晚期阿尔茨海默病和路易体痴呆中镜像征和电视征的患病率及临床意义
Prevalence and Clinical Implications of the Mirror and TV Signs in Advanced Alzheimer's Disease and Dementia with Lewy Bodies.
作者信息
Nagahama Yasuhiro, Fukui Toshiya, Akutagawa Hiroshi, Ohtaki Hiroko, Okabe Momoka, Ito Tatsuya, Suga Hiroko, Fujishiro Hiroshige
机构信息
Department of Psychiatry and Neurology, Kawasaki Memorial Hospital, Kawasaki-city, Japan.
出版信息
Dement Geriatr Cogn Dis Extra. 2020 Mar 26;10(1):56-62. doi: 10.1159/000506510. eCollection 2020 Jan-Apr.
OBJECTIVE
To explore the prevalence and clinical implications of the mirror and TV signs in the moderate to advanced stages of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB).
METHODS
We retrospectively examined the prevalence of clinical and psychiatric symptoms including the mirror and TV signs in 200 subjects with AD and 200 with DLB and evaluated the relationships among the symptoms.
RESULTS
The mirror sign was found in 3.0% of AD and 4.5% of DLB subjects. The TV sign was found in 1.5% of AD and 4.0% of DLB subjects. The prevalence of the mirror and TV signs was not significantly different between the AD and DLB groups. Visual hallucination, visual illusion, misidentification of person, and sleep talking were significantly more frequent in DLB than in AD subjects. The mirror sign was significantly associated with lower Mini-Mental State Examination scores, whereas the TV sign was significantly associated with the misidentification of person.
CONCLUSIONS
Both the mirror and TV signs were rare even in the moderate to advanced stages of AD and DLB. The mirror sign may be independent from other delusional misidentification syndromes (DMSs). Being associated mainly with global cognitive decline, the mirror sign is unlikely attributed to any specific cognitive impairment or the dysfunction of localized brain areas. In contrast, the TV sign was significantly more often coexistent with the misidentification of person, suggesting that the TV sign may partly share common neuropsychological mechanisms with DMSs.
目的
探讨镜像征和电视征在中度至重度阿尔茨海默病（AD）和路易体痴呆（DLB）中的患病率及临床意义。
方法
我们回顾性研究了200例AD患者和200例DLB患者的临床和精神症状，包括镜像征和电视征的患病率，并评估了这些症状之间的关系。
结果
在AD患者中，镜像征的发现率为3.0%，在DLB患者中为4.5%。电视征在AD患者中的发现率为1.5%，在DLB患者中为4.0%。AD组和DLB组的镜像征和电视征患病率无显著差异。DLB患者的视幻觉、视错觉、人物误认和梦呓比AD患者更常见。镜像征与简易精神状态检查得分较低显著相关，而电视征与人物误认显著相关。
结论
即使在AD和DLB的中度至重度阶段，镜像征和电视征也都很罕见。镜像征可能独立于其他妄想性误认综合征（DMS）。主要与整体认知功能下降相关，镜像征不太可能归因于任何特定的认知障碍或局部脑区功能障碍。相比之下，电视征与人物误认同时出现的情况明显更多，这表明电视征可能部分与DMS共享共同的神经心理学机制。
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