Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Neurology. 2013 Feb 5;80(6):569-73. doi: 10.1212/WNL.0b013e3182815485. Epub 2013 Jan 16.
Despite many neuropsychological studies to differentiate subcortical vascular dementia (SVaD) from Alzheimer disease (AD), previous studies did not eliminate confounding effects of mixed Alzheimer and vascular pathology. We aimed to investigate neuropsychological differences between patients with Pittsburgh compound B (PiB)-negative SVaD and those with PiB-positive AD.
We recruited patients who were clinically diagnosed with SVaD or AD and underwent an 11C-PiB-PET scan. All patients with SVaD fulfilled DSM-IV criteria for vascular dementia and had severe white matter hyperintensities. The diagnosis of AD was made on the basis of criteria for probable AD proposed by the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association.
The final patient sample consisted of 44/67 (65.7%) patients with SVaD who tested negative for PiB retention [PiB- SVaD] and 61/68 (89.7%) patients with AD who tested positive for PiB retention [PiB(+) AD]. Patients with PiB- SVaD performed better than patients with PiB(+) AD on both verbal and visual memory tests including delayed recalls of the Seoul verbal learning test and Rey complex figure test. Patients with PiB- SVaD were worse than patients with PiB(+) AD on phonemic fluency of the Controlled Oral Word Association Test and Stroop color test.
Patients with PiB- SVaD were better at memory but worse at frontal function than patients with PiB(+) AD. The differences in memory/frontal functions observed between the 2 groups, however, could not differentiate all individual data due to some overlap in the cutoff threshold.
尽管有许多神经心理学研究旨在区分皮质下血管性痴呆（SVaD）和阿尔茨海默病（AD），但之前的研究并未消除混合阿尔茨海默病和血管病理学的混杂效应。我们旨在研究 Pittsburgh 复合 B（PiB）阴性 SVaD 患者与 PiB 阳性 AD 患者之间的神经心理学差异。
我们招募了临床诊断为 SVaD 或 AD 且接受 11C-PiB-PET 扫描的患者。所有 SVaD 患者均符合血管性痴呆的 DSM-IV 标准，且有严重的白质高信号。AD 的诊断是基于国家神经病学、语言障碍和中风研究所-阿尔茨海默病及相关疾病协会提出的可能 AD 的标准。
最终的患者样本包括 44/67（65.7%）例 PiB 保留阴性的 SVaD 患者[PiB- SVaD]和 61/68（89.7%）例 PiB 保留阳性的 AD 患者[PiB(+) AD]。PiB- SVaD 患者在言语和视觉记忆测试中表现优于 PiB(+) AD 患者，包括首尔言语学习测试和 Rey 复杂图形测试的延迟回忆。PiB- SVaD 患者在受控口头单词联想测试和 Stroop 颜色测试的语音流畅性方面比 PiB(+) AD 患者差。
PiB- SVaD 患者在记忆方面优于 PiB(+) AD 患者，但在额叶功能方面较差。然而，由于截断阈值存在一些重叠，两组之间观察到的记忆/额叶功能差异无法区分所有个体数据。
