Neuroscience Research Australia, Sydney, New South Wales, Australia School of Medical Sciences, The University of New South Wales, Sydney, New South Wales, Australia ARC Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales, Australia.
Neuroscience Research Australia, Sydney, New South Wales, Australia ARC Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales, Australia School of Psychology, The University of New South Wales, Sydney, New South Wales, Australia.
J Neurol Neurosurg Psychiatry. 2014 Oct;85(10):1076-83. doi: 10.1136/jnnp-2013-307098. Epub 2014 Feb 25.
Behavioural-variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) patients experience behavioural and emotion recognition alterations, yet understanding of how socioemotional processing is affected with disease progression is minimal. Additionally, evidence suggests that bvFTD patients with limited brain atrophy on neuroimaging at presentation (bvFTD-la) have a more benign course than those with marked atrophy (bvFTD-ma). Longitudinal investigation of these patients, however, is lacking.
We investigated general cognition, emotion recognition and sarcasm detection in 20 bvFTD (8 with limited brain atrophy) and 17 AD patients longitudinally and used mixed models analyses to determine the level and rates of decline across groups over time.
At baseline, all patient groups performed worse than controls on general cognition and emotion recognition measures. The bvFTD-ma group showed significant impairment on the sarcasm detection task compared with controls. Longitudinally, an overall effect of time was present for general cognition (p<0.001); however, the rate of decline did not differ across groups. Trends for interactions between time and diagnosis were observed for both emotion recognition tasks (p=0.055; p=0.062), with the bvFTD-ma group declining more rapidly than AD or bvFTD-la groups. On the sarcasm detection task, the bvFTD-ma and AD patients declined, whereas bvFTD-la patients remained stable over time (p=0.002).
Tasks of sarcasm detection represent a clinically useful tool to differentiate between bvFTD and AD at baseline. Furthermore, tasks of socioemotional functioning can track progression within bvFTD and identify bvFTD patients more likely to show a faster rate of decline.
行为变异型额颞叶痴呆（bvFTD）和阿尔茨海默病（AD）患者存在行为和情绪识别改变，但对于疾病进展如何影响社会情感处理的理解甚少。此外，有证据表明，在影像学上表现为局限性脑萎缩的 bvFTD 患者（bvFTD-la）比那些存在明显萎缩的患者（bvFTD-ma）病程更良性。然而，对这些患者的纵向研究却很少。
我们对 20 名 bvFTD 患者（8 名存在局限性脑萎缩）和 17 名 AD 患者进行了一般认知、情绪识别和讽刺检测的纵向研究，并使用混合模型分析来确定随时间推移各组的水平和下降速度。
在基线时，所有患者组在一般认知和情绪识别测量上的表现均差于对照组。与对照组相比，bvFTD-ma 组在讽刺检测任务中表现出明显的损伤。纵向来看，一般认知存在时间的整体效应（p<0.001）；然而，各组的下降速度没有差异。在两个情绪识别任务中观察到时间与诊断之间的交互作用趋势（p=0.055；p=0.062），bvFTD-ma 组比 AD 或 bvFTD-la 组下降更快。在讽刺检测任务中，bvFTD-ma 和 AD 患者下降，而 bvFTD-la 患者随时间保持稳定（p=0.002）。
讽刺检测任务是区分基线时 bvFTD 和 AD 的一种临床有用工具。此外，社会情感功能任务可以跟踪 bvFTD 内的进展，并识别出更有可能表现出更快下降速度的 bvFTD 患者。
