Tellechea P, Pujol N, Esteve-Belloch P, Echeveste B, García-Eulate M R, Arbizu J, Riverol M
Departamento de Neurología, Clínica Universidad de Navarra, Pamplona, Navarra, España.
Departamento de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, España.
Neurologia (Engl Ed). 2018 May;33(4):244-253. doi: 10.1016/j.nrl.2015.08.002. Epub 2015 Nov 3.
Early-onset Alzheimer disease (EOAD), which presents in patients younger than 65 years, has frequently been described as having different features from those of late-onset Alzheimer disease (LOAD). This review analyses the most recent studies comparing the clinical presentation and neuropsychological, neuropathological, genetic, and neuroimaging findings of both types in order to determine whether EOAD and LOAD are different entities or distinct forms of the same entity. We observed consistent differences between clinical findings in EOAD and in LOAD. Fundamentally, the onset of EOAD is more likely to be marked by atypical symptoms, and cognitive assessments point to poorer executive and visuospatial functioning and praxis with less marked memory impairment. Alzheimer-type features will be more dense and widespread in neuropathology studies, with structural and functional neuroimaging showing greater and more diffuse atrophy extending to neocortical areas (especially the precuneus). In conclusion, available evidence suggests that EOAD and LOAD are 2 different forms of a single entity. LOAD is likely to be influenced by ageing-related processes.
早发性阿尔茨海默病（EOAD）出现在65岁以下的患者中，人们经常描述它具有与晚发性阿尔茨海默病（LOAD）不同的特征。本综述分析了最近比较这两种类型的临床表现、神经心理学、神经病理学、遗传学和神经影像学研究结果的研究，以确定EOAD和LOAD是不同的实体还是同一实体的不同形式。我们观察到EOAD和LOAD的临床发现存在一致差异。从根本上说，EOAD的发病更可能以非典型症状为特征，认知评估表明执行功能、视觉空间功能和实践能力较差，记忆损害不太明显。在神经病理学研究中，阿尔茨海默病类型的特征会更密集、更广泛，结构和功能神经影像学显示萎缩更大、更弥漫，延伸至新皮质区域（尤其是楔前叶）。总之，现有证据表明EOAD和LOAD是单一实体的两种不同形式。LOAD可能受衰老相关过程的影响。
