School of Psychology, University of Adelaide, Adelaide, Australia.
J Clin Exp Neuropsychol. 2010 Aug;32(7):682-98. doi: 10.1080/13803390903427414. Epub 2010 Jan 8.
The differential diagnosis of Alzheimer's disease (AD) and frontotemporal dementia (FTD) remains a difficult clinical issue. A recent meta-analysis by Hutchinson and Mathias (2007) found that many cognitive tests do not adequately differentiate between these types of dementia. However, their study did not examine the ability of neurobehavioral scales to distinguish between AD and FTD. The data from 33 studies, published between January 1994 and December 2008, examining the neurobehavioral symptoms of persons with AD (N = 2,305) and FTD (N = 971) were therefore analyzed. Weighted Cohen's d effect sizes, percentage overlap statistics, confidence intervals, and fail-safe Ns were calculated for each scale. The most discriminating measures were the Schedules for Clinical Assessment in Neuropsychiatry and the Scale for Emotional Blunting. The Middelheim Frontality Score and the Frontal Behavior Inventory also had excellent discriminative ability, surpassing the cognitive tests examined previously. Numerous other scales additionally showed large and significant differences between the AD and FTD groups, highlighting the importance of assessing neurobehavioral symptoms in this context. While these latter measures may be useful in providing a clinical profile of patients with dementia, greater overlap in the scores of patients with AD and FTD limits their usefulness in the context of differential diagnosis.
阿尔茨海默病（AD）和额颞叶痴呆（FTD）的鉴别诊断仍然是一个临床难题。Hutchinson 和 Mathias（2007 年）最近的一项荟萃分析发现，许多认知测试不能充分区分这两种类型的痴呆。然而，他们的研究并未探讨神经行为量表区分 AD 和 FTD 的能力。因此，分析了 1994 年 1 月至 2008 年 12 月期间发表的 33 项研究的数据，这些研究检查了 AD（N=2305）和 FTD（N=971）患者的神经行为症状。为每个量表计算了加权 Cohen's d 效应大小、百分比重叠统计、置信区间和失效安全 N。最具鉴别力的措施是精神科临床评估时间表和情绪迟钝量表。米德尔海姆额叶评分和额叶行为量表也具有出色的鉴别能力，超过了之前检查的认知测试。其他许多量表也显示出 AD 和 FTD 组之间存在显著差异，强调了在这种情况下评估神经行为症状的重要性。虽然这些后续措施可能有助于为痴呆患者提供临床概况，但 AD 和 FTD 患者的评分存在较大重叠限制了它们在鉴别诊断中的用途。
