Department of Neurology, Dong-A University College of Medicine, Busan, Korea.
J Clin Neurol. 2011 Mar;7(1):19-24. doi: 10.3988/jcn.2011.7.1.19. Epub 2011 Mar 31.
It is particularly difficult to differentiate dementia with Lewy bodies (DLB) from the related dementias of Alzheimer's disease (AD) and Parkinson's disease dementia (PDD). Few studies have been designed to comparatively analyze detailed neuropsychological assessments of DLB patients and patients with AD and PDD.
THREE GROUPS OF PATIENTS PARTICIPATED IN THIS STUDY: 10 with DLB, 76 with AD, and 17 with PDD, who had been diagnosed as probable DLB, AD, and PDD, respectively, according to the clinical criteria of the consortium on DLB, National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorder Association, and the clinical diagnostic criteria for PDD. All patients were evaluated by careful neurological examination with detailed neuropsychological testing.
Significant differences among the three groups were found for attention, memory, and executive function, which included tasks of backward digit span, three-word recall, verbal delayed recall, and the Stroop test. Post hoc analysis revealed that the deficiencies of attention on the digit span task were greater in the DLB group than in the AD and PDD groups. The scores for episodic verbal memory tasks were significantly lower in the DLB and AD groups than in the PDD group. The performance in frontal executive function, as indicated by the Stroop test, was significantly worse in the DLB and PDD groups than in the AD group.
The results of the present study show that the pattern of cognitive dysfunction, in terms of attention, episodic memory, and executive functions, differ between patients with DLB and patients with AD and PDD.
路易体痴呆(DLB)与相关的阿尔茨海默病(AD)和帕金森病痴呆(PDD)的鉴别诊断特别困难。很少有研究旨在比较分析 DLB 患者、AD 患者和 PDD 患者的详细神经心理学评估。
三组患者参与了本研究:10 例 DLB、76 例 AD 和 17 例 PDD,分别根据 DLB 联盟的临床标准、美国国立神经病学与交流障碍和卒中/阿尔茨海默病与相关障碍协会的临床诊断标准和 PDD 的临床诊断标准诊断为可能的 DLB、AD 和 PDD。所有患者均接受详细的神经心理学测试,通过仔细的神经系统检查进行评估。
三组患者在注意力、记忆力和执行功能方面存在显著差异,包括数字跨度倒背、三词回忆、言语延迟回忆和斯特鲁普测试。事后分析显示,DLB 组在数字跨度任务中的注意力缺陷比 AD 和 PDD 组更严重。DLB 和 AD 组的情景语言记忆任务得分明显低于 PDD 组。斯特鲁普测试表明,DLB 和 PDD 组的额叶执行功能明显比 AD 组差。
本研究结果表明,DLB 患者与 AD 和 PDD 患者的认知功能障碍模式不同,表现在注意力、情景记忆和执行功能方面。