Schroeter Matthias L, Pawelke Sarah, Bisenius Sandrine, Kynast Jana, Schuemberg Katharina, Polyakova Maryna, Anderl-Straub Sarah, Danek Adrian, Fassbender Klaus, Jahn Holger, Jessen Frank, Kornhuber Johannes, Lauer Martin, Prudlo Johannes, Schneider Anja, Uttner Ingo, Thöne-Otto Angelika, Otto Markus, Diehl-Schmid Janine
Leipzig & Clinic for Cognitive Neurology, University Hospital Leipzig, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
Department of Neurology, University of Ulm, Ulm, Germany.
Front Aging Neurosci. 2018 Jan 30;10:11. doi: 10.3389/fnagi.2018.00011. eCollection 2018.
Behavioral variant frontotemporal dementia (bvFTD) is characterized by deep alterations in behavior and personality. Although revised diagnostic criteria agree for executive dysfunction as most characteristic, impairments in social cognition are also suggested. The study aimed at identifying those neuropsychological and behavioral parameters best discriminating between bvFTD and healthy controls. Eighty six patients were diagnosed with possible or probable bvFTD according to Rascovsky et al. (2011) and compared with 43 healthy age-matched controls. Neuropsychological performance was assessed with a modified Reading the Mind in the Eyes Test (RMET), Stroop task, Trail Making Test (TMT), Hamasch-Five-Point Test (H5PT), and semantic and phonemic verbal fluency tasks. Behavior was assessed with the Apathy Evaluation Scale, Frontal Systems Behavioral Scale, and Bayer Activities of Daily Living Scale. Each test's discriminatory power was investigated by Receiver Operating Characteristic curves calculating the area under the curve (AUC). bvFTD patients performed significantly worse than healthy controls in all neuropsychological tests. Discriminatory power (AUC) was highest in behavioral questionnaires, high in verbal fluency tasks and the RMET, and lower in executive function tests such as the Stroop task, TMT and H5PT. As fluency tasks depend on several cognitive functions, not only executive functions, results suggest that the RMET discriminated better between bvFTD and control subjects than other executive tests. Social cognition should be incorporated into diagnostic criteria for bvFTD in the future, such as in the International Classification of Diseases (ICD)-11, as already suggested in the Diagnostic and Statistical Manual for Mental Disorders (DSM)-5.
行为变异型额颞叶痴呆（bvFTD）的特征是行为和人格发生深刻改变。尽管修订后的诊断标准一致认为执行功能障碍是最典型的特征，但社会认知障碍也被提及。该研究旨在确定那些最能区分bvFTD与健康对照的神经心理学和行为参数。根据拉斯科夫斯基等人（2011年）的标准，86例患者被诊断为可能或很可能患有bvFTD，并与43名年龄匹配的健康对照进行比较。通过改良的“读心术”测试（RMET）、斯特鲁普任务、连线测验（TMT）、哈马施五点测试（H5PT）以及语义和音素言语流畅性任务来评估神经心理学表现。通过冷漠评估量表、额叶系统行为量表和拜耳日常生活活动量表来评估行为。通过计算曲线下面积（AUC）的受试者工作特征曲线来研究每个测试的鉴别力。在所有神经心理学测试中，bvFTD患者的表现明显比健康对照差。行为问卷的鉴别力（AUC）最高，言语流畅性任务和RMET的鉴别力较高，而在执行功能测试如斯特鲁普任务、TMT和H5PT中较低。由于流畅性任务不仅依赖于执行功能，还依赖于多种认知功能，结果表明RMET在区分bvFTD和对照受试者方面比其他执行测试表现更好。未来，社会认知应纳入bvFTD的诊断标准，如《国际疾病分类》（ICD）-11中所建议的，就像《精神疾病诊断与统计手册》（DSM）-5中已经建议的那样。
