Frontotemporal dementia: a systematic review of artificial intelligence approaches in differential diagnosis.

Introduction: Frontotemporal dementia (FTD) is a neurodegenerative disorder characterized by progressive degeneration of the frontal and temporal lobes, leading to significant changes in personality, behavior, and language abilities. Early and accurate differential diagnosis between FTD, its subtypes, and other dementias, such as Alzheimer's disease (AD), is crucial for appropriate treatment planning and patient care. Machine learning (ML) techniques have shown promise in enhancing diagnostic accuracy by identifying complex patterns in clinical and neuroimaging data that are not easily discernible through conventional analysis. Methods: This systematic review, following PRISMA guidelines and registered in PROSPERO, aimed to assess the strengths and limitations of current ML models used in differentiating FTD from other neurological disorders. A comprehensive literature search from 2013 to 2024 identified 25 eligible studies involving 6,544 patients with dementia, including 2,984 with FTD, 3,437 with AD, 103 mild cognitive impairment (MCI) and 20 Parkinson's disease dementia or probable dementia with Lewy bodies (PDD/DLBPD). Results: The review found that Support Vector Machines (SVMs) were the most frequently used ML technique, often applied to neuroimaging and electrophysiological data. Deep learning methods, particularly convolutional neural networks (CNNs), have also been increasingly adopted, demonstrating high accuracy in distinguishing FTD from other dementias. The integration of multimodal data, including neuroimaging, EEG signals, and neuropsychological assessments, has been suggested to enhance diagnostic accuracy. Discussion: ML techniques showed strong potential for improving FTD diagnosis, but challenges like small sample sizes, class imbalance, and lack of standardization limit generalizability. Future research should prioritize the development of standardized protocols, larger datasets, and explainable AI techniques to facilitate the integration of ML-based tools into real-world clinical practice. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024520902.