Suhonen Noora-Maria, Hallikainen Ilona, Hänninen Tuomo, Jokelainen Jari, Krüger Johanna, Hall Anette, Pikkarainen Maria, Soininen Hilkka, Remes Anne M
Medical Research Center, Oulu University Hospital, Oulu, Finland.
Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.
J Alzheimers Dis. 2017;56(4):1241-1251. doi: 10.3233/JAD-160983.
While behavioral symptoms are both early and prevalent features of behavioral variant frontotemporal dementia (bvFTD), they can be present in other types of dementia as well, including Alzheimer's disease (AD) and even mild cognitive impairment (MCI). The Frontal Behavioral Inventory (FBI) was specifically developed to capture the behavioral and personality changes in bvFTD; it has also been modified into a self-administered caregiver questionnaire (FBI-mod). We examined the utility of the FBI-mod in differentiating bvFTD (n = 26), primary progressive aphasia (PPA) (n = 7), AD (n = 53), and MCI (n = 50) patients, and investigated how the FBI-mod may be associated with neuropsychological measures. The bvFTD patients scored significantly higher as compared to all other patient groups on the FBI-mod Total (p < 0.005), Negative (p < 0.005), and Positive (p < 0.01) scores. The cut-off point for the FBI-mod Total score that best discriminated the bvFTD and AD patients in our sample was 16, thus substantially lower than reported for the original FBI. For the bvFTD group, only mild correlations emerged between the FBI-mod and the cognitive measures. However, significant correlations between the FBI-mod and depressive symptoms as measured by the BDI-II were found for bvFTD. This suggests that while behavioral symptoms appear independent from cognitive deficits in bvFTD, they may nevertheless be interrelated with depressive symptoms. We conclude that the FBI-mod is an easily administered behavioral scale that can aid in differential diagnosis of bvFTD and should be used in clinical practice. The FBI-mod may further be considered as an outcome measure in clinical trials.
虽然行为症状是行为变异型额颞叶痴呆(bvFTD)的早期和常见特征,但它们也可能出现在其他类型的痴呆中,包括阿尔茨海默病(AD)甚至轻度认知障碍(MCI)。额叶行为量表(FBI)专门用于捕捉bvFTD中的行为和人格变化;它也已被修改为一份可自行填写的照料者问卷(FBI-mod)。我们研究了FBI-mod在区分bvFTD患者(n = 26)、原发性进行性失语(PPA)患者(n = 7)、AD患者(n = 53)和MCI患者(n = 50)方面的效用,并调查了FBI-mod与神经心理学测量指标之间的关联。与所有其他患者组相比,bvFTD患者在FBI-mod总分(p < 0.005)、负性得分(p < 0.005)和正性得分(p < 0.01)上的得分显著更高。在我们的样本中,最能区分bvFTD和AD患者的FBI-mod总分的临界点为16,因此大大低于原始FBI报告的数值。对于bvFTD组,FBI-mod与认知测量指标之间仅出现了轻度相关性;然而,发现bvFTD患者的FBI-mod与用贝克抑郁量表第二版(BDI-II)测量的抑郁症状之间存在显著相关性。这表明,虽然bvFTD中的行为症状似乎独立于认知缺陷,但它们可能仍与抑郁症状相关。我们得出结论,FBI-mod是一种易于实施的行为量表,可有助于bvFTD的鉴别诊断,应在临床实践中使用。FBI-mod还可进一步被视为临床试验中的一项疗效指标。