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社会人格测量在痴呆症研究中的新应用。

Novel applications of social-personality measures to the study of dementia.

作者信息

Mychack P, Rosen H, Miller B L

机构信息

University of California, San Francisco, Memory and Aging Center, Department of Neurology, San Francisco, CA 94143-1207, USA.

出版信息

Neurocase. 2001;7(2):131-43. doi: 10.1093/neucas/7.2.131.

Abstract

Despite the realization that personality change is a core feature of frontotemporal dementia (FTD), little work has been performed using personality as a diagnostic tool for this disease. Likewise, personality change in Alzheimer's disease (AD) has long been recognized, but generally has not been used for diagnostic purposes. We introduce novel social-personality measures (Big Five Inventory, Interpersonal Adjectives Scale and Interpersonal Measure of Psychopathy) in the differential diagnosis of AD and temporal subtypes of FTD, and integrate these measures with traditional behavioural and neuropsychological methods commonly used in diagnosing dementia. We present four cases: an FTD patient with predominantly left temporal degeneration, an FTD patient with predominantly right temporal degeneration and two patients with Alzheimer's disease (one with mild and the other with moderate impairment). Results show the diagnostic utility of these measures in differentiating among temporal subtypes of FTD and moderate AD. Right temporal FTD, in particular, shows profound shifts in personality and interpersonal behaviour, as well as a striking lack of insight into these shifts. In addition to diagnostic purposes, we discuss how measures of personality and interpersonal behaviour can be utilized as an important component of understanding disease susceptibility and risk, as well as offering insights into the neuroanatomical underpinnings of personality and social behaviour.

摘要

尽管人们已经认识到人格改变是额颞叶痴呆(FTD)的核心特征,但将人格作为该疾病诊断工具的研究却很少。同样,阿尔茨海默病(AD)中的人格改变早已为人所知,但通常未用于诊断目的。我们引入了新颖的社会人格测量方法(大五人格量表、人际形容词量表和精神病态人际测量)用于AD和FTD颞叶亚型的鉴别诊断,并将这些测量方法与痴呆诊断中常用的传统行为和神经心理学方法相结合。我们展示了四个病例:一名主要为左侧颞叶变性的FTD患者、一名主要为右侧颞叶变性的FTD患者以及两名阿尔茨海默病患者(一名轻度受损,另一名中度受损)。结果显示这些测量方法在区分FTD颞叶亚型和中度AD方面具有诊断效用。特别是右侧颞叶FTD,在人格和人际行为方面表现出深刻的变化,并且对这些变化明显缺乏洞察力。除了诊断目的外,我们还讨论了人格和人际行为测量如何作为理解疾病易感性和风险的重要组成部分,以及如何为理解人格和社会行为的神经解剖学基础提供见解。

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