Departments of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Departments of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Neurocase. 2024 Aug;30(4):135-141. doi: 10.1080/13554794.2024.2419177. Epub 2024 Oct 27.
A diagnosis of behavioral variant frontotemporal dementia (bvFTD) often relies on informant reports of significant behavioral changes. "BvFTD-by-proxy" describes situations of neuropsychiatric changes reported solely by an informant under circumstances that may raise questions regarding their objectivity. We present three cases of bvFTD-like symptoms reported by spouses, where progression was unclear, testing showed mild but stable executive dysfunction, and neuroimaging was unremarkable. The subjective nature of bvFTD criteria leaves patients vulnerable to misleading informant reports, especially amid relational discord, and may threaten patient autonomy. Recognizing and managing this situation is critical but time-consuming, often requiring coordinated care across multiple providers.
行为变异额颞叶痴呆（bvFTD）的诊断通常依赖于知情者报告的显著行为变化。“代诊 bvFTD”描述的是在可能引起其客观性质疑的情况下，知情者报告的神经精神变化仅由知情者报告的情况。我们介绍了 3 例由配偶报告的类似 bvFTD 症状的病例，这些病例的进展情况不明确，测试显示出轻微但稳定的执行功能障碍，神经影像学检查无明显异常。bvFTD 标准的主观性使患者容易受到误导性知情者报告的影响，尤其是在关系不和谐的情况下，这可能会威胁到患者的自主权。认识和管理这种情况至关重要，但很耗时，通常需要多个提供者之间的协调护理。
