Weiner Myron F, Hynan Linda S, Parikh Bhavin, Zaki Nasir, White Charles L, Bigio Eileen H, Lipton Anne M, Martin-Cook Kristin, Svetlik Doris A, Cullum C Munro, Vobach Steven, Rosenberg Roger N
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas 75390-9070, USA.
J Geriatr Psychiatry Neurol. 2003 Dec;16(4):245-50. doi: 10.1177/0891988703258671.
To determine if Alzheimer's disease (AD), its Lewy body (LB) variant (LBV), and diffuse LB disease (DLBD) are distinguishable at initial clinical evaluation, data from autopsy-confirmed AD, LBV, and DLBD were examined. No significant differences were found in age at onset, age at death, total duration of illness, duration of illness before initial visit, duration of illness from initial visit to death, or severity of illness at initial evaluation. Hallucinations and delusions were significantly more frequent for LBV and DLBD, respectively, than for AD, and falls were more frequent for DLBD than for AD. Extrapyramidal symptoms (EPS) were less frequent in neuroleptic-free AD subjects than in LB subjects; the percentage of AD patients with EPS after neuroleptic exposure was less than that among LB patients. Seizures were significantly more common for DLBD than for AD or LBV. LB dementias differed from AD at initial evaluation, with more frequent hallucinations and delusions, EPSs, and seizures, and longitudinally in neuroleptic sensitivity, but the data did not distinguish LBV from DLBD.
为了确定阿尔茨海默病（AD）、其路易体（LB）变异型（LBV）和弥漫性LB病（DLBD）在初次临床评估时是否可区分，我们检查了尸检确诊的AD、LBV和DLBD的数据。在发病年龄、死亡年龄、疾病总持续时间、初次就诊前的疾病持续时间、从初次就诊到死亡的疾病持续时间或初次评估时的疾病严重程度方面，未发现显著差异。幻觉和妄想分别在LBV和DLBD中比在AD中更常见，跌倒在DLBD中比在AD中更常见。无抗精神病药物治疗的AD患者锥体外系症状（EPS）比LB患者少；抗精神病药物暴露后出现EPS的AD患者百分比低于LB患者。癫痫发作在DLBD中比在AD或LBV中明显更常见。LB痴呆在初次评估时与AD不同，幻觉、妄想、EPS和癫痫发作更频繁，在抗精神病药物敏感性方面呈纵向差异，但数据无法区分LBV和DLBD。
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