Williams Guy B, Nestor Peter J, Hodges John R
Wolfson Brain Imaging Centre, Addenbrooke's Hospital, Cambridge, CB2 2QQ, UK.
Neuroimage. 2005 Feb 15;24(4):1042-51. doi: 10.1016/j.neuroimage.2004.10.023. Epub 2004 Dec 19.
Patients with frontotemporal dementia (FTD) can present with the clinical syndrome of semantic dementia due to a progressive loss of semantic knowledge or a neuropsychiatric syndrome characterised by aberrant social behaviours although frequently both co-exist. It has been assumed that the former is underpinned by damage to the temporal lobes and the latter, predominantly, by damage to the frontal lobes. Using the technique of voxel-based morphometry, we studied a group of FTD cases (n = 18) with a range of cognitive and neuropsychiatric features to correlate loss of semantic knowledge (as measured by the sum of two semantic tests) and aberrant behaviour (as measured by the neuropsychiatric inventory, NPI) with regional loss of grey matter volume. Semantic breakdown correlated with extensive loss of grey matter volume throughout the left anterior temporal lobe and less significantly with right temporal pole and subcallosal gyrus. Aberrant behaviour correlated with loss of grey matter volume in the dorso-mesial frontal lobe--paracingulate region, Brodmann areas 6/8/9--more so on the right. The frontal paracingulate correlation suggests that damage to this region may significantly contribute to the genesis of the behavioural syndrome seen in FTD.
额颞叶痴呆（FTD）患者可能会因语义知识的逐渐丧失而出现语义性痴呆的临床综合征，或出现以异常社会行为为特征的神经精神综合征，不过这两种情况常常同时存在。人们认为，前者是由颞叶损伤所致，而后者主要是由额叶损伤所致。我们运用基于体素的形态测量技术，研究了一组具有一系列认知和神经精神特征的FTD病例（n = 18），以将语义知识丧失（通过两项语义测试的总和来衡量）和异常行为（通过神经精神科问卷，即NPI来衡量）与灰质体积的区域性丧失相关联。语义衰退与整个左侧前颞叶灰质体积的广泛丧失相关，与右侧颞极和胼胝体下回的相关性较弱。异常行为与背内侧额叶 - 扣带旁区域（Brodmann 6/8/9区）的灰质体积丧失相关，右侧更为明显。额叶扣带旁的相关性表明，该区域的损伤可能对FTD中所见行为综合征的发生有显著影响。
