Brain mechanisms underlying neuropsychiatric symptoms in Alzheimer's disease: a systematic review of symptom-general and -specific lesion patterns.

Brain mechanisms underlying neuropsychiatric symptoms in Alzheimer's disease: a systematic review of symptom-general and -specific lesion patterns.
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DOI:
10.1186/s13024-021-00456-1
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发表时间:
2021-06-07
影响因子:
15.1
通讯作者:
Zhang Z
Zhang Z
中科院分区:
医学1区
文献类型:
--
作者:
Chen Y;Dang M;Zhang Z

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神经精神症状(NPSs)在阿尔茨海默病(AD)患者中很常见,并且与认知障碍加速和更早死亡相关。本综述旨在探讨阿尔茨海默病中神经精神症状的神经发病机制及其与阿尔茨海默病进展的关联。我们首先对神经精神症状的发病时间进行文献综述。不同的神经精神症状出现在阿尔茨海默病的不同疾病阶段,但大多数症状出现在阿尔茨海默病临床前阶段或轻度认知障碍阶段,并逐渐发展。接下来,我们描述了脑部病变的症状通用和特定模式。一般来说,前扣带回皮质是所有症状中常见的受损区域,前额叶皮质,尤其是眶额叶皮质,也是与大多数神经精神症状相关的关键区域。相比之下,前扣带回 - 皮质下回路与阿尔茨海默病中的冷漠特别相关,额叶 - 边缘回路与抑郁相关,杏仁核回路与焦虑相关。最后,我们通过将发病时间与神经精神症状的神经基础相结合,阐明了神经精神症状与阿尔茨海默病之间的关联。 网络版包含补充材料,可在10.1186/s13024 - 021 - 00456 - 1获取。
Neuropsychiatric symptoms (NPSs) are common in patients with Alzheimer’s disease (AD) and are associated with accelerated cognitive impairment and earlier deaths. This review aims to explore the neural pathogenesis of NPSs in AD and its association with the progression of AD. We first provide a literature overview on the onset times of NPSs. Different NPSs occur in different disease stages of AD, but most symptoms appear in the preclinical AD or mild cognitive impairment stage and develop progressively. Next, we describe symptom-general and -specific patterns of brain lesions. Generally, the anterior cingulate cortex is a commonly damaged region across all symptoms, and the prefrontal cortex, especially the orbitofrontal cortex, is also a critical region associated with most NPSs. In contrast, the anterior cingulate-subcortical circuit is specifically related to apathy in AD, the frontal-limbic circuit is related to depression, and the amygdala circuit is related to anxiety. Finally, we elucidate the associations between the NPSs and AD by combining the onset time with the neural basis of NPSs. The online version contains supplementary material available at 10.1186/s13024-021-00456-1.
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