Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Departments of Neurology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, South Korea.
J Alzheimers Dis. 2019;69(1):213-225. doi: 10.3233/JAD-190007.
Frontal behavioral impairment (FrBI) is commonly observed in various degenerative diseases and refers to various behavioral symptoms.
We investigated the effects of the presence of FrBI on cortical thickness, and the longitudinal neuropsychological changes in people in the predementia stage.
A total of 794 individuals completed neuropsychological tests and the Frontal Behavioral Inventory (FBI) Questionnaire, and underwent magnetic resonance (MR) scanning. Participants were analyzed and grouped into non-FrBI (FBI = 0) or FrBI (FBI≥1). Cortical thickness was measured on MR images using a surface-based method.
In total, 281 people with subjective cognitive decline (SCD) and 513 with amnestic mild cognitive impairment (aMCI) were assessed for FrBI. Relative to people without FrBI, those with FrBI presented reduced cortical thickness in the frontal, anterior temporal and lateral parietal regions (p < 0.05, FDR corrected). People with FrBI developed Alzheimer's disease, rather than behavioral variant frontotemporal dementia, as observed over seven years. Mixed effects models reported that people with FrBI have greater cognitive decline than those with non-FrBI in multiple domains, including language, memory, and executive functions (p < 0.05, FDR corrected). Furthermore, while negative FrBI symptoms (e.g., deficit behaviors) were associated with greater declines in multiple domains, positive FrBI symptoms (e.g., disinhibition symptoms) were related to declines in visuospatial function and verbal memory. Finally, the occurrence of both types of symptoms correlated with multi-domain cognitive decline.
FrBI predicted worse clinical outcomes, including reduced cortical thickness and cognitive decline, which are not necessarily specific to frontal dysfunction.
额部行为障碍（FrBI）常见于各种退行性疾病，是指各种行为症状。
我们研究 FrBI 对皮质厚度的影响以及处于痴呆前期的个体的纵向神经心理学变化。
共有 794 名个体完成了神经心理学测试和额叶行为量表（FBI）问卷，并进行了磁共振（MR）扫描。我们对参与者进行分析并分为非 FrBI（FBI=0）或 FrBI（FBI≥1）组。使用基于表面的方法在 MR 图像上测量皮质厚度。
共评估了 281 名有主观认知下降（SCD）和 513 名有遗忘型轻度认知障碍（aMCI）的个体的 FrBI。与无 FrBI 的个体相比，FrBI 个体的额部、前颞叶和外侧顶叶区域的皮质厚度降低（p<0.05，经 FDR 校正）。FrBI 患者在 7 年内发展为阿尔茨海默病，而不是行为变异额颞叶痴呆。混合效应模型报告称，FrBI 患者在包括语言、记忆和执行功能在内的多个领域的认知下降程度大于非 FrBI 患者（p<0.05，经 FDR 校正）。此外，虽然负性 FrBI 症状（如缺陷行为）与多个领域的更大下降相关，但正性 FrBI 症状（如去抑制症状）与视空间功能和言语记忆下降相关。最后，这两种类型的症状的发生均与多领域认知下降相关。
FrBI 预测了更差的临床结局，包括皮质厚度降低和认知下降，而这些不一定是额叶功能障碍所特有的。
