Millar David, Griffiths Philipa, Zermansky Adam J, Burn David J
Clinical Psychology, University of Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom.
Mov Disord. 2006 Feb;21(2):199-207. doi: 10.1002/mds.20707.
Frontal lobe dysfunction is a prominent feature of many neurological disorders. Early diagnosis may be enhanced by establishing a profile of cognitive, behavioral, and emotional change. Traditional psychometric assessment focuses on cognitive dysfunction and fails to identify behavioral changes, particularly those associated with orbitofrontal dysfunction. We examined progressive supranuclear palsy (PSP), a prototypical subcortical dementia with frontal features, using commonly available neuropsychological measures and a modification of the Katz Adjustment Scale-Relatives (KAS-R), an instrument first developed to assess dysexecutive changes in head-injured patients. Executive tests identified deficits in reasoning, planning, set shifting, verbal fluency, information processing speed, and response initiation. On the KAS-R, changes in apathy, social withdrawal, and independence were observed, with little change in belligerence, social irresponsibility, uncooperativeness, obstreperousness, anxiety, and depression. The results show the potential utility of this instrument in characterizing behavioral and emotional changes associated with frontal lobe dysfunction in neurodegenerative disease.
额叶功能障碍是许多神经系统疾病的一个显著特征。通过建立认知、行为和情绪变化的概况，可能会提高早期诊断的准确性。传统的心理测量评估侧重于认知功能障碍，无法识别行为变化，尤其是那些与眶额功能障碍相关的变化。我们使用常用的神经心理学测量方法以及对《卡茨适应量表 - 亲属版》（KAS - R）的修改版本，对进行性核上性麻痹（PSP）进行了研究，PSP是一种具有额叶特征的典型皮质下痴呆，该量表最初是为评估头部受伤患者的执行功能障碍而开发的。执行测试发现了推理、计划、任务转换、语言流畅性、信息处理速度和反应启动方面的缺陷。在KAS - R量表上，观察到了冷漠、社交退缩和独立性方面的变化，而在好斗、社会不负责任、不合作、吵闹、焦虑和抑郁方面变化不大。结果表明该量表在描述神经退行性疾病中与额叶功能障碍相关的行为和情绪变化方面具有潜在效用。
