Valverde Ana Herrero, Jimenez-Escrig Adriano, Gobernado Josè, Barón Manuel
Neurology Department, Hospital Fernando Fonseca, Estrada IC-19, 2720 Amadora, Lisbon, Portugal.
Clin Neurol Neurosurg. 2009 Apr;111(3):251-5. doi: 10.1016/j.clineuro.2008.10.012. Epub 2008 Dec 4.
To elaborate a brief but efficient neuropsychological assessment of frontotemporal dementia (FTD), selecting the most specific and sensitive cognitive and behavioural items for distinguish between AD and FTD in the earlier dementia stages.
Retrospective study with three groups, 35 patients with FTD, 46 with AD and 36 normal subjects, were administered the MMSE, FAB, Tower of London and Stoop's test along with a 98 items behavioural and cognitive questionnaire. The most sensitive items were selected and validated internally for diagnosis by lineal discriminant analysis.
From the 98 items in the questionnaire, 29 showed significant discriminatory power. Non-cognitive symptoms with higher odd-ratio for FTD compared to AD were impairment in social behaviour (disinhibition, aggressiveness), loss of insight and inappropriate acts. Language disorders, such as echolalia, verbal apraxia or aggramatism, dominate in the cognitive profile of FTD. FAB was confirmed as the best cognitive instrument to differentiate FTD and AD. A linear discriminant function with the combination of the FAB score and the items from our questionnaire with higher OR for FTD accurately classified 97% of individuals.
The neuropsychological tests allow the differentiation between FTD and AD. The combination of FAB test with the assessment of key behavioural and cognitive symptoms appears helpful in this distinction.
精心设计一项简短而有效的额颞叶痴呆（FTD）神经心理学评估，选择最具特异性和敏感性的认知及行为项目，以便在早期痴呆阶段区分阿尔茨海默病（AD）和FTD。
采用回顾性研究，对三组对象进行研究，35例FTD患者、46例AD患者和36名正常受试者，接受简易精神状态检查表（MMSE）、额叶评估量表（FAB）、伦敦塔测验和斯图普测验，同时还进行了一份包含98个项目的行为和认知问卷。通过线性判别分析，选择最敏感的项目并在内部进行诊断验证。
问卷中的98个项目中，29个显示出显著的鉴别力。与AD相比，FTD具有较高优势比的非认知症状包括社交行为受损（脱抑制、攻击性）、洞察力丧失和不适当行为。语言障碍，如模仿言语、言语失用或语法错乱，在FTD的认知特征中占主导地位。FAB被确认为区分FTD和AD的最佳认知工具。将FAB评分与问卷中FTD优势比更高的项目相结合的线性判别函数，准确地对97%的个体进行了分类。
神经心理学测试有助于区分FTD和AD。FAB测试与关键行为和认知症状评估相结合，似乎有助于这种区分。
