Department of Old Age Psychiatry, GGZinGeest, VU University Medical Center, Amsterdam, The Netherlands; Alzheimer Centre & Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
Department of Old Age Psychiatry, GGZinGeest, VU University Medical Center, Amsterdam, The Netherlands.
Am J Geriatr Psychiatry. 2018 May;26(5):569-579. doi: 10.1016/j.jagp.2017.12.008. Epub 2018 Feb 1.
Although deficits in social cognition are established as core features in behavioral variant frontotemporal dementia (bvFTD), it remains unresolved if impaired social cognition distinguishes bvFTD from the broad differential diagnoses in clinical practice. Our aim was to study whether social cognition discriminates bvFTD from other neurodegenerative diseases and psychiatric disorders in patients presenting with late-onset frontal symptoms. Next, we studied the association of social cognition with frontal symptoms and cognitive functioning.
In this longitudinal multicenter study, besides clinical rating scales for frontal symptoms, social cognition was determined by Ekman 60 Faces test and Faux Pas in addition to neuropsychological tests for other cognitive domains in patients with probable and definite bvFTD (N = 22), other neurodegenerative diseases (N = 24), and psychiatric disorders (N = 33). Median symptom duration was 2.8 years, and patients were prospectively followed over 2 years.
Total scores from Ekman 60 Faces test were significantly lower in bvFTD than in other neurodegenerative diseases and psychiatric disorders. Ekman 60 Faces test explained 91.2% of the variance of psychiatric disorders and other neurodegenerative diseases versus bvFTD (χ = 11.02, df = 1, p = 0.001) and was associated with all other cognitive domains. Faux Pas and the other cognitive domains did not differ between these diagnostic groups.
In this clinical sample Ekman 60 Faces test distinguished bvFTD successfully from other neurodegenerative diseases and psychiatric disorders. Although associated with social cognition, other cognitive domains were not discriminative. This study provides arguments to add the Ekman 60 Faces test to the neuropsychological examination in the diagnostic procedure of bvFTD.
尽管社会认知缺陷已被确定为行为变异额颞叶痴呆（bvFTD）的核心特征，但受损的社会认知是否能将 bvFTD 与临床实践中的广泛鉴别诊断区分开来仍未得到解决。我们的目的是研究社会认知是否能将 bvFTD 与其他神经退行性疾病和精神障碍患者的迟发性额症状区分开来。接下来，我们研究了社会认知与额症状和认知功能的关系。
在这项纵向多中心研究中，除了用于额症状的临床评分量表外，我们还使用 Ekman 60 张面孔测试和 faux pas 来确定社会认知，此外还对可能和明确的 bvFTD（N=22）、其他神经退行性疾病（N=24）和精神障碍患者进行了其他认知领域的神经心理学测试。中位症状持续时间为 2.8 年，患者前瞻性随访 2 年。
bvFTD 的 Ekman 60 张面孔测试总分明显低于其他神经退行性疾病和精神障碍。Ekman 60 张面孔测试解释了 bvFTD 与其他神经退行性疾病和精神障碍之间 91.2%的方差（χ=11.02，df=1，p=0.001），并与所有其他认知领域相关。 faux pas 和其他认知领域在这些诊断组之间没有差异。
在这个临床样本中，Ekman 60 张面孔测试成功地将 bvFTD 与其他神经退行性疾病和精神障碍区分开来。尽管与社会认知相关，但其他认知领域没有区别。这项研究为在 bvFTD 的诊断程序中添加 Ekman 60 张面孔测试到神经心理学检查提供了论据。
