Center for Aging Brain and Dementia, Department of Neurology, University of Brescia, Brescia, Italy.
Eur J Neurol. 2010 May;17(5):703-7. doi: 10.1111/j.1468-1331.2009.02911.x. Epub 2009 Dec 29.
Frontotemporal Lobar Degeneration (FTLD) is a heterogeneous disorder characterized by impairment in executive functions, behavioural disturbance and language deficit. Reliable scales of global impairment are under evaluation. A consortium of Mayo Clinic and University of California FTLD Centers has recently developed the FTLD-modified Clinical Dementia Rating (CDR) scale to assess FTLD severity.
To evaluate whether FTLD-modified CDR scores correlate with the pattern and degree of brain SPECT hypoperfusion in patients with FTLD.
Ninety-nine patients with FTLD entered the study. Patients underwent a clinical evaluation and a wide standardized neuropsychological assessment, including mini-mental state examination (MMSE) and FTLD-modified CDR. A brain SPECT perfusion imaging study was carried out in each patient. A linear correlation analysis between frontotemporal dementia-modified CDR or neuropsychological tests scores and perfusion data was performed.
There was a significant relationship between higher FTLD-modified CDR score and lower global regional cerebral blood flow in the frontal and temporal lobes, bilaterally. No significant correlation between MMSE and brain frontotemporal hypoperfusion was found. The correlation between brain hypoperfusion pattern and neuropsychological test scores tapping different cognitive domains fitted with previously published data.
The recently introduced FTLD-modified CDR scale correlates with the degree of frontotemporal hypoperfusion in patients with FTLD. This study confirms and further supports the usefulness of FTLD-modified CDR in future clinical trials to monitor disease progression.
额颞叶痴呆（FTLD）是一种异质性疾病，其特征是执行功能障碍、行为障碍和语言缺陷。目前正在评估可靠的总体损伤量表。梅奥诊所和加利福尼亚大学 FTLD 中心的一个联合会最近开发了 FTLD 改良临床痴呆评定量表（CDR），以评估 FTLD 的严重程度。
评估 FTLD 改良 CDR 评分是否与 FTLD 患者大脑 SPECT 低灌注的模式和程度相关。
99 例 FTLD 患者入组本研究。患者接受临床评估和广泛的标准化神经心理学评估，包括简易精神状态检查（MMSE）和 FTLD 改良 CDR。每位患者均进行脑 SPECT 灌注成像研究。对 FTLD 改良 CDR 或神经心理学测试评分与灌注数据之间进行线性相关分析。
FTLD 改良 CDR 评分较高与额叶和颞叶双侧大脑区域的全脑血流灌注降低显著相关。MMSE 与大脑额颞叶低灌注之间无显著相关性。大脑低灌注模式与不同认知领域神经心理学测试评分之间的相关性与先前发表的数据一致。
最近引入的 FTLD 改良 CDR 量表与 FTLD 患者的额颞叶低灌注程度相关。本研究证实并进一步支持 FTLD 改良 CDR 在未来临床试验中监测疾病进展的有用性。
