Gambogi Leandro Boson, Guimarães Henrique Cerqueira, De Souza Leonardo Cruz, Caramelli Paulo
Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brasil.
Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Neurociências, Belo Horizonte MG, Brasil.
Arq Neuropsiquiatr. 2019 Sep 23;77(9):654-668. doi: 10.1590/0004-282X20190107. eCollection 2019.
To explore the relationship between severe/serious mental illness (SMI) and the behavioral variant of frontotemporal dementia (bvFTD), as the patterns of symptoms and cognitive performance that characterize both disorders share similarities.
We performed a systematic review investigating what has already been published regarding the relationship between bvFTD and SMI. Studies were selected from PubMed and LILACS databases, including those published up to February 12, 2018. The search strategy included the following terms: "frontotemporal dementia" plus "bipolar", OR "frontotemporal dementia" plus "schizophrenia", OR "frontotemporal dementia" plus "schizoaffective". Publications without abstracts, case reports with absent genetic or histopathological confirmation, reviews and non-English language papers were excluded across the search process.
The search on PubMed retrieved 186 articles, of which 42 met eligibility criteria. On the LILACS database, none met the requirements. Generally, three major research aims were identified: 1) to look for frontotemporal lobar degeneration-associated genetic abnormalities in patients with prior SMI; 2) to compare the cognitive profile between patients affected by neurodegenerative disorders and schizophrenic patients; 3) to highlight the association between bvFTD and preceding psychiatric conditions and/or distinguish them both. The investigated mutations were found infrequently in the studied SMI samples. Cross-sectional studies comparing cognitive performance between bvFTD and psychiatric disorders mostly found no remarkable differences. There were only a few case reports identifying definite frontotemporal lobar degeneration in patients with previous psychiatric diagnoses.
The available evidence demonstrates how fragile the current understanding is regarding the association between bvFTD and prior SMI.
探讨重度/严重精神疾病（SMI）与行为变异型额颞叶痴呆（bvFTD）之间的关系，因为这两种疾病的症状模式和认知表现具有相似性。
我们进行了一项系统综述，调查已发表的关于bvFTD与SMI之间关系的研究。研究从PubMed和LILACS数据库中选取，包括截至2018年2月12日发表的研究。检索策略包括以下术语：“额颞叶痴呆”加“双相情感障碍”，或“额颞叶痴呆”加“精神分裂症”，或“额颞叶痴呆”加“分裂情感性障碍”。在整个检索过程中，排除了没有摘要的出版物、缺乏基因或组织病理学确认的病例报告、综述和非英语论文。
在PubMed上的检索共找到186篇文章，其中42篇符合纳入标准。在LILACS数据库中，没有一篇符合要求。一般来说，确定了三个主要研究目标：1）在既往患有SMI的患者中寻找与额颞叶变性相关的基因异常；2）比较神经退行性疾病患者和精神分裂症患者的认知概况；3）强调bvFTD与先前精神疾病之间的关联和/或区分两者。在所研究的SMI样本中很少发现所调查的突变。比较bvFTD和精神疾病患者认知表现的横断面研究大多没有发现显著差异。只有少数病例报告在先前有精神疾病诊断的患者中确定了明确的额颞叶变性。
现有证据表明，目前对bvFTD与既往SMI之间关联的理解是多么薄弱。
