Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia.
J Neurol Neurosurg Psychiatry. 2015 Jul;86(7):714-9. doi: 10.1136/jnnp-2014-309445. Epub 2015 Jan 16.
Current evidence suggests that neurocognitive testing has limited practical benefit in distinguishing behavioural-variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD). In this meta-analysis of 30 studies, theory of mind (ToM) performances of 784 individuals with bvFTD (n=273) and AD (n=511) were compared with 671 healthy controls. ToM performances of 227 patients with bvFTD and 229 with AD were also compared in studies matched for general cognition. ToM was impaired in both bvFTD (d=1.79) and AD (d=1.15). In bvFTD, patients were particularly impaired in advanced tasks such as recognition of faux pas and sarcasm (d>2.0). In AD, ToM deficits were relatively modest. In studies matched for general cognition, ToM was significantly impaired in bvFTD in comparision to AD (d=1.29), especially for faux pas recognition (d=1.75). ToM dysfunction is a robust and more specific feature of bvFTD. In contrast, ToM deficits are modest compared with level of general cognitive impairment in AD. In both disorders, longer duration of disease and level of general cognitive impairment are related to relatively more severe ToM deficits. Assessment of ToM can be beneficial for early identification of bvFTD.
目前的证据表明，神经认知测试在区分行为变异型额颞叶痴呆（bvFTD）和阿尔茨海默病（AD）方面的实际效果有限。在这项对 30 项研究的荟萃分析中，对 784 名 bvFTD（n=273）和 AD（n=511）患者以及 671 名健康对照者的心理理论（ToM）表现进行了比较。在匹配一般认知的研究中，还比较了 227 名 bvFTD 患者和 229 名 AD 患者的 ToM 表现。bvFTD（d=1.79）和 AD（d=1.15）患者的 ToM 表现均受损。在 bvFTD 中，患者在高级任务（如识别失礼和讽刺）中的表现尤其受损（d>2.0）。在 AD 中，ToM 缺陷相对较小。在匹配一般认知的研究中，与 AD 相比，bvFTD 患者的 ToM 明显受损（d=1.29），尤其是在识别失礼方面（d=1.75）。ToM 功能障碍是 bvFTD 的一个强有力且更具特异性的特征。相比之下，与 AD 中一般认知损伤的程度相比，ToM 缺陷相对较小。在这两种疾病中，疾病持续时间和一般认知损伤的程度与相对更严重的 ToM 缺陷有关。ToM 评估有助于早期识别 bvFTD。
