Tu Sicong, Spiers Hugo J, Hodges John R, Piguet Olivier, Hornberger Michael
Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, Australia.
FMRIB, Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK.
J Alzheimers Dis. 2017;59(3):883-892. doi: 10.3233/JAD-160592.
Diagnosis of behavioral variant frontotemporal dementia (bvFTD) can be challenging, in particular when patients present with significant memory problems, which can increase the chance of a misdiagnosis of Alzheimer's disease (AD). Growing evidence suggests spatial orientation is a reliable cognitive marker able to differentiate these two clinical syndromes.
Assess the integrity of egocentric and allocentric heading orientation and memory in bvFTD and AD, and their clinical implications.
A cohort of 22 patients with dementia (11 bvFTD; 11 AD) and 14 healthy controls were assessed on the virtual supermarket task of spatial orientation and a battery of standardized neuropsychological measures of visual and verbal memory performance.
Judgements of egocentric and allocentric heading direction were differentially impaired in bvFTD and AD, with AD performing significantly worse on egocentric heading judgements than bvFTD. Both patient cohorts, however, showed similar degree of impaired allocentric spatial representation, and associated hippocampal pathology.
The findings suggest egocentric heading judgements offer a more sensitive discriminant of bvFTD and AD than allocentric map-based measures of spatial memory.
行为变异型额颞叶痴呆（bvFTD）的诊断可能具有挑战性，尤其是当患者出现明显的记忆问题时，这会增加误诊为阿尔茨海默病（AD）的可能性。越来越多的证据表明，空间定向是一种能够区分这两种临床综合征的可靠认知标志物。
评估bvFTD和AD患者以自我为中心和以他为中心的航向定向及记忆的完整性及其临床意义。
对22名痴呆患者（11名bvFTD；11名AD）和14名健康对照者进行了空间定向的虚拟超市任务评估，以及一系列视觉和言语记忆表现的标准化神经心理学测量。
bvFTD和AD患者在以自我为中心和以他为中心的航向方向判断上存在不同程度的受损，AD患者在以自我为中心的航向判断上比bvFTD患者表现明显更差。然而，两个患者队列在以他为中心的空间表征受损程度以及相关海马病理方面表现相似。
研究结果表明，与基于地图的以他为中心的空间记忆测量相比，以自我为中心的航向判断对bvFTD和AD具有更敏感的鉴别作用。
