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右侧颞叶额颞叶痴呆变异型:系统评价。

Right Temporal Lobe Variant of Frontotemporal Dementia: Systematic Review.

机构信息

Center for Cognitive Neurology and Neuropsychiatry, Federal University of Goiás.

Department of Neurology, Federal University of Goiás School of Medicine, Goiânia, Goiás, Brazil.

出版信息

Alzheimer Dis Assoc Disord. 2022;36(3):272-279. doi: 10.1097/WAD.0000000000000511. Epub 2022 Jul 21.

Abstract

Frontotemporal dementia corresponds to a heterogenous group of syndromes characterized by progressive changes in behavior and/or language. Approximately 30% of patients with primary progressive aphasia, semantic variant (semantic dementia), present with atrophy in the right cerebral hemisphere, in a rare clinical condition called right temporal variant of frontotemporal dementia (rtvFTD). The objective of the study is to present the main demographic, clinical, neuropsychological, neuroimaging, and pathologic characteristics of rtvFTD patients. A systematic review of the literature was carried out in the PubMed, LILACS, and SCIELO databases between January and March 2022. After the evaluation process, 41 articles were selected, published between 1993 and 2021. We found that rtvFTD presents with severe and progressive prosopagnosia (related to anterior temporal lobe injury) associated with behavioral symptoms-desinibition (51%), apathy (39%), obsessive-compulsive symptoms (37%), changes in eating habits (33%), and depression (28%), which is different from semantic dementia. The most common pathologic pattern is TDP-43, type C. This field of knowledge has few studies (mainly reports and case series) and heterogenous nomenclature, which is a limitation. A multinational longitudinal registry of people with rtvFTD, with standardized assessment and description of symptoms, is necessary to elucidate the characteristics of this entity.

摘要

额颞叶痴呆是一组异质性综合征,其特征为行为和/或语言进行性改变。在原发性进行性失语症(语义痴呆)患者中,约有 30%存在右侧大脑半球萎缩,这种罕见的临床情况称为右侧颞叶额颞叶痴呆变异型(rtvFTD)。本研究旨在介绍 rtvFTD 患者的主要人口统计学、临床、神经心理学、神经影像学和病理学特征。我们于 2022 年 1 月至 3 月在 PubMed、LILACS 和 SCIELO 数据库中进行了文献系统性回顾。经过评估过程,共选择了 41 篇文章,发表时间为 1993 年至 2021 年。我们发现,rtvFTD 表现为严重和进行性面容失认症(与前颞叶损伤有关),伴有行为症状-去抑制(51%)、淡漠(39%)、强迫症状(37%)、饮食习惯改变(33%)和抑郁(28%),这与语义痴呆不同。最常见的病理模式是 TDP-43 型 C。该领域的研究较少(主要是报告和病例系列),且命名不统一,这是一个局限性。有必要建立 rtvFTD 患者的跨国纵向登记处,对症状进行标准化评估和描述,以阐明该实体的特征。

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