Barber R, Snowden J S, Craufurd D
Department of Psychiatry, Manchester Royal Infirmary, UK.
J Neurol Neurosurg Psychiatry. 1995 Jul;59(1):61-70. doi: 10.1136/jnnp.59.1.61.
The study examined the feasibility of differentiating frontotemporal dementia from Alzheimer's disease on the basis of retrospective historical information obtained from relatives of patients. A structured questionnaire was devised of patients' symptoms, with emphasis on those cognitive and neuropsychiatric features found in earlier prospective clinical studies to distinguish the two conditions. The questionnaire was given to close relatives of deceased patients in whom the diagnosis of non-Alzheimer's frontotemporal degeneration of Alzheimer's disease had been verified at necropsy. The interviewer had no previous contact or knowledge of those patients, nor clinical experience of patients with frontotemporal dementia. The questionnaire elicited a distinct profile of responses for the two diagnostic groups with emphasis on early personality change, unconcern, and socially inappropriate behaviour in frontotemporal dementia and disturbance in memory and topographical orientation prominent in patients with Alzheimer's disease. A scoring system separated out individual patients with frontotemporal dementia from those with Alzheimer's disease. It is concluded that it is possible to obtain useful information about the precise pattern of dementia from informants even many years after the patient's death. The questionnaire provides the foundation of a diagnostic instrument for use in family history studies of dementia.
该研究基于从患者亲属处获得的回顾性历史信息，探讨了区分额颞叶痴呆和阿尔茨海默病的可行性。设计了一份关于患者症状的结构化问卷，重点关注早期前瞻性临床研究中发现的用于区分这两种疾病的认知和神经精神特征。该问卷发放给已故患者的近亲，这些患者在尸检时已证实诊断为非阿尔茨海默病的额颞叶变性。访谈者此前与这些患者没有接触或了解，也没有额颞叶痴呆患者的临床经验。问卷针对两个诊断组引出了不同的回答特征，额颞叶痴呆强调早期人格改变、漠不关心和社交不当行为，而阿尔茨海默病患者则突出记忆和地形定向障碍。一种评分系统将额颞叶痴呆患者与阿尔茨海默病患者区分开来。得出的结论是，即使在患者去世多年后，也有可能从信息提供者那里获得有关痴呆症确切模式的有用信息。该问卷为痴呆症家族史研究中使用的诊断工具奠定了基础。
