Taub Institute for Research on Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Columbia University, 630 West 168th Street, P&S Box 16, New York, NY 10032, USA.
Curr Neurol Neurosci Rep. 2012 Oct;12(5):528-36. doi: 10.1007/s11910-012-0302-7.
Frontotemporal lobar degeneration is an umbrella term for several different disorders. In behavioral variant frontotemporal dementia (bvFTD), patients show deterioration in cognition and social behavior. New diagnostic criteria proposed by the International Behavioral Variant FTD Consortium provide greater sensitivity in diagnosing bvFTD. Current pharmacological management of symptoms relies on medications borrowed from treating Alzheimer's disease (AD) and psychiatric disorders. The evidence for using AD medications such as acetylcholinesterase inhibitors is questionable. Psychiatric medications can be helpful. Trazodone or SSRIs can have some efficacy in reducing disinhibition, repetitive behaviors, sexually inappropriate behaviors, and hyperorality. Small doses of atypical antipsychotics may be helpful in decreasing agitation and verbal outbursts. Nonpharmacological management includes caregiver education and support and behavioral interventions. While symptomatic treatments are likely to remain important behavior management tools, targeting the underlying pathology of bvFTD with disease-modifying agents will hopefully be the future of treatment.
额颞叶痴呆是几种不同疾病的总称。在行为变异额颞叶痴呆（bvFTD）中，患者表现出认知和社交行为的恶化。国际行为变异额颞叶痴呆联合会提出的新诊断标准在诊断 bvFTD 方面具有更高的敏感性。目前对症状的药物治疗依赖于从治疗阿尔茨海默病（AD）和精神疾病中借用的药物。使用乙酰胆碱酯酶抑制剂等 AD 药物的证据值得怀疑。精神科药物可能会有帮助。曲唑酮或 SSRIs 可能对减少脱抑制、重复行为、不适当性行为和过度口渴有一定疗效。小剂量非典型抗精神病药可能有助于减少激越和言语发作。非药物治疗包括对照顾者进行教育和支持以及行为干预。虽然对症治疗可能仍然是重要的行为管理工具，但用改变疾病的药物针对 bvFTD 的潜在病理有望成为未来的治疗方法。
