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Frontal release signs

MedGen UID:
318834
Concept ID:
C1833297
Finding
Synonym: Frontal release reflexes
 
HPO: HP:0000743

Definition

Primitive reflexes traditionally held to be a sign of disorders that affect the frontal lobes. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVFrontal release signs

Conditions with this feature

Frontotemporal dementia and/or amyotrophic lateral sclerosis 7
MedGen UID:
318833
Concept ID:
C1833296
Disease or Syndrome
CHMP2B frontotemporal dementia (CHMP2B-FTD) has been described in a single family from Denmark, in one individual with familial FTD from Belgium, and in one individual with FTD and no family history. It typically starts between ages 46 and 65 years with subtle personality changes and slowly progressive behavioral changes, dysexecutive syndrome, dyscalculia, and language disturbances. Disinhibition or loss of initiative is the most common presenting symptom. The disease progresses over a few years into profound dementia with extrapyramidal symptoms and mutism. Several individuals have developed an asymmetric akinetic rigid syndrome with arm and gait dystonia and pyramidal signs that may be related to treatment with neuroleptic drugs. Symptoms and disease course are highly variable. Disease duration may be as short as three years or longer than 20 years.
Supranuclear palsy, progressive, 2
MedGen UID:
324446
Concept ID:
C1836148
Disease or Syndrome
Spinocerebellar ataxia type 17
MedGen UID:
337637
Concept ID:
C1846707
Disease or Syndrome
Spinocerebellar ataxia type 17 (SCA17) is characterized by ataxia, dementia, and involuntary movements, including chorea and dystonia. Psychiatric symptoms, pyramidal signs, and rigidity are common. The age of onset ranges from three to 55 years. Individuals with full-penetrance alleles develop neurologic and/or psychiatric symptoms by age 50 years. Ataxia and psychiatric abnormalities are frequently the initial findings, followed by involuntary movement, parkinsonism, dementia, and pyramidal signs. Brain MRI shows variable atrophy of the cerebrum, brain stem, and cerebellum. The clinical features correlate with the length of the polyglutamine expansion but are not absolutely predictive of the clinical course.
Neurodegeneration with brain iron accumulation 5
MedGen UID:
763887
Concept ID:
C3550973
Disease or Syndrome
Beta-propeller protein-associated neurodegeneration (BPAN) is typically characterized by early-onset seizures, infantile-onset developmental delay, intellectual disability, absent-to-limited expressive language, motor dysfunction (ataxia), and abnormal behaviors often similar to autism spectrum disorder. Seizure types including generalized (absence, tonic, atonic, tonic-clonic and myoclonic), focal with impaired consciousness, and epileptic spasms, as well as epileptic syndromes (West syndrome and Lennox-Gastaut syndrome) can be seen. With age seizures tend to resolve or become less prominent, whereas cognitive decline and movement disorders (progressive parkinsonism and dystonia) emerge as characteristic findings.
Supranuclear palsy, progressive, 1
MedGen UID:
1640811
Concept ID:
C4551863
Disease or Syndrome
The spectrum of clinical manifestations of MAPT-related frontotemporal dementia (MAPT-FTD) has expanded from its original description of frontotemporal dementia and parkinsonian manifestations to include changes in behavior, motor function, memory, and/or language. A recent retrospective study suggested that the majority of affected individuals have either behavioral changes consistent with a diagnosis of behavioral variant FTD (bvFTD) or, less commonly, a parkinsonian syndrome (i.e., progressive supranuclear palsy, corticobasal syndrome, or Parkinson disease). Fewer than 5% of people with MAPT-FTD have primary progressive aphasia or Alzheimer disease. Clinical presentation may differ between and within families with the same MAPT variant. MAPT-FTD is a progressive disorder that commonly ends with a relatively global dementia in which some affected individuals become mute. Progression of motor impairment in affected individuals results in some becoming chairbound and others bedbound. Mean disease duration is 9.3 (SD: 6.4) years but is individually variable and can be more than 30 years in some instances.

Professional guidelines

PubMed

Pensato U, Amore G, Muccioli L, Sammali S, Rondelli F, Rinaldi R, D'Angelo R, Nicodemo M, Mondini S, Sambati L, Asioli GM, Rossi S, Santoro R, Cretella L, Ferrari S, Spinardi L, Faccioli L, Fanti S, Paccagnella A, Pierucci E, Casadei B, Pellegrini C, Zinzani PL, Bonafè M, Cortelli P, Bonifazi F, Guarino M
J Neurol 2023 May;270(5):2659-2673. Epub 2023 Mar 4 doi: 10.1007/s00415-023-11595-4. PMID: 36869888
Mechler K, Häge A, Schweinfurth N, Glennon JC, Dijkhuizen RM, Murphy D, Durston S, Williams S, K Buitelaar J, Banaschewski T, Dittmann RW, Tactics Consortium T
Z Kinder Jugendpsychiatr Psychother 2018 May;46(3):246-263. Epub 2017 Sep 18 doi: 10.1024/1422-4917/a000546. PMID: 28922069
Volkow ND, Fowler JS, Wang GJ, Swanson JM, Telang F
Arch Neurol 2007 Nov;64(11):1575-9. doi: 10.1001/archneur.64.11.1575. PMID: 17998440

Recent clinical studies

Etiology

Franco JG, Trzepacz PT, Velásquez-Tirado JD, Ocampo MV, Serna PA, Giraldo AM, López C, Zuluaga A, Zaraza-Morales D
J Acad Consult Liaison Psychiatry 2021 Jan-Feb;62(1):56-69. Epub 2020 Apr 13 doi: 10.1016/j.psym.2020.04.002. PMID: 32444154
Miki Y, Foti SC, Hansen D, Strand KM, Asi YT, Tsushima E, Jaunmuktane Z, Lees AJ, Warner TT, Quinn N, Ling H, Holton JL
Brain 2020 Jun 1;143(6):1798-1810. doi: 10.1093/brain/awaa126. PMID: 32385496
Funayama M, Muramatsu T, Koreki A, Kato M, Mimura M, Nakagawa Y
Behav Brain Res 2017 Jun 30;329:172-179. Epub 2017 Apr 29 doi: 10.1016/j.bbr.2017.04.054. PMID: 28465136
Arena JE, Weigand SD, Whitwell JL, Hassan A, Eggers SD, Höglinger GU, Litvan I, Josephs KA
J Neurol 2016 Feb;263(2):380-389. Epub 2015 Dec 24 doi: 10.1007/s00415-015-7990-2. PMID: 26705121
Hyde TM, Goldberg TE, Egan MF, Lener MC, Weinberger DR
Br J Psychiatry 2007 Aug;191:120-5. doi: 10.1192/bjp.bp.106.026773. PMID: 17666495

Diagnosis

Bonilha PÁAM, Cassarotti B, Nunes TEM, Teive HAG
Arq Neuropsiquiatr 2023 Oct;81(10):934-936. Epub 2023 Oct 29 doi: 10.1055/s-0043-1775886. PMID: 37899045Free PMC Article
Franco JG, Trzepacz PT, Velásquez-Tirado JD, Ocampo MV, Serna PA, Giraldo AM, López C, Zuluaga A, Zaraza-Morales D
J Acad Consult Liaison Psychiatry 2021 Jan-Feb;62(1):56-69. Epub 2020 Apr 13 doi: 10.1016/j.psym.2020.04.002. PMID: 32444154
Pradhan S, Tandon R
Am J Alzheimers Dis Other Demen 2020 Jan-Dec;35:1533317520922383. doi: 10.1177/1533317520922383. PMID: 32648477Free PMC Article
Arena JE, Weigand SD, Whitwell JL, Hassan A, Eggers SD, Höglinger GU, Litvan I, Josephs KA
J Neurol 2016 Feb;263(2):380-389. Epub 2015 Dec 24 doi: 10.1007/s00415-015-7990-2. PMID: 26705121
Gabalda MK, Weiss PS, Compton MT
Schizophr Res 2008 Dec;106(2-3):275-80. Epub 2008 Oct 2 doi: 10.1016/j.schres.2008.08.034. PMID: 18835133

Therapy

Molloy A, Cassidy E, Ryan A, O' Toole O
BMJ Case Rep 2011 Dec 1;2011 doi: 10.1136/bcr.08.2011.4642. PMID: 22674939Free PMC Article
Nicolson SE, Chabon B, Larsen KA, Kelly SE, Potter AW, Stern TA
Psychosomatics 2011 Nov-Dec;52(6):507-12. doi: 10.1016/j.psym.2011.06.008. PMID: 22054619
Litvan I, Mangone CA, McKee A, Verny M, Parsa A, Jellinger K, D'Olhaberriague L, Chaudhuri KR, Pearce RK
J Neurol Neurosurg Psychiatry 1996 Jun;60(6):615-20. doi: 10.1136/jnnp.60.6.615. PMID: 8648326Free PMC Article
Marder K, Liu X, Stern Y, Dooneief G, Bell K, Schofield P, Sacktor N, Todak G, Friedman R, Ehrhardt A
Neurology 1995 Feb;45(2):261-7. doi: 10.1212/wnl.45.2.261. PMID: 7854523
Sherman SJ, Boyer LV, Sibley WA
Stroke 1994 May;25(5):1065-7. doi: 10.1161/01.str.25.5.1065. PMID: 8165680

Prognosis

Franco JG, Trzepacz PT, Velásquez-Tirado JD, Ocampo MV, Serna PA, Giraldo AM, López C, Zuluaga A, Zaraza-Morales D
J Acad Consult Liaison Psychiatry 2021 Jan-Feb;62(1):56-69. Epub 2020 Apr 13 doi: 10.1016/j.psym.2020.04.002. PMID: 32444154
Arena JE, Weigand SD, Whitwell JL, Hassan A, Eggers SD, Höglinger GU, Litvan I, Josephs KA
J Neurol 2016 Feb;263(2):380-389. Epub 2015 Dec 24 doi: 10.1007/s00415-015-7990-2. PMID: 26705121
Sanderson AB, Arnold WD, Elsheikh B, Kissel JT
Muscle Nerve 2015 Mar;51(3):358-62. Epub 2015 Jan 9 doi: 10.1002/mus.24326. PMID: 25042002Free PMC Article
Nicolson SE, Chabon B, Larsen KA, Kelly SE, Potter AW, Stern TA
Psychosomatics 2011 Nov-Dec;52(6):507-12. doi: 10.1016/j.psym.2011.06.008. PMID: 22054619
Del Ser T, Hachinski V, Merskey H, Munoz DG
J Neurol Sci 2005 Apr 15;231(1-2):3-11. Epub 2004 Dec 29 doi: 10.1016/j.jns.2004.08.016. PMID: 15792814

Clinical prediction guides

Franco JG, Trzepacz PT, Velásquez-Tirado JD, Ocampo MV, Serna PA, Giraldo AM, López C, Zuluaga A, Zaraza-Morales D
J Acad Consult Liaison Psychiatry 2021 Jan-Feb;62(1):56-69. Epub 2020 Apr 13 doi: 10.1016/j.psym.2020.04.002. PMID: 32444154
Saitoh BY, Yamasaki R, Hiwatashi A, Matsushita T, Hayashi S, Mitsunaga Y, Maeda Y, Isobe N, Yoshida K, Ikeda SI, Kira JI
Mult Scler Relat Disord 2019 Jun;31:22-31. Epub 2019 Mar 12 doi: 10.1016/j.msard.2019.03.008. PMID: 30901701
Arena JE, Weigand SD, Whitwell JL, Hassan A, Eggers SD, Höglinger GU, Litvan I, Josephs KA
J Neurol 2016 Feb;263(2):380-389. Epub 2015 Dec 24 doi: 10.1007/s00415-015-7990-2. PMID: 26705121
Hyde TM, Goldberg TE, Egan MF, Lener MC, Weinberger DR
Br J Psychiatry 2007 Aug;191:120-5. doi: 10.1192/bjp.bp.106.026773. PMID: 17666495
Del Ser T, Hachinski V, Merskey H, Munoz DG
J Neurol Sci 2005 Apr 15;231(1-2):3-11. Epub 2004 Dec 29 doi: 10.1016/j.jns.2004.08.016. PMID: 15792814

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