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额颞叶痴呆:探讨遗传学的分散先兆及其与葡萄糖代谢、双相情感障碍和肌萎缩侧索硬化症的关系。

Frontotemporal dementia: Addressing the scattered harbingers of genetics and its relationship with glucose metabolism, bipolar disorder, and amyotrophic lateral sclerosis.

机构信息

Department of Neurology, Bharati Vidyapeeth University Medical College, Pune, India.

Department of Neurology, Shadan Institute of Medical Sciences, Hyderabad, India.

出版信息

Dis Mon. 2023 May;69(5):101545. doi: 10.1016/j.disamonth.2023.101545. Epub 2023 Mar 14.

Abstract

Frontotemporal Dementia, also known by the name Pick's disease, is a rare form of dementia that can run for several generations. The two key characteristics are argyrophilic, spherical intraneuronal inclusions, which most frequently impact the frontal and temporal poles, and localized cortical atrophy (Pick bodies). Although personality decline and memory loss are frequently more severe than the visuospatial and apraxia disorders that are common in Alzheimer's disease, clinical overlap with other non-Alzheimer degenerative disorders is being increasingly recognized. The limbic system, which includes the hippocampus, entorhinal cortex, and amygdala, typically experiences the greatest levels of neuronal loss and degeneration. In the hippocampus's dentate fascia, several Pick bodies are frequently seen. Leukoencephalopathy and inflated cortical neurons are less specific symptoms (Pick cells). In this paper, we review the factors leading to Picks disease along with its pathophysiology, clinical manifestations, diagnosis, imaging, treatment, prognosis, and a comprehensive discussion on the same. We have also discussed the relationship of frontotemporal dementia with glucose metabolism, bipolar disorder, and amyotrophic lateral sclerosis, all of which are emerging fields of interest and need more studies.

摘要

额颞叶痴呆,又称皮克病,是一种罕见的痴呆症,可遗传数代。其两个关键特征是嗜银性、球形的神经元内包涵体,这些包涵体最常影响额叶和颞叶极,以及局部皮质萎缩(Pick 体)。尽管人格下降和记忆力丧失通常比阿尔茨海默病中常见的视觉空间和失用障碍更为严重,但越来越多的人认识到与其他非阿尔茨海默病退行性疾病的临床重叠。包括海马体、内嗅皮层和杏仁核在内的边缘系统通常经历最大程度的神经元丧失和退化。在海马体的齿状回 fascia 中,经常可以看到多个 Pick 体。脑白质病和膨胀的皮质神经元是不太特异的症状(Pick 细胞)。本文综述了皮克病的发病机制及其发病机制、临床表现、诊断、影像学、治疗、预后,并对其进行了全面讨论。我们还讨论了额颞叶痴呆与葡萄糖代谢、双相情感障碍和肌萎缩侧索硬化症的关系,这些都是新兴的研究领域,需要更多的研究。

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