Huang Nancy, Hornberger Michael, Hodges John R, Burrell James R
Neuroscience Research Australia, Barker Street, Randwick, Sydney, NSW 2031, Australia.
J Neurol. 2014 Aug;261(8):1598-605. doi: 10.1007/s00415-014-7389-5. Epub 2014 Jun 4.
Corticobasal syndrome (CBS) is a complex neurodegenerative disorder with marked clinical, neuropsychological, and pathological heterogeneity. Measurement of disease progression in CBS is complex and little understood. This study aimed to establish clinical and neuropsychological indicators of prognosis in CBS. Patients with CBS were retrospectively recruited from a frontotemporal dementia specific research clinic. All patients underwent detailed clinical and neuropsychological testing including the frontotemporal dementia rating scale (FRS). Using the differences in FRS logit scores over a period of 12 months, CBS patients were divided into rapid and slow progressor groups. Demographic, clinical and neuropsychological features were compared between the two groups. Sixteen participants who met defined criteria were included (9 males, 7 females; mean age 65.8 ± 22 years; median symptom duration 51.8 ± 22 years; mean duration of follow-up 11.4 ± 2.8 months). There were no significant differences between the rapid and slow progressors in age, gender, symptom duration, motor/cognitive presentation, and ACE-R scores at baseline. Clinically, slow progressors were significantly more likely to have a motor speech disorder, with a trend for more frequent dysgraphia, whereas rapid progressors were more likely to exhibit surface dyslexia. Rapid and slow progressor groups did not differ on neuropsychological performance. The presence of motor speech disorder, dysgraphia, and surface dyslexia may be useful in differentiating patients with rapid progression of CBS from those with a more indolent disease course.
皮质基底节综合征(CBS)是一种复杂的神经退行性疾病,具有显著的临床、神经心理学和病理学异质性。CBS疾病进展的测量很复杂,人们对此了解甚少。本研究旨在确立CBS预后的临床和神经心理学指标。从一个额颞叶痴呆专科研究诊所回顾性招募CBS患者。所有患者均接受了详细的临床和神经心理学测试,包括额颞叶痴呆评定量表(FRS)。利用12个月期间FRS逻辑得分的差异,将CBS患者分为快速进展组和缓慢进展组。比较两组的人口统计学、临床和神经心理学特征。纳入了16名符合既定标准的参与者(9名男性,7名女性;平均年龄65.8±22岁;症状持续时间中位数51.8±22年;平均随访时间11.4±2.8个月)。快速进展组和缓慢进展组在年龄、性别、症状持续时间、运动/认知表现以及基线时的ACE-R得分方面无显著差异。临床上,缓慢进展者更有可能出现运动性言语障碍,书写障碍更为常见,而快速进展者更有可能表现出表层失读症。快速进展组和缓慢进展组在神经心理学表现上没有差异。运动性言语障碍、书写障碍和表层失读症的存在可能有助于区分CBS快速进展患者和病程较缓慢的患者。