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阿尔茨海默病患者额叶功能障碍与异常运动行为的关系。

Relationship of frontal lobe dysfunction and aberrant motor behaviors in patients with Alzheimer's disease.

机构信息

Department of Psychiatry, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan.

出版信息

Int Psychogeriatr. 2010 May;22(3):463-9. doi: 10.1017/S1041610209991323. Epub 2009 Dec 15.

DOI:10.1017/S1041610209991323
PMID:20003629
Abstract

BACKGROUND

In order to address the neuropsychological pathogenesis of aberrant motor behaviors in Alzheimer's disease (AD), we used a cross-sectional study design to investigate the association between frontal lobe function, including executive function, and activity disturbances (wandering, purposeless activities and inappropriate activities).

METHODS

Among 75 consecutive outpatients with AD, 50 subjects with a Clinical Dementia Rating (CDR) score of 1 or 2 were selected and divided into two groups based on data obtained from interviews with their caregivers: an aberrant motor behaviors (AMB) group (n = 22), and a non-aberrant motor behaviors (NAMB) group (n = 28). Aberrant motor behavior was defined according to whether the "activity disturbance" score (ranging from 0 to 9) of the Behavioral Pathology in Alzheimer Disease (Behave-AD) scale was 0 or >or=1. The total and subtest scores of the Frontal Assessment Battery (FAB) were then compared between the two groups.

RESULTS

Significant differences were found between the FAB total (P < 0.05) and the subtest scores (lexical fluency, conflicting instructions; P < 0.05) in the two groups. The FAB score was significantly associated with the activity disturbance score (r = -0.49; P<0.001). A stepwise multiple regression analysis showed that only the FAB score significantly influenced the activity disturbance score (P < 0.001).

CONCLUSIONS

This finding suggested that in addition to episodic memory disturbance, frontal lobe dysfunctions might lead patients with AD to develop aberrant motor behavior.

摘要

背景

为了探讨阿尔茨海默病(AD)患者异常运动行为的神经心理学发病机制,我们采用横断面研究设计,调查额叶功能(包括执行功能)与活动障碍(徘徊、无目的活动和不适当活动)之间的关系。

方法

在 75 例连续的 AD 门诊患者中,选择 50 例临床痴呆评定量表(CDR)评分为 1 或 2 的患者,并根据与他们的照料者进行访谈获得的数据将他们分为两组:异常运动行为(AMB)组(n = 22)和非异常运动行为(NAMB)组(n = 28)。异常运动行为定义为行为病理阿尔茨海默病量表(Behave-AD)的“活动障碍”评分(范围为 0 至 9)是否为 0 或≥1。然后比较两组的额叶评估量表(FAB)总分和各亚测试评分。

结果

两组间 FAB 总分(P < 0.05)和各亚测试评分(词汇流畅性、矛盾指令;P < 0.05)存在显著差异。FAB 评分与活动障碍评分显著相关(r = -0.49;P < 0.001)。逐步多元回归分析显示,只有 FAB 评分显著影响活动障碍评分(P < 0.001)。

结论

这一发现表明,除了情景记忆障碍外,额叶功能障碍可能导致 AD 患者出现异常运动行为。

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