Grossi Dario, De Lucia Natascia, Milan Graziella, Trojano Luigi
1Neuropsychology Lab,Department of Psychology,Second University of Naples,Caserta,Italy.
2Geriatric Centre Frullone ASL NA/1,Naples,Italy.
J Int Neuropsychol Soc. 2015 Jan;21(1):1-7. doi: 10.1017/S135561771400099X. Epub 2014 Nov 17.
Environmental dependency (ED) phenomena, including utilization behavior and imitation behavior, are clinical manifestations typically observed in patients with the behavioral variant of fronto-temporal dementia (bvFTD), who may also show the closing-in (CI) phenomenon. Here, we explored the neuropsychological correlates of ED and CI in bvFTD, and the association of ED with CI to clarify the mechanisms underlying these clinical manifestations. Thirty-one bvFTD patients underwent a wide cognitive assessment in addition to special tasks to detect occurrence of CI and ED phenomena. Both ED and CI phenomena were present in more than half of the sample. Logistic regression analyses revealed that both ED and CI phenomena were significantly associated with poor scores on frontal neuropsychological tests. Although ED and CI often co-occurred, 3/12 patients with CI did not show ED, and 5/18 patients with ED did not show CI. A logistic regression model showed that the presence of ED was not significantly associated to CI. CI and ED are associated to progressive derangement of frontal functions in bvFTD. However, specific frontal dysfunctions might explain the occurrence of either phenomenon in isolation.
环境依赖（ED）现象，包括利用行为和模仿行为，是额颞叶痴呆行为变异型（bvFTD）患者典型的临床表现，这类患者也可能出现趋近现象（CI）。在此，我们探究了bvFTD中ED和CI的神经心理学关联，以及ED与CI的相关性，以阐明这些临床表现背后的机制。31例bvFTD患者除了接受检测CI和ED现象发生的特殊任务外，还接受了广泛的认知评估。样本中超过半数患者同时存在ED和CI现象。逻辑回归分析显示，ED和CI现象均与额叶神经心理学测试得分较低显著相关。尽管ED和CI经常同时出现，但12例CI患者中有3例未表现出ED，18例ED患者中有5例未表现出CI。逻辑回归模型显示，ED的存在与CI无显著关联。CI和ED与bvFTD中额叶功能的进行性紊乱有关。然而，特定的额叶功能障碍可能单独解释任一现象的发生。
