Vicente-Alba P, Moreno-Carretero M J, San Millan-Tejado B, Outomuro-Perez J M
Complejo Hospitalario Universitario de Vigo, Vigo, Espana.
Complejo Hospitalario Universitario de Vigo, 36200 Vigo, Espana.
Rev Neurol. 2018 Dec 1;67(11):436-440.
The behavioural variant of frontotemporal dementia is characterised by progressive social, cognitive and personality deterioration associated with several molecular pathologies of frontotemporal lobar dementia (FTLD): FTLD-tau, FTLD-TDP and FTLD-FUS. Its diagnosis requires pathological studies.
A 61-year-old male, with a three-year progressive history of behavioural disorder, apathy, poor language skills, perseveration, lack of empathy, bulimia and executive dysfunction. Neuroimaging revealed right-dominant frontal cortical atrophy, and a single-photon emission tomography brain scan showed bilateral frontal hypoperfusion with thalamic and caudate involvement. Clinically, he was diagnosed with probable frontotemporal dementia, behavioural variant. On his death, his brain was donated to the Neurological Tissue Bank and the neuropathological diagnosis was corticobasal degeneration.
Corticobasal degeneration is one of the FTLD-tau tauopathies. The 2013 diagnostic criteria for corticobasal degeneration include executive dysfunction and behavioural and personality disorders similar to those of this patient as a clinical phenotype. The anatomoclinical case presented illustrates the absence of any correlation between the clinical phenotype and the underlying neuropathological diagnosis in frontotemporal dementia, and the need to conduct a histopathological study in order to reach a definitive diagnosis.
额颞叶痴呆的行为变异型的特征是社会、认知和人格进行性衰退,与额颞叶痴呆(FTLD)的几种分子病理学相关:FTLD- tau、FTLD-TDP和FTLD-FUS。其诊断需要病理研究。
一名61岁男性,有三年行为障碍、冷漠、语言能力差、持续性动作、缺乏同理心、贪食和执行功能障碍的进行性病史。神经影像学显示右侧优势额叶皮质萎缩,单光子发射断层扫描脑扫描显示双侧额叶灌注不足,累及丘脑和尾状核。临床上,他被诊断为可能的额颞叶痴呆,行为变异型。他去世后,其大脑被捐赠给神经组织库,神经病理学诊断为皮质基底节变性。
皮质基底节变性是FTLD- tau蛋白病之一。2013年皮质基底节变性的诊断标准包括执行功能障碍以及与该患者类似的行为和人格障碍作为临床表型。所呈现的解剖临床病例说明了额颞叶痴呆的临床表型与潜在神经病理学诊断之间不存在任何相关性,以及为了得出明确诊断需要进行组织病理学研究。