[P2-479]: SELF-SCHEMA ALTERATIONS IN DEMENTIA
[P2-479]: SELF-SCHEMA ALTERATIONS IN DEMENTIA
复制标题
[P2-479]：痴呆症中的自我图式改变
DOI：
10.1016/j.jalz.2017.06.1136
复制
发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Bond R
中科院分区：
文献类型：
--
作者：
Bond R
自我图式（Self schema）是大脑对自我及其边界的模型，它控制着内感受和外部感觉信号的处理以及我们与世界（包括他人）的互动。自我图式的abbandage在战略定位局灶性脑损伤和精神疾病中得到了很好的认可，然而，在痴呆症中，自我图式的处理还没有得到系统的研究。本研究对额颞叶痴呆（FTD）、典型阿尔茨海默病（AD）和逻辑缺失性失语（LPA）的患者进行了一项关于自我图式变化的综合性症状调查（疼痛和温度意识）、触觉敏感性、躯体精神病和恐惧症、人际敏感性、人际接触和个人空间。问卷项目记录照顾者的印象，改变在这些领域，因为病人的疾病发作。自我图式症状的神经解剖学相关性进行了评估，使用基于体素的形态学的患者的体积脑MR images.ResultsSelf图式症状报告的行为变异FTD（100%），语义性痴呆（80%）和logopenic失语症（100%）和相当大比例的患者进行性非流畅性失语症（70%）和典型的AD（70%）的患者。综合征组表现出不同的症状特征：疼痛和温度感知的变化在所有组中均很常见，主要是对LPA和典型AD的敏感性增加，而FTD综合征表现出更复杂的特征。接近和/或触摸他人的倾向改变在行为变异型FTD和语义性痴呆中更常见，而对自身体型的意识改变和对他人情绪状态的意识丧失是行为变异型FTD的标志，对接近他人的偏好改变尤其与典型AD相关。自我图式症状与灰质损失的分布在健康brain.ConclusionsSymptoms改变自我图式处理的皮质-皮质下网络牵连在重大痴呆症是常见的。症状特征可以对FTD和AD的综合征进行分层，反映这些疾病靶向的脑网络的参与。自我图式改变可能持有神经生物学的见解和新的生物标志物在常见的痴呆症的承诺。
Background‘Self schema’-the brain's model of the self and its boundaries–governs the processing of interoceptive and external sensory signals and our interactions with the world, including other people. Abnormalities of self schema are well recognised following strategically-located focal brain insults and in psychiatric illness; however, self schema processing has not been systematically studied in dementia. Here we undertook a comprehensive survey of symptoms relating to self schema changes in a cohort of patients representing major syndromes of frontotemporal dementia (FTD) and typical Alzheimer's disease (AD) and logopenic aphasia (LPA).MethodsWe designed a symptom questionnaire for completion by patients’ caregivers, covering self schema dimensions including homeostatic signals (pain and temperature awareness), tactile sensitivity, somatic psychosis and phobias, interpersonal sensitivity, interpersonal contact and personal space. Questionnaire items recorded caregivers’ impressions of change in these domains since onset of the patient's illness. Neuroanatomical correlates of self schema symptoms were assessed using voxel-based morphometry of patients’ volumetric brain MR images.ResultsSelf schema symptoms were reported for most patients with behavioural variant FTD (100%), semantic dementia (80%) and logopenic aphasia (100%) and a substantial proportion of patients with progressive nonfluent aphasia (70%) and typical AD (70%). Syndromic groups showed variable symptom profiles: changes in pain and temperature awareness were common in all groups, chiefly increased sensitivity with LPA and typical AD while FTD syndromes showed a more mixed profile. Altered propensity to approach and/or touch others was more common with behavioural variant FTD and semantic dementia, while altered awareness of own body habitus and loss of awareness of others’ emotional states were hallmarks of behavioural variant FTD and altered preference for proximity to others was particularly associated with typical AD. Self schema symptoms were associated with grey matter loss within the distributed cortico-subcortical network implicated in self schema processing in the healthy brain.ConclusionsSymptoms of altered self schema processing are common in major dementias. Symptom profiles may stratify syndromes of FTD and AD, reflecting involvement of the brain networks targeted by these diseases. Self schema alterations may hold neurobiological insights and the promise of novel biomarkers in common dementias.