Schubert Samantha, Leyton Cristian E, Hodges John R, Piguet Olivier
Neuroscience Research Australia, NSW, Australia.
The Faculty of Health Sciences, The University of Sydney, NSW, Australia.
J Alzheimers Dis. 2016;51(3):775-82. doi: 10.3233/JAD-150802.
Alzheimer's disease (AD) and behavioral-variant of frontotemporal dementia (bvFTD) can present with an overlapping neuropsychological profile, which often hinders their clinical differentiation.
To compare changes over time in memory, general cognition tasks, and functional scales between bvFTD and AD.
Consecutive cases diagnosed with probable bvFTD (n = 22) and typical AD (n = 31) with at least two clinical visits were selected. Of these, 13 (9 AD, 4 bvFTD) underwent Pittsburgh compound B PET scan, which supported the clinical diagnosis in all cases. Mixed-model regressions were used to estimate the differential rate of decline on selected tasks between cohorts.
Analyses demonstrated that, despite equivalent baseline performance, bvFTD patients experienced a more rapid functional deterioration and a steeper decline in global cognition than AD patients. At baseline, both groups were impaired on executive function and memory tasks compared to controls, but these deficits were more marked in the bvFTD group. In addition, performance on these domains continued to decline more rapidly in this group.
Neither the initial neuropsychological assessment nor projected performances can reliably distinguish the totality of bvFTD and AD individuals. Nevertheless, annual rates of progression on cognitive tasks provide valuable information and will potentially help establish the impact of future therapeutic treatments in these dementia syndromes.
阿尔茨海默病（AD）和行为变异型额颞叶痴呆（bvFTD）可能呈现出重叠的神经心理学特征，这常常阻碍它们的临床鉴别。
比较bvFTD和AD在记忆、一般认知任务及功能量表方面随时间的变化。
选取连续诊断为可能的bvFTD（n = 22）和典型AD（n = 31）且至少有两次临床就诊的病例。其中，13例（9例AD，4例bvFTD）接受了匹兹堡化合物B PET扫描，所有病例扫描结果均支持临床诊断。采用混合模型回归估计队列间所选任务的差异衰退率。
分析表明，尽管基线表现相当，但bvFTD患者比AD患者功能恶化更快，整体认知衰退更明显。在基线时，与对照组相比，两组在执行功能和记忆任务方面均受损，但这些缺陷在bvFTD组更为明显。此外，该组在这些领域的表现继续更快下降。
初始神经心理学评估和预测表现均无法可靠地区分所有bvFTD和AD个体。然而，认知任务的年进展率提供了有价值的信息，并可能有助于确定未来治疗对这些痴呆综合征的影响。
