Mentis M J, Weinstein E A, Horwitz B, McIntosh A R, Pietrini P, Alexander G E, Furey M, Murphy D G
Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, MD 20892, USA.
Biol Psychiatry. 1995 Oct 1;38(7):438-49. doi: 10.1016/0006-3223(94)00326-x.
Brain lesions have been reported with increasing frequency in the delusional misidentification syndromes (DMS). This is the first controlled study to describe DMS regional cerebral metabolic rates of glucose (rCMRglc). We compared rCMRglc (using positron emission tomography) and neuropsychological data in 9 patients with DMS and Alzheimer dementia (AD), 15 AD patients without DMS, and 17 healthy controls. The DMS group differed from the AD group without DMS in having significant hypometabolism in paralimbic (orbitofrontal and cingulate areas bilaterally) and left medial temporal areas, and significant bilateral normalized hypermetabolism in sensory association cortices (superior temporal and inferior parietal) without right left asymmetry. Compared to healthy controls, both AD groups had significant dorso lateral frontal hypometabolism bilaterally. No specific DMS neuropsychological profile was identified. Dysfunctional connections among multimodal association areas, paralimbic structures, and dorsolateral frontal cortex are proposed as the predisposing neural deficit underlying DMS, causing cognitive-perceptual-affective dissonance, which under specific conditions results in "positive" delusion formation.
在妄想性错认综合征（DMS）中，脑部病变的报道频率越来越高。这是第一项描述DMS区域脑葡萄糖代谢率（rCMRglc）的对照研究。我们比较了9例患有DMS和阿尔茨海默病（AD）的患者、15例无DMS的AD患者以及17名健康对照者的rCMRglc（使用正电子发射断层扫描）和神经心理学数据。DMS组与无DMS的AD组不同，其在边缘旁区域（双侧眶额叶和扣带区域）和左侧内侧颞叶区域存在明显的代谢减低，在感觉联合皮层（颞上回和顶下小叶）存在明显的双侧标准化代谢增高且无左右不对称。与健康对照者相比，两个AD组在双侧背外侧额叶均存在明显的代谢减低。未发现特定的DMS神经心理学特征。多模态联合区域、边缘旁结构和背外侧额叶皮层之间的功能连接障碍被认为是DMS潜在的易患神经缺陷，导致认知 - 感知 - 情感失调，在特定条件下导致“阳性”妄想的形成。
