Utility of testing for apraxia and associated features in dementia.
Utility of testing for apraxia and associated features in dementia.
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DOI：
10.1136/jnnp-2015-312945
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发表时间：
2016-11
期刊：
影响因子：
--
通讯作者：
Butler CR
中科院分区：
文献类型：
--
作者：
Ahmed S;Baker I;Thompson S;Husain M;Butler CR
现有的文献表明，失用症和相关的顶叶缺陷的存在或不存在可能是临床相关的痴呆综合征的鉴别诊断。本研究调查了阿尔茨海默病（AD）和额颞叶痴呆（FTD）谱系障碍的这些功能的概况，在第一次介绍。对111例就诊于牛津认知障碍诊所（英国牛津）的患者进行了回顾性病例记录分析，包括29例遗忘型AD、12例后皮质萎缩（PCA）、12例逻辑缺失型原发性进行性失语（lvPPA）、20例行为变异型FTD（bvFTD）、7例非流利变异型PPA（nfvPPA）、语义变异型PPA（svPPA）6例，主观认知功能障碍（SCI）25例。感兴趣的临床特征是：肢体失用症，言语失用症（AOS），以及阅读障碍，书写困难和计算障碍的左顶叶症状。PCA、遗忘型AD、lvPPA和nfvPPA的肢体失用发生率最高。仅在nfvPPA中观察到AOS。AD谱系疾病中相关顶叶特征的发生率高于FTD谱系疾病。关键鉴别诊断挑战之间的组比较显示，lvPPA和nfvPPA可根据左顶叶特征和AOS的存在进行显著区分，遗忘型AD可通过肢体失用症与bvFTD、svPPA和SCI进行区分。回归分析表明，肢体失用症可以成功区分AD和FTLD谱系障碍，准确率为83%。可以观察到疾病特异性的肢体失用症和相关缺陷。由于认知症状重叠，FTD和AD谱系障碍可能难以区分，特别是失用症的测量似乎是一种有希望的方法。
Existing literature suggests that the presence or absence of apraxia and associated parietal deficits may be clinically relevant in differential diagnosis of dementia syndromes. This study investigated the profile of these features in Alzheimer's disease (AD) and frontotemporal dementia (FTD) spectrum disorders, at first presentation. Retrospective case note analysis was undertaken in 111 patients who presented to the Oxford Cognitive Disorders Clinic, Oxford, UK, including 29 amnestic AD, 12 posterior cortical atrophy (PCA), 12 logopenic primary progressive aphasia (lvPPA), 20 behavioural variant FTD (bvFTD), 7 non-fluent variant PPA (nfvPPA), 6 semantic variant PPA (svPPA) and 25 patients with subjective cognitive impairment (SCI). The clinical features of interest were: limb apraxia, apraxia of speech (AOS), and left parietal symptoms of dyslexia, dysgraphia, and dyscalculia. The prevalence of limb apraxia was highest in PCA, amnestic AD, lvPPA and nfvPPA. AOS was only observed in nfvPPA. Associated parietal features were more prevalent in AD spectrum than FTD spectrum disorders. Group comparisons between key differential diagnostic challenges showed that lvPPA and nfvPPA could be significantly differentiated on the presence of left parietal features and AOS, and amnestic AD could be differentiated from bvFTD, svPPA and SCI by limb apraxia. Regression analysis showed that limb apraxia could successfully differentiate between AD and FTLD spectrum disorders with 83% accuracy. Disease-specific profiles of limb apraxia and associated deficits can be observed. FTD and AD spectrum disorders can be difficult to differentiate due to overlapping cognitive symptoms, and measures of apraxia, in particular, appear to be a promising discriminator.
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DOI：
10.1016/j.jalz.2011.03.005
发表时间：
2011-05
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
--
作者：
McKhann GM;Knopman DS;Chertkow H;Hyman BT;Jack CR Jr;Kawas CH;Klunk WE;Koroshetz WJ;Manly JJ;Mayeux R;Mohs RC;Morris JC;Rossor MN;Scheltens P;Carrillo MC;Thies B;Weintraub S;Phelps CH
通讯作者：
Phelps CH
影响因子：
6
作者：
Adeli A;Whitwell JL;Duffy JR;Strand EA;Josephs KA
通讯作者：
Josephs KA
影响因子：
14.5
作者：
Kas, Aurelie;de Souza, Leonardo Cruz;Sarazin, Marie
通讯作者：
Sarazin, Marie
影响因子：
14.5
作者：
Libon, David J.;Rascovsky, Katya;Grossman, Murray
通讯作者：
Grossman, Murray
影响因子：
9.9
作者：
McMonagle, P;Deering, F;Kertesz, A
通讯作者：
Kertesz, A