Mental Health Care Line, Michael E. DeBakey VA Medical Center.
Department of Psychology, University of Houston.
Neuropsychology. 2024 Oct;38(7):637-652. doi: 10.1037/neu0000969. Epub 2024 Aug 29.
Executive dysfunction is characteristic of behavioral variant frontotemporal dementia (bvFTD) but can be challenging to detect. Dispersion-based intraindividual variability (IIV-d) is hypothesized to reflect a sensitive index of executive dysfunction and has demonstrated relevance to functional decline but has not been evaluated in bvFTD.
We report on 477 demographically matched participants (159 cognitively healthy [CH], 159 clinical Alzheimer's disease [AD], 159 clinical bvFTD/prodromal bvFTD) who completed the Uniform Data Set 3.0 Neuropsychological Battery. IIV-d was measured using the coefficient of variance (CoV; raw and demographically adjusted) across 12 Uniform Data Set 3.0 Neuropsychological Battery indicators and the informant-rated Functional Activities Questionnaire assessed daily functioning.
Analysis of covariance showed that participants in the bvFTD/prodromal bvFTD group exhibited higher raw and demographically adjusted CoV compared to CH participants, at a very large effect size ( = 1.28-1.47). Demographically adjusted (but not raw) CoV was lower in the bvFTD/prodromal bvFTD group than the AD group, though the effect size was small ( = .38). Both CoV metrics accurately differentiated the bvFTD/prodromal bvFTD and CH groups (areas under the curve = .84), but not bvFTD/prodromal bvFTD and AD groups (areas under the curve = .59). Regression analyses in the bvFTD/prodromal bvFTD group indicated that higher IIV-d on both metrics was associated with greater daily functioning impairment, over and above covariates.
Compared to healthy adults, individuals with bvFTD/prodromal bvFTD show greater levels of performance variability across a battery of neuropsychological measures, which interferes with everyday functioning. These data demonstrate the clinical utility and ecological validity of IIV-d in bvFTD/prodromal bvFTD, though these findings should be replicated in more diverse samples. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
执行功能障碍是行为变异额颞叶痴呆（bvFTD）的特征，但很难检测到。基于分散的个体内变异性（IIV-d）被假设反映了执行功能障碍的一个敏感指标，并且与功能下降有关，但尚未在 bvFTD 中进行评估。
我们报告了 477 名在人口统计学上匹配的参与者（159 名认知健康[CH]，159 名临床阿尔茨海默病[AD]，159 名临床 bvFTD/前驱 bvFTD），他们完成了统一数据集 3.0 神经心理学电池。使用均数方差（CoV；原始和人口统计学调整）测量 12 个统一数据集 3.0 神经心理学电池指标的 IIV-d，并使用 informant-rated 功能活动问卷评估日常功能。
协方差分析显示，bvFTD/前驱 bvFTD 组的参与者的原始和人口统计学调整的 CoV 高于 CH 参与者，具有非常大的效应量（=1.28-1.47）。bvFTD/前驱 bvFTD 组的人口统计学调整后的（但不是原始的）CoV 低于 AD 组，尽管效应量较小（=0.38）。两种 CoV 指标都能准确地区分 bvFTD/前驱 bvFTD 和 CH 组（曲线下面积=0.84），但不能区分 bvFTD/前驱 bvFTD 和 AD 组（曲线下面积=0.59）。bvFTD/前驱 bvFTD 组的回归分析表明，在这两个指标上，更高的 IIV-d 与更大的日常功能障碍有关，超过了协变量。
与健康成年人相比，bvFTD/前驱 bvFTD 个体在一系列神经心理学测试中表现出更大的变异性，这会干扰日常生活功能。这些数据表明，IIV-d 在 bvFTD/前驱 bvFTD 中具有临床实用性和生态有效性，尽管这些发现需要在更多样化的样本中得到复制。（PsycInfo 数据库记录（c）2024 APA，保留所有权利）。
