Sjögren M, Wallin A, Edman A
Department of Psychiatry and Neurochemistry, Sahlgrenska University Hospital, Mölndal, Sweden.
Int J Geriatr Psychiatry. 1997 Jun;12(6):656-61.
Our hypothesis was that patients with vascular dementia and a dominating frontal lobe syndrome have a symptomatology that reflects a more widespread lesion compared with patients with frontotemporal dementia.
Patients with vascular dementia and a dominating frontal lobe syndrome (VAD-F; N = 11) were compared with regard to clinical symptoms and imaging features on CT scans of the brain with patients with frontotemporal dementia (FTD; N = 21).
A neuropsychiatric diagnostic ward.
Thirty-two inpatients, aged 48-78 years, with frontotemporal dementia or vascular dementia.
Relatives were questioned about the initial symptoms. At the clinical investigation, mental and neurological symptoms and signs were recorded using the STEP method (stepwise comparative status analysis). CT scan features of the brain were evaluated by a trained neuroradiologist. The GBS-i (Gottfries-Bråne-Steen, intellectual variables) scale was used to measure the degree of dementia.
At the onset of dementia, loss of memory (p < 0.001), sudden onset (p < 0.001), confusion (p < 0.05) and unspecified neurological signs (p < 0.05) had been significantly more frequent in the VAD-F group. At the time of the clinical investigation, lack of social awareness and presence of primitive reflexes were more frequent in the FTD group (p < 0.01 and p < 0.05, respectively) and visuospatial deficits more frequent in the VAD-F group (p < 0.05). CT of the brain showed that, apart from brain infarcts (present only in the VAD-F group), paraventricular leukoaraiosis was significantly more pronounced in the VAD-F group (p < 0.05). The groups did not differ with respect to age, age at onset or level of dementia.
The findings support our hypothesis.
我们的假设是，与额颞叶痴呆患者相比，患有血管性痴呆且以额叶综合征为主的患者所表现出的症状反映了更广泛的病变。
将患有血管性痴呆且以额叶综合征为主（VAD - F；n = 11）的患者与额颞叶痴呆（FTD；n = 21）患者在临床症状和脑部CT扫描影像特征方面进行比较。
一个神经精神诊断病房。
32名年龄在48 - 78岁之间的住院患者，患有额颞叶痴呆或血管性痴呆。
向亲属询问初始症状。在临床检查中，使用STEP方法（逐步比较状态分析）记录精神和神经症状及体征。由一名经过培训的神经放射科医生评估脑部CT扫描特征。使用GBS - i（Gottfries - Bråne - Steen，智力变量）量表测量痴呆程度。
在痴呆发病时，VAD - F组中记忆丧失（p < 0.001）、突然发病（p < 0.001）、意识模糊（p < 0.05）和未明确的神经体征（p < 0.05）更为常见。在临床检查时，FTD组中缺乏社会意识和存在原始反射更为常见（分别为p < 0.01和p < 0.05），而VAD - F组中视觉空间缺陷更为常见（p < 0.05）。脑部CT显示，除了脑梗死（仅在VAD - F组中出现）外，VAD - F组脑室旁白质疏松更为明显（p < 0.05）。两组在年龄、发病年龄或痴呆程度方面无差异。
研究结果支持我们的假设。
