Vleugel E E, Chong Y K, van der Mast R C
GGZ Buitenamstel.
Tijdschr Psychiatr. 2006;48(9):705-15.
Frontotemporal dementia (FTD) generally has a presenile onset, behavioural problems dominate the clinical picture and cognitive functions are still relatively intact. Therefore particularly in the early stages of FTD it is difficult to differentiate this type of dementia from other types of dementia and psychiatric disorders.
To review the options currently available for diagnosing FTD and to evaluate their significance for clinical practice.
A literature search via PubMed, Embase and the Cochrane Library (1999-2005) using the key words 'frontotemporal dementia' and 'diagnosis' or 'differential diagnosis'. Genetic and post-mortem studies were excluded.
The selected literature concerned differential clinical symptoms, neuropsychological research and questionnaires, neuroimaging and fluid abnormalities and dealt mainly with the difference between FTD and other types of dementia but not with differences between FTD and psychiatric disorders.
Measuring instruments that are helpful for diagnosing FTD are the Manchester Behavioural Questionnaire, the Frontal Behaviour Inventory and the Frontal Assessment Battery. Even better indicators of FTD are asymmetrical frontotemporal structural abnormalities in a CT- or MRI-scan and a decrease infrontal metabolism and perfusion in a PET- or SPECT-scan, although not all detected abnormalities are specific for FTD. Whatever the method used, early diagnosis is difficult; the sensitivity of nearly all diagnostic methods increases as the illness progresses. On the basis of this review of the literature some diagnostic techniques are recommended that can be applied if FTD is suspected.
额颞叶痴呆（FTD）通常起病于老年前期，临床症状以行为问题为主，认知功能相对保留。因此，尤其是在FTD的早期阶段，很难将这种类型的痴呆与其他类型的痴呆及精神疾病区分开来。
综述目前可用于诊断FTD的方法，并评估其在临床实践中的意义。
通过PubMed、Embase和Cochrane图书馆（1999 - 2005年）进行文献检索，使用关键词“额颞叶痴呆”和“诊断”或“鉴别诊断”。排除基因和尸检研究。
所选文献涉及临床症状差异、神经心理学研究与问卷、神经影像学及脑脊液异常，主要探讨了FTD与其他类型痴呆的差异，而非FTD与精神疾病的差异。
有助于诊断FTD的测量工具包括曼彻斯特行为问卷、额叶行为量表和额叶评估量表。CT或MRI扫描显示的不对称额颞叶结构异常以及PET或SPECT扫描显示的额叶代谢和灌注降低是更能提示FTD的指标，尽管并非所有检测到的异常都具有FTD特异性。无论采用何种方法，早期诊断都很困难；几乎所有诊断方法的敏感性都会随着疾病进展而增加。基于对文献的综述，推荐了一些在怀疑FTD时可应用的诊断技术。
