Neuropsychiatric Symptoms in Alzheimer Disease, Vascular Dementia, and Mixed Dementia
Neuropsychiatric Symptoms in Alzheimer Disease, Vascular Dementia, and Mixed Dementia
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DOI：
10.1159/000455127
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发表时间：
2017-01-01
影响因子：
3
通讯作者：
Tartaglia, Maria Carmela
中科院分区：
文献类型：
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作者：
Anor, Cassandra J.;O'Connor, Sean;Tartaglia, Maria Carmela
背景/目的：神经精神症状（NPS）在阿尔茨海默病（AD）和血管性痴呆（VaD）中很常见，并且给患者和护理人员带来痛苦。NPS可能与潜在的病理相关。先前的研究表明，额叶病变和血管变化，如白质高信号（WMH）与特定的NPS有显著关联。本研究旨在比较AD、VaD以及混合性AD/VaD患者的NPS，并评估NPS患病率与额叶WMH体积相关的差异。
方法：共有180名有NPS且具备磁共振成像（MRI）数据的患者（92例可能为AD，占51%；34例可能为VaD，占19%；54例可能为混合性AD/VaD，占30%）被纳入研究。进行回归分析以确定NPS患病率与诊断之间以及NPS与额叶WMH之间的关系。
结果：VaD患者比AD患者有明显更多的激越（p < 0.05；40%对14%）和睡眠障碍（p < 0.05；57%对32%），并且比混合性AD/VaD患者有明显更多的抑郁（p < 0.05；48%对20%）和异常运动行为（p < 0.05；31%对13%）。有妄想的AD患者右侧额叶WMH体积明显大于无妄想的患者（p < 0.05；有妄想/无妄想 = 314.8/112.6立方毫米）。
结论：NPS患病率的差异可能与潜在的病理相关，由于其对治疗有影响，值得进一步研究。（c）2017 S. Karger AG，巴塞尔
Background/Aims: Neuropsychiatric symptoms (NPS) are common in Alzheimer disease (AD) and vascular dementia (VaD), and are distressful to patients and caregivers. NPS are likely related to the underlying pathology. Previous studies suggest that frontal lobe lesions and vascular changes such as white matter hyperintensities (WMH) have a significant association with specific NPS. The current study aimed to compare NPS in patients with AD, VaD, and mixed AD/VaD, and to evaluate the differences in the prevalence of NPS in relation to frontal WMH volume. Methods: In total, 180 patients with NPS and MRI data (92 probable AD, 51%; 34 probable VaD, 19%; and 54 probable mixed AD/VaD, 30%) were included in the study. Regression analyses were performed to determine the relationships between NPS prevalence and diagnosis, and between NPS and frontal WMH. Results: VaD patients had significantly more agitation (p < 0.05; 40 vs. 14%) and sleep disturbances (p < 0.05; 57 vs. 32%) than AD patients, and significantly more depression (p < 0.05; 48 vs. 20%) and aberrant motor behaviors (p < 0.05; 31 vs. 13%) than mixed AD/VaD patients. AD patients with delusions had significantly greater right frontal WMH volumes than those without (p < 0.05; delusions 1/0 = 314.8/112.6 mm(3)). Conclusion: Differences in NPS prevalence are likely related to the underlying pathology and warrant further study as they have implications for treatment. (c) 2017 S. Karger AG, Basel