Victoroff Jeff, Lin Feng V, Coburn Kerry L, Shillcutt Samuel D, Voon Valerie, Ducharme Simon
From the Department of Psychiatry, University of Southern California, Rancho Palos Verdes, Calif. (JV); the Departments of Nursing, Psychiatry, Neuroscience, and Brain and Cognitive Science, University of Rochester, Rochester, N.Y. (FVL); the Department of Psychiatry, Mercer University School of Medicine, Macon, Ga. (KLC, SDS); the University of Cambridge, Department of Psychiatry, Cambridge, United Kingdom, and Cambridgeshire and Peterborough NHS Foundation Trust (VV); and the Departments of Psychiatry, Neurology and Neurosurgery, Montreal Neurological Institute and McGill University Health Centre, McGill University, Montreal, Quebec, Canada (SD).
J Neuropsychiatry Clin Neurosci. 2018 Winter;30(1):14-21. doi: 10.1176/appi.neuropsych.16080155. Epub 2017 Sep 6.
Alzheimer's disease (AD) is commonly associated with noncognitive behavioral changes (NCBCs). The authors systematically reviewed whether neuroimaging has helped with understanding the pathophysiology, diagnosis, or management of NCBCs associated with AD, including depression, aggression or agitation, anxiety, apathy, psychosis, and sleep disorder. The authors identified dissociable neural substrates with multimodal imaging: depression implicates the lateral and superior prefrontal cortex; apathy and agitation implicate the dorsal anterior cingulate; psychosis implicates right lateralized frontal and medial temporal areas; and anxiety implicates mesial temporal regions. Frontal white matter changes appear to underlie many NCBCs, emphasizing the preventative management of vascular risk factors. Further delineation of underlying neurocircuitry and pathophysiology in larger data sets might lead to biomarker identification for diagnosis and optimizing treatment targets.
阿尔茨海默病（AD）通常与非认知行为改变（NCBCs）相关。作者系统回顾了神经影像学是否有助于理解与AD相关的NCBCs的病理生理学、诊断或管理，这些NCBCs包括抑郁、攻击或激越、焦虑、淡漠、精神病和睡眠障碍。作者通过多模态成像确定了可分离的神经基质：抑郁涉及外侧和前额叶上皮质；淡漠和激越涉及背侧前扣带回；精神病涉及右侧额叶和颞叶内侧区域；焦虑涉及颞叶内侧区域。额叶白质改变似乎是许多NCBCs的基础，强调了对血管危险因素的预防性管理。在更大的数据集中进一步描绘潜在的神经回路和病理生理学可能会导致用于诊断和优化治疗靶点的生物标志物识别。
