遗忘型与行为型痴呆的神经病理学相关的冷漠和抑制障碍。
Apathy and Disinhibition Related to Neuropathology in Amnestic Versus Behavioral Dementias.
机构信息
1 Cognitive Neurology and Alzheimer's Disease Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
2 Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
出版信息
Am J Alzheimers Dis Other Demen. 2019 Aug;34(5):337-343. doi: 10.1177/1533317519853466. Epub 2019 Jun 6.
OBJECTIVES
Investigating the frequency of apathy and disinhibition in patients clinically diagnosed with dementia of the Alzheimer type (DAT) or behavioral variant frontotemporal dementia (bvFTD) with neuropathology of either Alzheimer disease (AD) or frontotemporal lobar degeneration (FTLD).
METHODS
Retrospective data from 887 cases were analyzed, and the frequencies of apathy and disinhibition were compared at baseline and longitudinally in 4 groups: DAT/AD, DAT/FTLD, bvFTD/FTLD, and bvFTD/AD.
RESULTS
Apathy alone was more common in AD (33%) than FTLD (25%), and the combination of apathy and disinhibition was more common in FTLD (43%) than AD (14%; < .0001). Over time, apathy became more frequent in AD with increasing dementia severity (33%-41%; < .006).
CONCLUSIONS
Alzheimer disease neuropathology had the closest association with the neuropsychiatric symptom of apathy, while FTLD was most associated with the combination of apathy and disinhibition. Over time, the frequency of those with apathy increased in both AD and FTLD neuropathology.
目的
调查经临床诊断为阿尔茨海默病型痴呆（DAT）或行为变异额颞叶痴呆（bvFTD）且具有阿尔茨海默病（AD）或额颞叶变性（FTLD）神经病理学的患者中出现淡漠和去抑制的频率。
方法
分析了 887 例病例的回顾性数据，并在 4 组患者中比较了基线时和纵向的淡漠和去抑制频率：DAT/AD、DAT/FTLD、bvFTD/FTLD 和 bvFTD/AD。
结果
单纯淡漠在 AD（33%）中比 FTLD（25%）更常见，而淡漠和去抑制的组合在 FTLD（43%）中比 AD（14%；<.0001）更常见。随着痴呆严重程度的增加，AD 中淡漠的频率也会增加（33%-41%；<.006）。
结论
AD 神经病理学与神经精神症状淡漠关系最密切，而 FTLD 与淡漠和去抑制的组合关系最密切。随着时间的推移，AD 和 FTLD 神经病理学患者中出现淡漠的频率均增加。
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