Department of Neurology, Diakonessenhuis, PO Box 80250, 3508 TG, Utrecht, The Netherlands.
J Neurol Neurosurg Psychiatry. 2012 Dec;83(12):1145-8. doi: 10.1136/jnnp-2012-302437. Epub 2012 Aug 29.
Disproportionate medial temporal lobe atrophy (MTA) is an early finding in Alzheimer's disease (AD). Episodic memory impairment in AD is associated with the degree of MTA. Episodic memory impairment and MTA are also found in semantic dementia (SD) and in right temporal lobe atrophy (RTLA), the temporal variants of frontotemporal dementia, but their relationship is unclear.
To compare episodic memory impairment among patients with these temporal variants of frontotemporal dementia with that of patients with AD with the same degree of MTA.
Episodic memory was tested with the visual association test, and semantic memory (SM) with animal fluency and the visual association naming test. MTA was measured using a visual rating scale. Each patient with SD or RTLA was matched for MTA with two patients with AD. Comparisons of episodic memory and SM were made for patients with SD versus matched patients with AD; patients with RTLA versus matched patients with AD and for SD, RTLA and all patients with AD.
27 patients with SD and 11 with RTLA were matched with 54 and 22 patients with AD, respectively. Episodic memory was less impaired in patients with SD than in those with AD (8 versus 2; p<0.001) and in patients with RTLA than in those with AD (10 versus 4.5; p=0.009). Semantic memory was more affected in patients with SD than in those with AD, and the Mini Mental State Examination score was higher in patients with RTLA than in those with AD. Comparison of the three diagnostic groups showed that episodic memory was most impaired in AD, whereas SM was most impaired in SD.
Since episodic memory impairment is more severe in AD than in SD and RTLA, despite a comparable degree of MTA, atrophy of the medial temporal lobe alone cannot account for episodic memory dysfunction.
阿尔茨海默病（AD）中存在不成比例的内侧颞叶萎缩（MTA），是早期发现。AD 中的情景记忆损伤与 MTA 的程度相关。情景记忆损伤和 MTA 也存在于语义性痴呆（SD）和右侧颞叶萎缩（RTLA）中，这两种疾病都是额颞叶痴呆的颞叶变异型，但它们之间的关系尚不清楚。
比较这些额颞叶痴呆的颞叶变异型患者与 MTA 程度相同的 AD 患者之间的情景记忆损伤。
使用视觉联想测验测试情景记忆，使用动物流畅性和视觉联想命名测验测试语义记忆（SM）。使用视觉评分量表测量 MTA。将每位 SD 或 RTLA 患者与 2 位 AD 患者按 MTA 匹配。比较 SD 患者与匹配的 AD 患者、RTLA 患者与匹配的 AD 患者以及 SD、RTLA 和所有 AD 患者之间的情景记忆和 SM。
27 例 SD 患者和 11 例 RTLA 患者分别与 54 例和 22 例 AD 患者匹配。与 AD 患者相比，SD 患者的情景记忆损伤程度较轻（8 分比 2 分；p<0.001），RTLA 患者的情景记忆损伤程度较轻（10 分比 4.5 分；p=0.009）。与 AD 患者相比，SD 患者的语义记忆损伤更严重，RTLA 患者的 Mini 精神状态检查得分更高。比较这三个诊断组，AD 患者的情景记忆损伤最严重，而 SD 患者的 SM 损伤最严重。
尽管 MTA 程度相似，但与 AD 相比，SD 和 RTLA 患者的情景记忆损伤更严重，单纯内侧颞叶萎缩不能解释情景记忆功能障碍。
