Grupo de Neurologia Cognitiva e do Comportamento, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Programa de Pós-Graduação em Neurociências da, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Int J Geriatr Psychiatry. 2021 Dec;36(12):1848-1857. doi: 10.1002/gps.5503. Epub 2021 Feb 20.
Differentiating patients with behavioral variant frontotemporal dementia (bvFTD) from Alzheimer's disease (AD) is important as these two conditions have distinct treatment and prognosis. Using episodic impairment and medial temporal lobe atrophy as a tool to make this distinction has been debatable in the recent literature, as some patients with bvFTD can also have episodic memory impairment and medial temporal lobe atrophy early in the disease.
To compare brain atrophy patterns of patients with bvFTD with and without episodic memory impairment to that of patients with AD.
We analyzed 19 patients with bvFTD, 21 with AD and 21 controls, matched by age, sex, and years of education. They underwent brain MRI and the memory test from the Brief Cognitive Battery (BCB) to assess episodic memory. We then categorized the bvFTD group into amnestic (BCB delayed recall score <7) and non-amnestic.
The amnestic bvFTD group (n = 8) had significant gray matter atrophy in the left parahippocampal gyrus, right cingulate and precuneus regions compared with the nonamnestic group. Compared with AD, amnestic bvFTD had more atrophy in the left fusiform cortex, left insula, left inferior temporal gyrus and right temporal pole, whereas patients with AD had more atrophy in the left hippocampus, left frontal pole and left angular gyrus.
There is a group of amnestic bvFTD patients with episodic memory dysfunction and significant atrophy in medial temporal structures, which poses a challenge in considering only these features when differentiating bvFTD from AD clinically.
区分行为变异型额颞叶痴呆（bvFTD）与阿尔茨海默病（AD）患者非常重要，因为这两种疾病的治疗和预后截然不同。使用情景记忆障碍和内侧颞叶萎缩作为区分这两种疾病的工具在最近的文献中一直存在争议，因为一些 bvFTD 患者在疾病早期也可能出现情景记忆障碍和内侧颞叶萎缩。
比较有和无情景记忆障碍的 bvFTD 患者与 AD 患者的脑萎缩模式。
我们分析了 19 名 bvFTD 患者、21 名 AD 患者和 21 名对照组，这些患者按照年龄、性别和受教育年限进行匹配。他们接受了脑部 MRI 和 Brief Cognitive Battery（BCB）的记忆测试，以评估情景记忆。然后，我们将 bvFTD 组分为遗忘型（BCB 延迟回忆评分<7）和非遗忘型。
遗忘型 bvFTD 组（n=8）与非遗忘型组相比，左侧海马旁回、右侧扣带回和楔前叶区域的灰质萎缩显著。与 AD 相比，遗忘型 bvFTD 患者的左侧梭状回、左侧岛叶、左侧颞下回和右侧颞极萎缩更明显，而 AD 患者的左侧海马、左侧额极和左侧角回萎缩更明显。
存在一组遗忘型 bvFTD 患者，其表现为情景记忆功能障碍和内侧颞叶结构明显萎缩，这在临床上仅考虑这些特征来区分 bvFTD 与 AD 时带来了挑战。
