Which neuropsychiatric and behavioural features distinguish frontal and temporal variants of frontotemporal dementia from Alzheimer's disease?
Which neuropsychiatric and behavioural features distinguish frontal and temporal variants of frontotemporal dementia from Alzheimer's disease?
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DOI：
10.1136/jnnp.69.2.178
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发表时间：
2000-08-01
影响因子：
11
通讯作者：
Hodges, JR
中科院分区：
文献类型：
--
作者：
Bozeat, S;Gregory, CA;Hodges, JR
目的：调查额颞叶痴呆（FTD）和阿尔茨海默病（AD）患者情绪、人格和行为改变的患病率，从而确定哪些特征能可靠地区分这两种疾病。要建立是否额叶和颞叶的FTD的变体的特点是不同的行为changes. Methods-一个问卷调查的目的是评估广泛的神经精神的变化，它纳入功能报告在以前的研究FTD和组件的神经精神的库存。(1)这项研究由37名阿尔茨海默病（AD）患者和33名额颞叶痴呆（FTD）患者的护理人员完成，其中包括20名颞叶变异型FTD（tv FTD）或语义性痴呆患者和13名额叶变异型FTD（fv FTD）患者。探索性的主成分因子分析和判别函数analysisapplied.Results-Factor分析显示四个强大的和有意义的症状集群：因子1-刻板和饮食行为;因子2-执行功能障碍和自我照顾;因子3-情绪变化;因子4-丧失社会意识。只有刻板和改变的饮食行为和社会意识的丧失才能可靠地将AD与FTD区分开来，而疾病严重程度无影响。相比之下，执行功能障碍，自我照顾差，坐立不安显示出疾病严重程度的显着影响，与受损患者得分更高。情绪变化在三个患者组中同样普遍。个体症状分析显示，与fv FTD患者相比，语义性痴呆患者的精神僵硬和抑郁发生率增加。相反，后一组表现出更大的去抑制。判别函数分析正确分类71.4%的整体和86.5%的AD患者。结论，这份问卷关闭显着差异FTD和AD患者之间，但只有刻板的行为，饮食偏好的变化，去抑制，社会意识差的功能可靠地分开组。患有fv FTD和语义性痴呆的患者在行为上非常相似，反映了共同网络、腹侧额叶、颞极和杏仁核的参与。发现执行障碍症状和自我护理不良受疾病严重程度的影响，反映了FTD和AD病程中可能相对较晚扩散至背外侧前额叶区。该问卷可能在诊断和监测治疗中具有价值。
Objectives-To investigate the prevalence of changes in mood, personality, and behaviour in frontotemporal dementia (FTD) and Alzheimer's disease (AD) and hence, which features reliably distinguish between them. To establish whether the frontal and temporal variants of FTD are characterised by different behavioural changes.Methods-A questionnaire was designed to assess a wide range of neuropsychiatric changes; it incorporated features reported in previous studies of FTD and components of the neuropsychiatric inventory.(1) This was completed by 37 carers of patients with Alzheimer's disease (AD) and 33 patients with frontotemporal dementia (FTD), comprising 20 with temporal variant FTD (tv FTD) or semantic dementia and 13 with frontal variant FTD (fv FTD). An exploratory principal components factor analysis and discriminant function analysis was applied.Results-Factor analysis showed four robust and meaningful symptom clusters: factor 1-stereotypic and eating behaviour; factor 2-executive dysfunction and self care; factor 3-mood changes; factor 4-loss of social awareness. Only stereotypic and altered eating behaviour and loss of social awareness reliably differentiated AD from FTD with no effect of disease severity. By contrast, executive dysfunction, poor self care, and restlessness showed a significant effect of disease severity only, with the more impaired patients scoring more highly. Changes in mood were found to be equally prevalent in the three patient groups. Analysis of individual symptoms showed increased rates of mental rigidity and depression in the patients with semantic dementia compared with those with fv FTD. Conversely, the latter group showed greater disinhibition. Discriminant function analysis correctly classified 71.4% overall and 86.5% of the patients with AD.Conclusions-This questionnaire closed striking differences between patients with FTD and AD, but only stereotypic behaviour, changes in eating preference, disinhibition, and features of poor social awareness reliably separated the groups. The patients with fv FTD and semantic dementia were behaviourally very similar, reflecting the involvement of a common network, the ventral frontal lobe, temporal pole, and amygdala. Dys-executive symptoms and poor self care were found to be affected by the severity of the disease, reflecting perhaps spread to dorsolateral prefrontal areas relatively late in the course of both FTD and AD. This questionnaire may be of value in the diagnosis and the monitoring of therapies.