒ”‡˜‹‡™Ǥ –‡—”‘’•›…Š‘Ž‘…ʹͲͲʹǢͺ
ͳ  ǣͷ
 ͸͸Ȃͷͺ͵Ǥ  

ͳ
 ͺ ‹ƒ ǡ
”‘••ƒ ǣ ”‘–‘–‡’‘”ƒŽ Ž‘„ƒ” †‡‰‡‡”ƒ–‹‘ǣ ”‡…‡– ’”‘‰”‡•• ‹ ƒ–‡‘”–‡ †‹ƒ‰‘•‹•Ǥ …–ƒ
‡—”‘’ƒ–Š‘ŽʹͲͲ͹Ǣͳ  ͳͶǣʹ
 ͵ȂʹͻǤ
 

ͳ
 ͻ ‡›‹‡Žǡ‹˜ƒ—†Ǧ‡…Š‘—šǡƒ‹‡”ǡ
ƒ›ƒ”†ǣƒ……ƒ†‡‹’ƒ‹”‡–•‹’ƒ–‹‡–•™‹–Šˆ”‘–‘Ǧ–‡’‘”ƒŽ
†‡‡–‹ƒǤ ‡—”‘Ž‡—”‘•—”‰•›…Š‹ƒ–”›ʹͲͲͷǢ͹  ͸ǣͳ
 ͷͺͳȂͳͷͺͶǤ  

ʹ
 Ͳ ‘š‡”ǡ
ƒ”„—––ǡƒ‹ǡ‡ŽŽ—–Š ǡ‡—Šƒ—• ǡ‹ŽŽ‡”ǡ‹•„‡”‰‡”
ǣ‡†‹ƒŽ˜‡”•—•Žƒ–‡”ƒŽˆ”‘–ƒŽ
Ž‘„‡…‘–”‹„—–‹‘•–‘˜‘Ž—–ƒ”›•ƒ……ƒ†‡…‘–”‘Žƒ•”‡˜‡ƒŽ‡†„›–Š‡•–—†›‘ˆ’ƒ–‹‡–•™‹–Šˆ”‘–ƒŽŽ‘„‡†‡‰‡Ǧ
‡”ƒ–‹‘Ǥ ‡—”‘•…‹ʹͲͲ͸Ǣʹ  ͸ǣ͸
 ͵ͷͶȂ͸͵͸͵Ǥ 

ʹ
 ͳ
ƒ”„—–– ǡ ƒ–Ž‹ ǡ ‡ŽŽ—–Š ǡ …Š‡ ǡ ‘Š•‘ ǡ ‘•‡ ǡ ‡ƒ ǡ ”ƒ‡” ǡ ‡—Šƒ—• ǡ ‹ŽŽ‡” ǡ
‹•„‡”‰‡”
ǡ‘š‡”ǣ…—Ž‘‘–‘”ˆ—…–‹‘‹ˆ”‘–‘–‡’‘”ƒŽŽ‘„ƒ”†‡‰‡‡”ƒ–‹‘ǡ”‡Žƒ–‡††‹•‘”†‡”•ƒ†
ŽœŠ‡‹‡”ǯ•†‹•‡ƒ•‡Ǥ”ƒ‹ʹͲͲͺǢͳ  ͵ͳǣͳ
 ʹ͸ͺȂͳʹͺͳǤ  

ʹ
 ʹ —””‡ŽŽ ǡ‘”„‡”‰‡”ǡƒ”’‡–‡”ǡ‹‡”ƒǡ‘†‰‡• ǣƒ……ƒ†‹…ƒ„‘”ƒŽ‹–‹‡•‹ˆ”‘–‘–‡’‘”ƒŽ
†‡‡–‹ƒǤ‡—”‘Ž‘‰›ʹͲͳʹǢ͹  ͺǣͳ
 ͺͳ͸Ȃͳͺʹ͵Ǥ  

ʹ
 ͵ ‹ŽŽ‡”ǡ‘–‡ǡ‘–‘ǡ‡˜›ǡ‘‘‡ǡƒ”„›ǡ‡”ƒǡ‡ƒǡ—‹‰• ǣ•–—†›‘ˆ–Š‡—†Ǧ
ƒ…Š‡•–‡””‡•‡ƒ”…Š…”‹–‡”‹ƒˆ‘”ˆ”‘–‘–‡’‘”ƒŽ†‡‡–‹ƒǣ…Ž‹‹…ƒŽƒ†•‹‰Ž‡Ǧ’Š‘–‘‡‹••‹‘…‘””‡ŽƒǦ
–‹‘•Ǥ‡—”‘Ž‘‰›ͳͻͻ͹ǢͶ  ͺǣͻ
 ͵͹ȂͻͶʹǤ
 

 Ͷ ‘…”‡ŽŽ ǡ ‘Ž•–‡‹ ǣ‹‹Ǧ‡–ƒŽ–ƒ–‡šƒ‹ƒ–‹‘ȋȌǤ•›…Š‘’Šƒ”ƒ…‘Ž—ŽŽͳͻͺͺǢʹ

ʹ  Ͷǣ͸
 ͺͻȂ͸ͻʹǤ  

ʹ
 ͷ ƒ–‘ǡƒ–‘ǡ‘›ƒ‰‹ǡ‹œ—‘•Š‹ǡ‹—”ƒǡ‘‹‡ǡƒ›ƒ‘ǣƒŽ‘”‹…’ƒ––‡”–‡•–™‹–Š•’‡…‹ƒŽ”‡ˆ‡”‡…‡
–‘ˆƒ‹Ž—”‡‘ˆˆ‹šƒ–‹‘Ǧ•—’’”‡••‹‘Ǥ…–ƒ–‘Žƒ”›‰‘Žͳͻ͹ͻǢͺ  ͺǣͻ
 ͹ȂͳͲͶǤ  

ʹ
 ͸ ƒ‡‘”‹ǡ‘ǡƒ‡†ƒǣ‡”‡„”ƒŽ…‘–”‹„—–‹‘–‘–Š‡˜‹•—ƒŽ•—’’”‡••‹‘‘ˆ˜‡•–‹„—Žƒ”›•–ƒ‰—•Ǥ”…Š
–‘Žƒ”›‰‘Žͳͻ͹ͻǢͳ  Ͳͷǣͷ
 ͹ͻȂͷͺͳǤ
 

ʹ
 ͹ ƒ‡‘”‹ǡ‹„ƒǡŠ‹œƒ™ƒǣ‹•—ƒŽ•—’’”‡••‹‘‘ˆ…ƒŽ‘”‹…›•–ƒ‰—•‹„”ƒ‹Ǧ•–‡Ž‡•‹‘•Ǥ…ƒ†
…‹ͳͻͺͳǢ͵ ͹Ͷǣͺ
  Ͷ͸ȂͺͷͶǤ


ʹ
 ͺ ‹‘•Š‹ƒǡ ”‡›ǡ‘‡’’‡ǡ ‘•–‡”ǡ—ŠŽǣ†‹ƒ‰‘•–‹…ƒ’’”‘ƒ…Š‹ŽœŠ‡‹‡”ǯ•†‹•‡ƒ•‡—•‹‰
–Š”‡‡Ǧ†‹‡•‹‘ƒŽ•–‡”‡‘–ƒ…–‹…•—”ˆƒ…‡’”‘Œ‡…–‹‘•‘ˆˆŽ—‘”‹‡ǦͳͺǦ 
Ǥ —…Ž‡†ͳͻͻͷǢ͵  ͸ǣͳ
 ʹ͵ͺȂͳʹͶͺǤ  

ʹ
 ͻ —„‘‹•ǡŽƒ…Š‡˜•›ǡ‹–˜ƒǡ‹ŽŽ‘ǣŠ‡ ǣƒ ”‘–ƒŽ••‡••‡–ƒ––‡”›ƒ–„‡†•‹†‡Ǥ‡—”‘Ž‘‰›ʹͲͲͲǢ 

ͷ
 ͷǣͳ
 ͸ʹͳȂͳ͸ʹ͸Ǥ
͵
 Ͳ ƒ–‘ǡƒ™ƒ•ƒ‹ǣ†‡–‹ˆ‹…ƒ–‹‘‘ˆ–Š‡—”‹Œ‡…‡ŽŽȀ…Ž‹„‹‰ˆ‹„‡”œ‘‡ƒ†‹–•–ƒ”‰‡–‡—”‘•”‡•’‘•‹„Ž‡
ˆ‘”‡›‡Ǧ‘˜‡‡–…‘–”‘Ž„›–Š‡…‡”‡„‡ŽŽƒ”ˆŽ‘……—Ž—•Ǥ”ƒ‹‡•”ƒ‹‡•‡˜ͳͻͻͳǢͳ  ͸ǣ͵
 ͻȂ͸ͶǤ  

͵
 ͳ —•Š‹‹ǡƒ–‘ǡ‹—”ƒǡƒ™ƒ•ƒ‹ǣŽ‹„‹‰ˆ‹„‡””‡•’‘•‡•‘ˆ—”‹Œ‡…‡ŽŽ•–‘”‡–‹ƒŽ‹ƒ‰‡‘˜‡‡–
‹…ƒ–…‡”‡„‡ŽŽƒ”ˆŽ‘……—Ž—•Ǥ ‡—”‘’Š›•‹‘ŽͳͻͻͶǢ͹  ͳǣͳ
 ͵͵͸Ȃͳ͵ͷͲǤ  

͵
 ʹ ‡‘‰ǡŠ‘ǡƒ” ǡƒ‰ ǡ‡‡ ǡƒ‰ǡƒǡ‹ǣͳͺ Ǧ 
ˆ‹†‹‰•‹ˆ”‘–‘–‡’‘”ƒŽ
†‡‡–‹ƒǣƒƒƒŽ›•‹•‘ˆʹͻ’ƒ–‹‡–•Ǥ —…Ž‡†ʹͲͲͷǢͶ  ͸ǣʹ
 ͵͵Ȃʹ͵ͻǤ  

͵
 ͵ ‡‡Žƒƒ”ǡƒ’ƒ ǡ
ƒ””ƒ—š
ǡ†‡‘‹‰ǡ‡‹Œ•ǡƒŽ‡ƒǡ‘œ‡—ŽŽ‡” ǡƒŽ‘ǡ˜ƒ™‹‡–‡ ǣ
”ƒ‹’‡”ˆ—•‹‘’ƒ––‡”•‹ˆƒ‹Ž‹ƒŽˆ”‘–‘–‡’‘”ƒŽŽ‘„ƒ”†‡‰‡‡”ƒ–‹‘Ǥ‡—”‘Ž‘‰›ʹͲͳͳǢ͹  ͹ǣ͵
 ͺͶȂ͵ͻʹǤ  

͵
 Ͷ ‡”ˆƒ‹ŽŽ‹‡ǡ†”‹ƒƒ•‡ǡ‹‡™‹Œœ‡†ǡ‡‡†‹…–—•ǡ••‡‘’’‡Ž‡ǡƒ––Œ‡•ǡ‹Œ‡„—”‰ǡ
˜ƒ†‡” Ž‹‡”ǡƒ‡”–•ƒǡ—‹Œ‡” ǡ‘‡ŽŽƒƒ”†ǡ…Š‡Ž–‡•ǡ˜ƒ‡”…‡Žǡƒ”Š‘ˆ ǣ‡”‡„”ƒŽ
’‡”ˆ—•‹‘ƒ†‰Ž—…‘•‡‡–ƒ„‘Ž‹•‹ŽœŠ‡‹‡”ǯ•†‹•‡ƒ•‡ƒ†ˆ”‘–‘–‡’‘”ƒŽ†‡‡–‹ƒǣ–™‘•‹†‡•‘ˆ–Š‡•ƒ‡
…‘‹ǫ—”ƒ†‹‘ŽʹͲͳͷǢʹ  ͷǣ͵ ͲͷͲȂ͵ͲͷͻǤ
 

͵
 ͷ ƒ†‡ƒ‡”•ǡ‡—ƒǡƒ…‡œ‹‡ǣ†˜ƒ…‡•‹—†‡”•–ƒ†‹‰–Š‡‘Ž‡…—Žƒ”„ƒ•‹•‘ˆˆ”‘–‘–‡’‘”ƒŽ
†‡‡–‹ƒǤƒ–‡˜‡—”‘ŽʹͲͳʹǢͺ  ǣͶ
 ʹ͵ȂͶ͵ͶǤ