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左背外侧前额叶皮质萎缩与阿尔茨海默病的额叶功能相关,并加重照料者负担。

Left dorsolateral prefrontal cortex atrophy is associated with frontal lobe function in Alzheimer's disease and contributes to caregiver burden.

作者信息

Matsuoka Kiwamu, Yasuno Fumihiko, Hashimoto Akiko, Miyasaka Toshiteru, Takahashi Masato, Kiuchi Kuniaki, Iida Junzo, Kichikawa Kimihiko, Kishimoto Toshifumi

机构信息

Department of Psychiatry, Nara Medical University, Kashihara, Japan.

Department of Psychiatric and Mental Health Nursing, Nara Medical University, Kashihara, Japan.

出版信息

Int J Geriatr Psychiatry. 2018 May;33(5):703-709. doi: 10.1002/gps.4843. Epub 2017 Dec 27.

Abstract

OBJECTIVE

Caregivers of patients with dementia experience physical and mental deterioration. We have previously reported a correlation between caregiver burden and the Frontal Assessment Battery (FAB) total scores of patients with Alzheimer's disease (AD), especially regarding the dependency factor from the Zarit Burden Interview. The present study aimed to identify an objective biomarker for predicting caregiver burden.

METHODS

The participants were 26 pairs of caregivers and patients with AD and mild-to-moderate dementia. Correlations between regional gray matter volumes in the patients with AD and the FAB total scores were explored by using whole-brain voxel-based morphometric analysis. Path analysis was used to estimate the relationships between regional gray matter volumes, FAB total scores, and caregiver burden based on the Zarit Burden Interview.

RESULTS

The voxel-based morphometric revealed a significant positive correlation between the FAB total scores and the volume of the left dorsolateral prefrontal cortex. This positive correlation persisted after controlling for the effect of general cognitive dysfunction, which was assessed by using the Mini-Mental State Examination. Path analysis revealed that decreases in FAB scores, caused by reduced frontal lobe volumes, negatively affected caregiver burden.

CONCLUSIONS

The present study revealed that frontal lobe function, based on FAB scores, was affected by the volume of the left dorsolateral prefrontal cortex. Decreased scores were associated with greater caregiver burden, especially for the dependency factor. These findings may facilitate the development of an objective biomarker for predicting caregiver burden.

摘要

目的

痴呆症患者的照料者会经历身心衰退。我们之前曾报道过照料者负担与阿尔茨海默病(AD)患者的额叶评估量表(FAB)总分之间存在相关性,特别是在 Zarit 负担访谈中的依赖因子方面。本研究旨在确定一种预测照料者负担的客观生物标志物。

方法

参与者为 26 对 AD 及轻度至中度痴呆患者及其照料者。通过基于体素的全脑形态测量分析,探讨 AD 患者区域灰质体积与 FAB 总分之间的相关性。基于 Zarit 负担访谈,采用路径分析来估计区域灰质体积、FAB 总分与照料者负担之间的关系。

结果

基于体素的形态测量显示,FAB 总分与左侧背外侧前额叶皮质体积之间存在显著正相关。在控制了通过简易精神状态检查表评估的一般认知功能障碍的影响后,这种正相关仍然存在。路径分析表明,额叶体积减小导致的 FAB 评分降低对照料者负担有负面影响。

结论

本研究表明,基于 FAB 评分的额叶功能受左侧背外侧前额叶皮质体积的影响。评分降低与更重的照料者负担相关,尤其是在依赖因子方面。这些发现可能有助于开发一种预测照料者负担的客观生物标志物。

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