Jiménez-Huete Adolfo, Riva Elena, Toledano Rafael, Campo Pablo, Esteban Jesús, Barrio Antonio Del, Franch Oriol
Department of Neurology, General Neurology Unit, Hospital Ruber Internacional, Madrid, Spain
Department of Neurology, General Neurology Unit, Hospital Ruber Internacional, Madrid, Spain.
Am J Alzheimers Dis Other Demen. 2014 Dec;29(8):723-31. doi: 10.1177/1533317514534954. Epub 2014 May 16.
The validity of neuropsychological tests for the differential diagnosis of degenerative dementias may depend on the clinical context. We constructed a series of logistic models taking into account this factor.
We retrospectively analyzed the demographic and neuropsychological data of 301 patients with probable Alzheimer's disease (AD), frontotemporal degeneration (FTLD), or dementia with Lewy bodies (DLB). Nine models were constructed taking into account the diagnostic question (eg, AD vs DLB) and subpopulation (incident vs prevalent).
The AD versus DLB model for all patients, including memory recovery and phonological fluency, was highly accurate (area under the curve = 0.919, sensitivity = 90%, and specificity = 80%). The results were comparable in incident and prevalent cases. The FTLD versus AD and DLB versus FTLD models were both inaccurate.
The models constructed from basic neuropsychological variables allowed an accurate differential diagnosis of AD versus DLB but not of FTLD versus AD or DLB.
神经心理学测试用于退行性痴呆鉴别诊断的有效性可能取决于临床背景。我们构建了一系列考虑到这一因素的逻辑模型。
我们回顾性分析了301例可能患有阿尔茨海默病（AD）、额颞叶变性（FTLD）或路易体痴呆（DLB）患者的人口统计学和神经心理学数据。构建了九个模型，考虑了诊断问题（如AD与DLB）和亚组（新发与现患）。
所有患者的AD与DLB模型，包括记忆恢复和语音流畅性，具有高度准确性（曲线下面积 = 0.919，敏感性 = 90%，特异性 = 80%）。新发和现患病例的结果相当。FTLD与AD以及DLB与FTLD模型均不准确。
由基本神经心理学变量构建的模型能够对AD与DLB进行准确的鉴别诊断，但无法对FTLD与AD或DLB进行准确鉴别诊断。
