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以右侧前颞叶优势为主的额颞叶痴呆的临床识别:一项多中心回顾性队列研究。

Clinical recognition of frontotemporal dementia with right anterior temporal predominance: A multicenter retrospective cohort study.

机构信息

Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan, Amsterdam, The Netherlands.

Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, California, USA.

出版信息

Alzheimers Dement. 2024 Aug;20(8):5647-5661. doi: 10.1002/alz.14076. Epub 2024 Jul 10.

Abstract

INTRODUCTION

Although frontotemporal dementia (FTD) with right anterior temporal lobe (RATL) predominance has been recognized, a uniform description of the syndrome is still missing. This multicenter study aims to establish a cohesive clinical phenotype.

METHODS

Retrospective clinical data from 18 centers across 12 countries yielded 360 FTD patients with predominant RATL atrophy through initial neuroimaging assessments.

RESULTS

Common symptoms included mental rigidity/preoccupations (78%), disinhibition/socially inappropriate behavior (74%), naming/word-finding difficulties (70%), memory deficits (67%), apathy (65%), loss of empathy (65%), and face-recognition deficits (60%). Real-life examples unveiled impairments regarding landmarks, smells, sounds, tastes, and bodily sensations (74%). Cognitive test scores indicated deficits in emotion, people, social interactions, and visual semantics however, lacked objective assessments for mental rigidity and preoccupations.

DISCUSSION

This study cumulates the largest RATL cohort unveiling unique RATL symptoms subdued in prior diagnostic guidelines. Our novel approach, combining real-life examples with cognitive tests, offers clinicians a comprehensive toolkit for managing these patients.

HIGHLIGHTS

This project is the first international collaboration and largest reported cohort. Further efforts are warranted for precise nomenclature reflecting neural mechanisms. Our results will serve as a clinical guideline for early and accurate diagnoses.

摘要

简介

尽管额颞叶痴呆(FTD)伴右侧前颞叶(RATL)优势已被认识,但该综合征的统一描述仍缺失。本多中心研究旨在建立一个有凝聚力的临床表型。

方法

通过初始神经影像学评估,从 12 个国家的 18 个中心获得了 360 名 RATL 萎缩为主的 FTD 患者的回顾性临床数据。

结果

常见症状包括精神僵化/专注(78%)、抑制障碍/不适当的社会行为(74%)、命名/找词困难(70%)、记忆障碍(67%)、冷漠(65%)、同理心丧失(65%)和面部识别障碍(60%)。现实生活中的例子揭示了地标、气味、声音、味道和身体感觉方面的障碍(74%)。认知测试评分表明在情绪、人物、社交互动和视觉语义方面存在缺陷,但缺乏对精神僵化和专注的客观评估。

讨论

本研究累积了最大的 RATL 队列,揭示了先前诊断指南中被低估的独特 RATL 症状。我们的新方法,结合现实生活中的例子和认知测试,为临床医生提供了一个全面的工具包来管理这些患者。

重点

该项目是第一个国际合作和最大的报告队列。需要进一步努力为反映神经机制的精确命名法提供依据。我们的研究结果将作为早期和准确诊断的临床指南。

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