Kovalenko E A, Makhnovich E V, Bogolepova A N, Osinovskaya N A, Beregov M M
Pirogov Russian National Research Medical University, Moscow, Russia.
Federal Center of Brain Research and Neurotechnologies, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2024;124(4. Vyp. 2):56-63. doi: 10.17116/jnevro202412404256.
The most common cause of severe cognitive impairment in adults is Alzheimer's disease (AD). Depending on the age of onset, AD is divided into early (<65 years) and late (≥65 years) forms. Early-onset AD (EOAD) is significantly less common than later-onset AD (LOAD) and accounts for only about 5-10% of cases. However, its medical and social significance, as a disease leading to loss of ability to work and legal capacity, as well as premature death in patients aged 40-64 years, is extremely high. Patients with EOAD compared with LOAD have a greater number of atypical clinical variants - 25% and 6-12.5%, respectively, which complicates the differential diagnosis of EOAD with other neurodegenerative diseases. However, the typical classical amnestic variant predominates in both EOAD and LOAD. Also, patients with EOAD have peculiarities according to neuroimaging data: when performing MRI of the brain, patients with EOAD often have more pronounced parietal atrophy and less pronounced hippocampal atrophy compared to patients with LOAD. The article pays attention to the features of the clinical and neuroimaging data in patients with EOAD; a case of a patient with EOAD is presented.
成年人严重认知障碍最常见的病因是阿尔茨海默病（AD）。根据发病年龄，AD分为早发型（<65岁）和晚发型（≥65岁）。早发型AD（EOAD）明显比晚发型AD（LOAD）少见，仅占病例的5%-10%左右。然而，作为导致40-64岁患者丧失工作能力和法律行为能力以及过早死亡的疾病，其医学和社会意义极高。与LOAD患者相比，EOAD患者有更多非典型临床变异型——分别为25%和6%-12.5%，这使得EOAD与其他神经退行性疾病的鉴别诊断变得复杂。然而，典型的经典遗忘型在EOAD和LOAD中均占主导。此外，根据神经影像学数据，EOAD患者有其特点：在进行脑部MRI检查时，与LOAD患者相比，EOAD患者通常顶叶萎缩更明显，海马萎缩不那么明显。本文关注EOAD患者的临床和神经影像学数据特征；并介绍了一例EOAD患者的病例。
