Behavioral phenomenology in Alzheimer's disease, frontotemporal dementia, and late-life depression: A retrospective analysis
Behavioral phenomenology in Alzheimer's disease, frontotemporal dementia, and late-life depression: A retrospective analysis
复制标题
DOI：
10.1177/089198879701000206
复制
发表时间：
1997-04-01
影响因子：
2.6
通讯作者：
Benson, DF
中科院分区：
文献类型：
--
作者：
Swartz, JR;Miller, BL;Benson, DF
通常，处于早期阶段的阿尔茨海默病 (AD)、额颞叶痴呆 (FTD) 和晚年抑郁症患者在临床上很难区分。尽管这些疾病之间存在微妙的认知差异，但非认知行为现象学可能提供额外的区分能力。在 19 名 AD 受试者、19 名 FTD 受试者、16 名晚年精神病性抑郁症 (LLPD) 和 19 名晚年非精神病性抑郁症 (LLNPD) 受试者中，使用神经精神病学临床评估时间表 (SCAN) 回顾性量化非认知行为症状，并使用单向方差分析和多变量逐步判别分析（利用折刀法）进行比较。 FTD 组的平均总 SCAN 得分最高，而 AD 组的平均总 SCAN 得分最低。方差分析显示四个诊断组之间的平均总 SCAN 分数存在显着差异 (P < .0001)。通过判别分析，四种疾病表现出不同的行为异常簇，并通过这些症状进行区分 (P < .0001)。确定了 14 个 SCAN 项目组症状的子集，这些症状共同正确分类了每个诊断类别中以下百分比的受试者：AD 94.7%、FTD 100%、LLPD 87.5% 和 LLNPD 100%。这些结果表明，AD、FTD、LLPD 和 LLNPD 在不使用认知数据的情况下通过 SCAN 进行了回顾性区分。更好地定义不同痴呆症和精神疾病的非认知行为症状的纵向过程对于诊断和帮助定义与选择性神经解剖学和神经化学脑病理学相关的行为综合征都很有价值。
Often patients in the early stages of Alzheimer's disease (AD), frontotemporal dementia (FTD), and late-life depression can be difficult to differentiate clinically. Although subtle cognitive distinctions exist between these disorders, noncognitive behavioral phenomenology may provide additional discriminating power. In 19 subjects with AD, 19 with FTD, 16 with late-life psychotic depression (LLPD), and 19 with late-life nonpsychotic depression (LLNPD), noncognitive behavioral symptoms were quantified retrospectively using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and compared using both a one-way ANOVA and a multivariate stepwise discriminant analysis, which utilized a jackknife procedure. The FTD group showed the highest mean total SCAN score, while the AD group showed the lowest. ANOVA showed significant differences in the mean total SCAN scores between the four diagnostic groups (P < .0001). With the discriminant analysis,the four disorders demonstrated different clusters of behavioral abnormalities and were differentiated by these symptoms (P < .0001). A subset of 14 SCAN item group symptoms was identified that collectively classified correctly the following percentages of subjects in each diagnostic category: AD 94.7%, FTD 100%, LLPD 87.5%, and LLNPD 100%. These results indicate that AD, FTD, LLPD, and LLNPD were distinguished retrospectively by the SCAN without using cognitive data. Better definition of the longitudinal course of noncognitive behavioral symptoms in different dementias and psychiatric disorders will be valuable both for diagnosis and to help define behavioral syndromes that are associated with selective neuroanatomic and neurochemical brain pathology.