Alzheimer Center and Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
J Int Neuropsychol Soc. 2018 Jul;24(6):593-605. doi: 10.1017/S1355617718000115. Epub 2018 Mar 19.
A meta-analysis of the extent, nature and pattern of memory performance in behavioral variant frontotemporal dementia (bvFTD). Multiple observational studies have challenged the relative sparing of memory in bvFTD as stated in the current diagnostic criteria.
We performed a meta-analytic review covering the period 1967 to February 2017 of case-control studies on episodic memory in bvFTD versus control participants (16 studies, 383 patients, 603 control participants), and patients with bvFTD versus those with Alzheimer's disease (AD) (20 studies, 452 bvFTD, 874 AD). Differences between both verbal and non-verbal working memory, episodic memory learning and recall, and recognition memory were examined. Data were extracted from the papers and combined into a common metric measure of effect, Hedges' d.
Patients with bvFTD show large deficits in memory performance compared to controls (Hedges' d -1.10; 95% confidence interval [CI] [-1.23, -0.95]), but perform significantly better than patients with AD (Hedges' d 0.85; 95% CI [0.69, 1.03]). Learning and recall tests differentiate best between patients with bvFTD and AD (p<.01). There is 37-62% overlap in test scores between the two groups.
This study points to memory disorders in patients with bvFTD, with performance at an intermediate level between controls and patients with AD. This indicates that, instead of being an exclusion criterion for bvFTD diagnosis, memory deficits should be regarded as a potential integral part of the clinical spectrum. (JINS, 2018, 24, 593-605).
对行为变异型额颞叶痴呆(bvFTD)的记忆表现程度、性质和模式进行荟萃分析。多项观察性研究对当前诊断标准中所述的 bvFTD 记忆相对保留提出了挑战。
我们对 1967 年至 2017 年 2 月间关于 bvFTD 与对照组参与者(16 项研究,383 名患者,603 名对照组参与者)以及 bvFTD 与阿尔茨海默病(AD)患者(20 项研究,452 名 bvFTD,874 名 AD)的情景记忆病例对照研究进行了荟萃分析回顾。检查了两种口头和非口头工作记忆、情景记忆学习和回忆以及识别记忆之间的差异。从论文中提取数据并合并为一个共同的效应度量,Hedges' d。
与对照组相比,bvFTD 患者的记忆表现存在较大缺陷(Hedges' d -1.10;95%置信区间[CI] [-1.23,-0.95]),但与 AD 患者相比,其表现明显更好(Hedges' d 0.85;95%CI [0.69,1.03])。学习和回忆测试能最好地区分 bvFTD 和 AD 患者(p<.01)。两组之间的测试分数有 37-62%的重叠。
本研究指出了 bvFTD 患者的记忆障碍,其表现处于对照组和 AD 患者之间的中间水平。这表明,记忆缺陷不应作为 bvFTD 诊断的排除标准,而应被视为临床谱的潜在组成部分。(JINS,2018,24,593-605)。