Memory Clinic, University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland.
Faculty of Psychology, University of Basel, Basel, Switzerland.
J Neurol. 2023 Jul;270(7):3433-3441. doi: 10.1007/s00415-023-11666-6. Epub 2023 Mar 23.
Early-stage behavioural variant frontotemporal dementia (bvFTD) is often misdiagnosed, highlighting the need for new diagnostic instruments. Based on the revised diagnostic criteria for bvFTD, we developed the Behavioural Dysfunction Questionnaire (BDQ). In this explorative study, we aimed to determine the best scoring and analytical method for the BDQ to discriminate between bvFTD and non-bvFTD patients.
34 patients with early-stage bvFTD, 56 with early-stage Alzheimer's disease dementia (ADD) and 41 with major depressive disorder (MDD) were recruited. We calculated BDQ-items with or without inclusion of a time criterion: (a) without time criterion, (b) with 10 years' time criterion (symptom presence less than 10 years), and (c) with 3 years' time criterion (symptom presentation within the first 3 years). Using these three differently calculated items, we generated six variables, i.e. 3*2 [BDQ-Global Score (BDQ-GS; domains average score); BDQ-Global Domain Score (BDQ-GDS; domains categorical score)]. Then, we performed univariate and bivariate (BDQ-GS and BDQ-GDS combined) ROC analyses.
Models including BDQ-GS, BDQ-GDS or both variables combined discriminated similarly between groups. In contrast, models without time criterion or with 10 years' time criterion discriminated better than models including variables with 3 years' time criterion. These models discriminated highly (AUC = 85.98-87.78) between bvFTD and MDD and bvFTD and ADD, respectively.
BDQ-scores without any time criterion discriminated highly between early-stage bvFTD and non-bvFTD groups, which could improve the early diagnosis of bvFTD. With its standardised procedure, the BDQ is also appropriate for repeated assessments.
早期行为变异额颞叶痴呆(bvFTD)常被误诊,这凸显了对新诊断工具的需求。基于修订后的 bvFTD 诊断标准,我们开发了行为障碍问卷(BDQ)。在这项探索性研究中,我们旨在确定 BDQ 的最佳评分和分析方法,以区分 bvFTD 和非 bvFTD 患者。
招募了 34 例早期 bvFTD 患者、56 例早期阿尔茨海默病痴呆(ADD)患者和 41 例重度抑郁症(MDD)患者。我们计算了包含或不包含时间标准的 BDQ 项目:(a)不包含时间标准,(b)包含 10 年时间标准(症状存在少于 10 年),和(c)包含 3 年时间标准(症状发生在最初 3 年内)。使用这三个不同计算的项目,我们生成了六个变量,即 3*2 [BDQ-全球评分(BDQ-GS;域平均评分);BDQ-全球域评分(BDQ-GDS;域分类评分)]。然后,我们进行了单变量和双变量(BDQ-GS 和 BDQ-GDS 组合)ROC 分析。
包括 BDQ-GS、BDQ-GDS 或两个变量组合的模型在组间的区分能力相似。相比之下,不包含时间标准或包含 10 年时间标准的模型比包含 3 年时间标准的变量的模型具有更好的区分能力。这些模型在 bvFTD 和 MDD 以及 bvFTD 和 ADD 之间具有较高的区分能力(AUC=85.98-87.78)。
不包含任何时间标准的 BDQ 评分可以高度区分早期 bvFTD 和非 bvFTD 组,这可以提高 bvFTD 的早期诊断。BDQ 具有标准化程序,也适合重复评估。