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To the Editor:
Guedj et al. consider the existence of a continuous pathologic process in frontotemporal dementia (FTD) to FTD/motor neuron disease (MND) and eventually to MND.1 Since Yuasa reported an autopsy case of amyotrophic lateral sclerosis (ALS) with dementia, this disease has been considered a distinct entity from ALS without dementia.2
Results of functional imaging studies of ALS, including those conducted by us,3 suggest the existence of continuous cortical degeneration spreading from the motor cortex to the prefrontal region.4 Investigators have regarded these findings sufficient to hypothesize the existence of a continuum from FTD, FTD/MND, and MND, as Guedj et al. maintained in their article.1
However, there has been some controversy regarding this continuum, partially because of the lack of clinical studies concerning progressive cognitive deterioration in MND that …
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