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PiB阴性的皮质下血管性痴呆与行为变异型额颞叶痴呆的神经精神特征

Neuropsychiatric characteristics of PiB-negative subcortical vascular dementia versus behavioral variant frontotemporal dementia.

作者信息

Jung Na-Yeon, Kim Hee Jin, Kim Yeo Jin, Kim Seonwoo, Seo Sang Won, Kim Eun-Joo, Na Duk L

机构信息

Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea; Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea; Pusan National University School of Medicine and Medical Research Institute, Pusan, Republic of Korea.

Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.

出版信息

Arch Gerontol Geriatr. 2016 Nov-Dec;67:86-91. doi: 10.1016/j.archger.2016.07.002. Epub 2016 Jul 16.

Abstract

BACKGROUND

Neuropsychiatric symptoms of subcortical vascular dementia (SVaD) are mainly associated with damage to frontal-subcortical circuits and may be similar to symptoms of behavioral variant frontotemporal dementia (bvFTD). The aim of this study was to determine whether the neuropsychiatric manifestations of the Pittsburgh compound B (PiB)-negative SVaD and bvFTD groups differ.

METHODS

We compared the Caregiver-Administered Neuropsychiatry Inventory (CGA-NPI) between 48 patients with PiB(-) SVaD and 31 patients with bvFTD. A stepwise logistic regression was applied to determine the best model to predict SVaD.

RESULTS

The SVaD group showed a higher frequency of depression, whereas the bvFTD group had a higher frequency of elation, aberrant motor behavior and appetite/eating disorders. Regarding NPI subscores, the bvFTD group had greater severity of elation, apathy, disinhibition, aberrant motor behavior and appetite/eating disorders, whereas SVaD did not have significantly higher subscores in any domains. The most predictive models that tend to find suggestions of SVaD, as opposed to bvFTD, are as follows: (1) the presence of depression and the absence of appetite/eating disorders, (2) higher NPI subscores of depression and lower NPI subscores of irritability and aberrant motor behavior.

CONCLUSION

Apart from apathy, SVaD differed from bvFTD in that negative symptoms were more common in SVaD than bvFTD, whereas positive symptoms were predominant in bvFTD compared to SVaD.

摘要

背景

皮质下血管性痴呆(SVaD)的神经精神症状主要与额-皮质下环路受损有关,可能类似于行为变异型额颞叶痴呆(bvFTD)的症状。本研究的目的是确定匹兹堡化合物B(PiB)阴性的SVaD组和bvFTD组的神经精神表现是否存在差异。

方法

我们比较了48例PiB(-)SVaD患者和31例bvFTD患者的照顾者管理的神经精神病学量表(CGA-NPI)。应用逐步逻辑回归来确定预测SVaD的最佳模型。

结果

SVaD组抑郁发生率较高,而bvFTD组欣快、异常运动行为和食欲/饮食障碍的发生率较高。关于NPI子分数,bvFTD组欣快、冷漠、脱抑制、异常运动行为和食欲/饮食障碍的严重程度更高,而SVaD在任何领域的子分数均无显著更高。与bvFTD相比,最能预测SVaD的模型如下:(1)存在抑郁且无食欲/饮食障碍,(2)抑郁的NPI子分数较高,易怒和异常运动行为的NPI子分数较低。

结论

除了冷漠外,SVaD与bvFTD的不同之处在于,与bvFTD相比,消极症状在SVaD中更常见,而与SVaD相比,积极症状在bvFTD中占主导地位。

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