Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Bipolar Disorders Clinic, Stanford University, Stanford, California.
Biol Psychiatry. 2015 Nov 15;78(10):684-92. doi: 10.1016/j.biopsych.2015.03.028. Epub 2015 Apr 8.
Frontotemporal dementia (FTD) is the most frequently occurring dementia in the presenile population. Despite epidemiologic data showing that patients with FTD may have experienced previous psychiatric disorders and that patients with psychotic disorders may develop dementia more often than expected in the nonaffected population, the overlap between these two conditions has been underestimated. Nevertheless, the identification in recent years of several genetic causes of FTD associated with heterogeneous and atypical presentations, including pure psychiatric symptoms, has shifted scientific interest back to obtaining a better understanding of common mechanisms between FTD and psychotic disorders. We review the current knowledge of the FTD spectrum and common features shared by FTD and some psychiatric diseases, starting from Pick's clinical description of the disease, moving toward pathogenic aspects of the disease and genetic causes and associated phenotypes, and finishing with analysis of crossing borders between FTD and psychiatric disorders (mainly represented by schizophrenia and bipolar spectrum disorders) in clinical practice in terms of overlapping symptoms, differential diagnosis, comorbidity, and treatment issues.
额颞叶痴呆(FTD)是最常见的早发性痴呆。尽管流行病学数据显示,FTD 患者可能经历过先前的精神障碍,而精神障碍患者在非受影响人群中发展为痴呆的可能性高于预期,但这两种情况之间的重叠一直被低估。尽管如此,近年来发现了几种与异质和非典型表现相关的 FTD 遗传原因,包括纯粹的精神症状,这使得科学界重新关注于更好地理解 FTD 和精神障碍之间的共同机制。我们回顾了 FTD 谱系的现有知识以及 FTD 和一些精神疾病之间的共同特征,从匹克临床描述该病开始,转向疾病的发病机制和遗传原因及其相关表型,最后分析 FTD 和精神障碍(主要代表为精神分裂症和双相谱系障碍)在临床实践中的边界交叉问题,包括重叠症状、鉴别诊断、共病和治疗问题。