Differentiating frontal and temporal variant frontotemporal dementia from Alzheimer's disease
Differentiating frontal and temporal variant frontotemporal dementia from Alzheimer's disease
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DOI：
10.1212/wnl.54.12.2277
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发表时间：
2000-06-27
期刊：
影响因子：
9.9
通讯作者：
Hodges, JR
中科院分区：
文献类型：
--
作者：
Perry, RJ;Hodges, JR
目的/背景：确定额颞叶痴呆(FTD)和阿尔茨海默病(AD)早期鉴别的困难是否源于未能区分FTD的颞叶和额叶变异。方法：比较早期阿尔茨海默型痴呆(DAT；n=10)、FTD的时间变异型(TV-FTD或语义性痴呆；n=5)和额部变异型(FV-FTD；n=10)患者的神经心理特征，并与正常对照组(n=10)进行比较。结构MRI显示TV-FTD患者的颞叶萎缩，FV-FTD组的额叶萎缩。结果：TV-FTD受试者在语义记忆方面表现出严重的缺陷，注意力和执行功能保持不变。患有FV-FTD的受试者表现出相反的模式。注意力和执行功能受损将FV-FTD患者与早期DAT患者区分开来，后者严重健忘。结论：语义记忆和注意/执行功能的双重分离使FTD的时间和额叶变异明显分离，有助于FTD和AD的早期鉴别。这些特征性的认知特征反映了各证候的病理分布，支持了下侧颞叶新皮质在语义记忆中的作用，支持了海马内侧颞叶结构在情景记忆中的复合体，以及额叶在执行功能中的作用。
Objective/Background: To determine whether difficulty in the early differentiation between frontotemporal dementia (FTD) and AD may arise from a failure to discriminate between the temporal and frontal variants of FTD. Methods: Neuropsychological profiles of patients with early dementia of Alzheimer type (DAT; n = 10), the temporal variant of FTD (tv-FTD or semantic dementia; n = 5), and the frontal variant of FTD (fv-FTD; n = 10) were compared to each other and normal controls (n = 10). Structural MRI demonstrated temporal lobe atrophy in the tv-FTD patients and frontal lobe atrophy in the fv-FTD group. Results: Subjects with tv-FTD showed severe deficits in semantic memory with preservation of attention and executive function. Subjects with fv-FTD showed the reverse pattern. Attention and executive function impairment separated the fv-FTD patients from the early DAT subjects, who were densely amnesic. Conclusion: The double dissociation in performance on semantic memory and attention/executive function clearly separated the temporal and frontal variants of FTD and aids the early differentiation of FTD from AD. The characteristic cognitive profiles reflect the distribution of pathology within each syndrome and support the putative role of the inferolateral temporal neocortex in semantic memory, the medial temporal lobe structures of the hippocampal, complex in episodic memory, and the frontal lobes in executive function.