Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil.
Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil.
J Alzheimers Dis. 2018;66(4):1577-1585. doi: 10.3233/JAD-180528.
The behavioral variant frontotemporal dementia (bvFTD) shares some clinical features with severe mental disorders, such as bipolar affective disorder (BAD), schizophrenia (SCZ), and schizoaffective disorder (SZA), and at least for a small subgroup of patients, these conditions may share similar pathological genetic mutations.
To investigate the frequency of a past medical history satisfying diagnostic criteria for BAD, SCZ, and SZA in a bvFTD outpatient sample, and to compare the clinical profile of patients with and without a positive history.
Cross-sectional study in which participants were consecutively selected after receiving a diagnosis of probable bvFTD and had a caregiver interviewed with SCID-I. The sample was categorized into two groups: with (bvFTD+) or without (bvFTD-) prior medical history satisfying diagnostic criteria for BAD/SCZ/SZA. Subjects went through cognitive, functional, and neuropsychiatric evaluations.
Overall, 46 bvFTD patients were included; bvFTD+ patients accounted for 36.9% of the sample. The main nosology fulfilling criteria was BAD (76.5%). The groups differed in Neuropsychiatric Inventory scores (p = 0.01), use of antipsychotics (p = 0.01), family history of psychosis (p = 0.01), presence of primitive reflexes (p = 0.04), Frontal Assessment Battery performance (p = 0.01), Ekman's facial emotion recognition test (p = 0.03), frequency of apathy (p = 0.03), and stereotyped behavior (p = 0.01). All these parameters were more frequent/worse in the bvFTD+ group.
A prior medical history compatible with BAD/SCZ/SZA was found in more than 1/3 of this sample of bvFTD patients and was associated with subtle distinctive clinical features.
行为变异额颞叶痴呆（bvFTD）与一些严重的精神障碍具有一些相似的临床特征，例如双相情感障碍（BAD）、精神分裂症（SCZ）和分裂情感障碍（SZA），并且对于一小部分患者来说，这些疾病可能具有相似的病理性遗传突变。
调查在 bvFTD 门诊患者样本中，满足 BAD、SCZ 和 SZA 诊断标准的既往病史的频率，并比较具有和不具有阳性病史患者的临床特征。
这是一项横断面研究，研究对象为被诊断为可能的 bvFTD 并接受 SCID-I 访谈的连续患者。该样本分为两组：具有（bvFTD+）或不具有（bvFTD-）满足 BAD/SCZ/SZA 诊断标准的既往病史。患者接受认知、功能和神经心理评估。
总体而言，共纳入 46 例 bvFTD 患者；bvFTD+患者占样本的 36.9%。满足标准的主要疾病诊断是 BAD（76.5%）。两组在神经精神病学量表评分（p=0.01）、抗精神病药物使用（p=0.01）、精神病家族史（p=0.01）、原始反射存在（p=0.04）、额叶评估量表表现（p=0.01）、Ekman 的面部情绪识别测试（p=0.03）、淡漠（p=0.03）和刻板行为（p=0.01）的频率方面存在差异。所有这些参数在 bvFTD+组中更频繁/更差。
在该 bvFTD 患者样本中，超过 1/3 的患者存在与 BAD/SCZ/SZA 相符的既往病史，且与细微独特的临床特征相关。
