Tautvydaitė D, Antonietti J P, Henry H, von Gunten A, Popp J
Department of Psychiatry, Service of Old Age Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Institute of Psychology, University of Lausanne, Lausanne, Switzerland.
J Psychiatr Res. 2017 Jul;90:12-20. doi: 10.1016/j.jpsychires.2016.12.024. Epub 2017 Feb 4.
Specific changes in personality profiles may represent early non-cognitive symptoms of Alzheimer's disease (AD). Evaluating the subject's personality changes may add significant clinical information, as well as help to better understand the interaction between personality change, cognitive decline, and cerebral pathology. With this study we aimed to describe the relationship between personality changes and cerebrospinal fluid (CSF) markers of AD pathology at early clinical stages of the disease. One hundred and ten subjects, of whom 66 cognitively impaired patients (57 with mild cognitive impairment (MCI), and 9 with mild dementia) and 44 healthy controls, had neuropsychological examination as well as lumbar puncture to determine concentrations of CSF biomarkers of AD pathology (amyloid beta (Aβ), phosphorylated tau (ptau-181), and total-tau (tau)). The Revised NEO Personality Inventory (NEO-PI-R) was administered twice, once to evaluate subjects' current personality and once to assess personality traits retrospectively 5 years before evaluation. Subjects with an AD CSF biomarker profile showed significant increase in neuroticism and decrease in conscientiousness over time as compared to non-AD CSF biomarker group. In regression analysis controlling for global cognition as measured by the MMSE score, increasing neuroticism and decreasing extraversion, openness to experience and conscientiousness were associated with lower Aβ concentrations but not with tau and ptau-181 concentrations. Our findings suggest that early and specific changes in personality are associated with cerebral AD pathology. Concentrations of CSF biomarkers, additionally to severity of the cognitive impairment, significantly contribute in predicting specific personality changes.
人格特征的特定变化可能代表阿尔茨海默病（AD）早期的非认知症状。评估受试者的人格变化可能会增加重要的临床信息，同时有助于更好地理解人格变化、认知衰退和脑病理学之间的相互作用。通过本研究，我们旨在描述疾病早期临床阶段人格变化与AD病理学脑脊液（CSF）标志物之间的关系。110名受试者，其中66名认知受损患者（57名轻度认知障碍（MCI）患者和9名轻度痴呆患者）以及44名健康对照者，接受了神经心理学检查以及腰椎穿刺，以确定AD病理学脑脊液生物标志物（淀粉样β蛋白（Aβ）、磷酸化tau蛋白（ptau-181）和总tau蛋白（tau））的浓度。修订版大五人格量表（NEO-PI-R）进行了两次施测，一次用于评估受试者当前的人格，另一次用于回顾性评估评估前5年的人格特质。与非AD脑脊液生物标志物组相比，具有AD脑脊液生物标志物特征的受试者随着时间的推移神经质显著增加，尽责性显著降低。在以MMSE评分衡量的整体认知进行控制的回归分析中，神经质增加以及外向性、开放性体验和尽责性降低与较低的Aβ浓度相关，但与tau和ptau-181浓度无关。我们的研究结果表明，人格的早期特定变化与脑AD病理学相关。脑脊液生物标志物的浓度，除了认知障碍的严重程度外，在预测特定人格变化方面也有显著贡献。
