Degeneration of frontal serotonin-containing neurons occurs in frontal lobe dementia (FLD). The associated loss of serotonin transmission may contribute to the frontal lobe dysfunction associated with this disorder. FLD patients will undergo a controlled clinical trial of an orally administered serotonergic agent (Sertraline) which acts centrally to selectively block serotonin uptake to treat patients' cognitive and behavioral frontal dysfunction. Study subjects will be evaluated at regular intervals with a battery of neuropsychological and behavioral tests designed to assess frontal and other cognitive functions. In addition, compliance and levels of the medication will be measured in the blood and when possible in the cerebrospinal fluid (CSF).
Characterized as having behavioral manifestations using a standardized neuropsychiatric scale and interview. FLD patients' frontal cognitive sysfunctions characterized using a short neurobehavioral test battery. Patients must be able to be tested and cooperative with the procedures required in this protocol. No contraindications to the use of Sertraline. No medical conditions that can reasonably be expected to subject the patient to unwarranted risk (e.g., cancer) or require frequent changes in medication. Well-controlled medical conditions such as hypertension and diabetes will not be excluded. Patients must not be pregnant or nursing and must be using effective contraception, if still at child-bearing age. No history of prior severe traumatic brain injury or other severe neurologic or psychiatric condition, such as psychosis, stroke, multiple sclerosis, or spinal cord injury. Not using any psychotropic medication which cannot be stopped 4 weeks before the study.