Apathy in frontotemporal dementia: behavioral and neuroimaging correlates.
Apathy in frontotemporal dementia: behavioral and neuroimaging correlates.
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DOI：
10.3233/ben-2011-0351
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发表时间：
2012
影响因子：
2.8
通讯作者：
Grossman M
中科院分区：
文献类型：
--
作者：
Eslinger PJ;Moore P;Antani S;Anderson C;Grossman M
我们调查了额颞叶痴呆（FTD）患者，特别是行为变异型社会和执行缺陷（bvFTD）患者的冷漠形式的目标导向的动机变化的发生。采用标准化行为量表调查和比较病人和照顾者的冷漠程度。在bvFTD病例中，情感淡漠评分与社会认知、执行功能和脑MRI萎缩指标进一步相关。结果表明，尽管患者自我评定正常，但护理者评定bvFTD患者的冷漠评分显著升高。进行性非流利性失语症和语义性痴呆的FTD样本的护理者和自我评分与健康对照组及其被调查者无差异。在bvFTD样本中，看护者冷漠评分与一般认知筛查或抑郁评分不相关，但与社会认知和执行功能测量显著相关。基于体素的形态测定显示，bvFTD中的情感淡漠评级与右侧尾状核（包括腹侧纹状体）、右侧颞顶交界处、右侧后下回和中颞回以及左侧额盖-前颞区的显著萎缩相关。研究结果表明，bvFTD与目标导向动机行为的显著中断相关，涉及皮质-基底神经节回路中断，也与社交和执行功能缺陷相关。
We investigated the occurrence of goal-directed motivational change in the form of apathy in patients with frontotemporal dementia (FTD), particularly those with behavioral variant social and executive deficits (bvFTD). Standardized behavioral inventory was employed to survey and compare apathy ratings from patients and caregivers. In cases of bvFTD, apathy ratings were further related to measures of social cognition, executive function, and atrophy on brain MRI. Results indicated that caregivers rated bvFTD patients as having significantly elevated apathy scores though patient self-ratings were normal. Caregiver and self-ratings of FTD samples with progressive nonfluent aphasia and semantic dementia did not differ from healthy controls and their informants. In the bvFTD sample, caregiver apathy scores were not correlated with general cognitive screening or depression scores, but were significantly correlated with social cognition and executive function measures. Voxel-based morphometry revealed that apathy ratings in bvFTD were related to prominent atrophy in the right caudate (including the ventral striatum), the right temporo-parietal junction, right posterior inferior and middle temporal gyri, and left frontal operculum- anterior insula region. Findings suggest that bvFTD is associated with a significant breakdown in goal-directed motivated behavior involving disruption of cortical-basal ganglia circuits that is also related to social and executive function deficits.