Pasquier Florence
Memory Clinic, Department of Neurology, University Hospital, Lille, France.
Curr Opin Psychiatry. 2005 Nov;18(6):628-32. doi: 10.1097/01.yco.0000185988.05741.2a.
A precise diagnosis of the cause of dementia during life is needed for proper management, in order to explain the symptoms to the patient and to the close relatives, and to give appropriate indications on the prognosis and possibly on the genetic risk. Frontotemporal dementia remains under-diagnosed and often misdiagnosed for Alzheimer's disease, the most common cause of dementia. More and more studies explore the differences between the two syndromes.
Progress in neuropsychological testing improves the ability to distinguish between syndromes and knowledge on brain functioning. More attention has been paid over these last months--or years--on emotion, insight, behavior, artistic creativity and quality of responses. Yet, biomarkers do not improve the diagnostic accuracy of trained clinicians, and do not help to distinguish between histological subtypes of frontotemporal dementia.
Improvement in knowledge on cognitive and emotional impairment in frontotemporal dementia and Alzheimer's disease is essential for the management of the patient--information can be given to the patients and the families that helps them to understand and to behave in consequence.
为了向患者及其近亲解释症状，并就预后以及可能的遗传风险给出适当提示，在患者生前准确诊断痴呆病因对于恰当管理至关重要。额颞叶痴呆的诊断率仍然较低，且常被误诊为最常见的痴呆病因——阿尔茨海默病。越来越多的研究在探索这两种综合征之间的差异。
神经心理学测试的进展提高了区分综合征的能力以及对大脑功能的认识。在过去几个月或几年里，人们对情绪、洞察力、行为、艺术创造力和反应质量给予了更多关注。然而，生物标志物并不能提高训练有素的临床医生的诊断准确性，也无助于区分额颞叶痴呆的组织学亚型。
提高对额颞叶痴呆和阿尔茨海默病认知及情感障碍的认识对于患者管理至关重要——可以向患者及其家属提供有助于他们理解并相应行事的信息。
