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散发性与遗传性行为变异型额颞叶痴呆中精神药物的使用情况

Psychotropic medication usage in sporadic versus genetic behavioral-variant frontotemporal dementia.

作者信息

Vargas-Gonzalez Juan-Camilo, Dimal Nico, Cortez Kasey, Heuer Hilary, Forsberg Leah K, Appleby Brian S, Barmada Sami, Bozoki Andrea, Clark David, Cobigo Yann, Darby R Ryan, Dickerson Bradford C, Domoto-Reilly Kimiko, Galasko Douglas R, Geschwind Daniel H, Ghoshal Nupur, Graff-Radford Neill R, Grant Ian M, Irwin David, Hsiung Ging-Yuek Robin, Honig Lawrence S, Kantarci Kejal, Léger Gabriel C, Litvan Irene, Mackenzie Ian R, Masdeu Joseph C, Mendez Mario F, Onyike Chiadi U, Pascual Belen, Pressman Peter, Ramos Eliana Marisa, Roberson Erik D, Rogalski Emily, Boeve Brad F, Boxer Adam L, Rosen Howie J, Tartaglia Maria Carmela

机构信息

Division of Neurology, University of Toronto, Toronto, Ontario, Canada.

Memory Clinic, University Health Network, Toronto, Ontario, Canada.

出版信息

Alzheimers Dement. 2025 Feb;21(2):e14448. doi: 10.1002/alz.14448. Epub 2024 Dec 23.

Abstract

INTRODUCTION

Psychotropic medication (PM) use in behavioral-variant frontotemporal dementia (bvFTD) is higher than in other dementias. However, no information exists on whether PM use differs between sporadic and genetic bvFTD.

METHODS

We analyzed data from sporadic and genetic bvFTD participants with PM prescriptions in the Advancing Research and Treatment in Frontotemporal Lobar Degeneration/Longitudinal Evaluation of Familial Frontotemporal Dementia Subjects study. We estimated ordinal odds ratio (OOR) of having more PM comparing sporadic and genetic bvFTD. Finally, we explored the neuropsychiatric symptom (NPS) combinations using classification and regression trees (CART).

RESULTS

We included 263 with sporadic and 193 with genetic bvFTD. The OOR for sporadic bvFTD to be on PM was 1.75 (95% confidence interval: 1.21 to 2.53) for the fully adjusted model. CART revealed the most common NPS combination was apathy + personality changes in 18% of participants.

DISCUSSION

Participants with sporadic bvFTD were twice as likely to be on PM compared to genetic bvFTD. The reason for increased PM usage in sporadic bvFTD participants should be further investigated.

HIGHLIGHTS

We report on patients with behavioral variant frontotemporal dementia (bvFTD). We evaluated the psychotropic medication (PM) prescription at baseline in the cohort. Patients with sporadic bvFTD had more prescriptions for PM than genetic patients. The frequency of symptoms combination was different in sporadic and genetic bvFTD.

摘要

引言

行为变异型额颞叶痴呆(bvFTD)中精神药物(PM)的使用高于其他痴呆症。然而,关于散发性和遗传性bvFTD之间PM使用是否存在差异尚无相关信息。

方法

我们在额颞叶变性进展研究与治疗/家族性额颞叶痴呆受试者纵向评估研究中分析了有PM处方的散发性和遗传性bvFTD参与者的数据。我们估计了散发性和遗传性bvFTD使用更多PM的序数优势比(OOR)。最后,我们使用分类与回归树(CART)探索了神经精神症状(NPS)组合。

结果

我们纳入了263例散发性bvFTD患者和193例遗传性bvFTD患者。在完全调整模型中,散发性bvFTD使用PM的OOR为1.75(95%置信区间:1.21至2.53)。CART显示最常见的NPS组合是18%的参与者出现淡漠+人格改变。

讨论

与遗传性bvFTD相比,散发性bvFTD参与者使用PM的可能性是其两倍。散发性bvFTD参与者中PM使用增加的原因应进一步研究。

要点

我们报告了行为变异型额颞叶痴呆(bvFTD)患者。我们评估了队列中基线时的精神药物(PM)处方。散发性bvFTD患者的PM处方比遗传性患者更多。散发性和遗传性bvFTD的症状组合频率不同。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a07a/11848424/276de02821ad/ALZ-21-e14448-g002.jpg

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