Zhang L L, Wang Y, Cheng Y, Zhang N
Department of Neurology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Zhonghua Nei Ke Za Zhi. 2017 Dec 1;56(12):903-908. doi: 10.3760/cma.j.issn.0578-1426.2017.12.003.
To compare the differences in cognitive function and behavioral and psychological symptoms between patients with Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD). Thirty-six AD patients and 20 bvFTD patients at mild-to-moderate stage, who were biomarker-confirmed by positron emission tomography (PET), were assessed with a neuropsychological battery and neuropsychiatry inventory (NPI). Cognitive domains, including memory, language, information processing speed and executive function, and behavioral and psychological symptoms were assessed and compared. AD patients had lower scores in immediate recall, delayed recall and recognition than bvFTD patients (all 0.05); while bvFTD patients had poorer performance in language and executive function than AD patients (all 0.05). The NPI total score was significantly higher in patients with bvFTD compared with patients with AD (17.5±5.7 vs 9.3±3.5, 0.05). In respect to the 12 items of NPI, the incidence of agitation and irritability was higher in AD group than in bvFTD group (72.2% vs 35.0%, 55.6% vs 20.0%, all 0.05); while the incidence of apathy, disinhibition, euphoria, aberrant motor behavior and appetite/eating was higher in bvFTD group than in AD group (65.0% vs 33.3%, 80.0% vs 5.5%, 70.0% vs 5.6%, 40.0% vs 11.1%, 50.0% vs 5.6%, all 0.05). Comprehensive neuropsychological assessment and evaluation of behavioral and psychological symptoms of patients with dementia are helpful in distinguishing AD from bvFTD.
比较阿尔茨海默病(AD)患者与行为变异型额颞叶痴呆(bvFTD)患者在认知功能以及行为和心理症状方面的差异。对36例经正电子发射断层扫描(PET)生物标志物确诊的轻至中度阶段的AD患者和20例bvFTD患者进行了神经心理测验和神经精神病学量表(NPI)评估。对包括记忆、语言、信息处理速度和执行功能在内的认知领域以及行为和心理症状进行了评估和比较。AD患者在即刻回忆、延迟回忆和识别方面的得分低于bvFTD患者(均P<0.05);而bvFTD患者在语言和执行功能方面的表现比AD患者差(均P<0.05)。bvFTD患者的NPI总分显著高于AD患者(17.5±5.7 vs 9.3±3.5,P<0.05)。在NPI的12项中,AD组的激越和易激惹发生率高于bvFTD组(72.2% vs 35.0%,55.6% vs 20.0%,均P<0.05);而bvFTD组的淡漠、脱抑制、欣快、异常运动行为和食欲/饮食方面的发生率高于AD组(65.0% vs 33.3%,80.0% vs 5.5%,70.0% vs 5.6%,40.0% vs 11.1%,50.0% vs 5.6%,均P<0.05)。对痴呆患者进行全面的神经心理评估以及行为和心理症状评估有助于区分AD和bvFTD。