阿尔茨海默病与行为变异型额颞叶痴呆患者认知功能和精
神行为症状的特点
张丽玲;王颖;程焱;张楠
【期刊名称】《中华内科杂志》 【年(卷),期】2017(056)012
【摘要】Objective To compare the differences in cognitive function and behavioral and psychological symptoms between patients with Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD). Methods Thirty-six AD patients and 20 bvFTD patients at mild-to-moderate stage, who were biomarker-confirmed by positron emission tomography (PET), were assessed with a neuropsychological battery and neuropsychiatry inventory (NPI). Cognitive
domains,
including
memory,
language,
information
processing speed and executive function, and behavioral and psychological symptoms were assessed and compared. Results AD patients had lower scores in immediate recall, delayed recall and recognition than bvFTD patients (all P<0.05); while bvFTD patients had poorer performance in language and executive function than AD patients (all P<0.05). The NPI total score was significantly higher in patients with bvFTD compared with patients with AD (17.5±5.7 vs 9.3±3.5, P<0.05). In respect to the 12 items of NPI, the incidence of agitation and irritability was higher in AD group than in bvFTD group
(72.2%vs 35.0%, 55.6%vs 20.0%, all P<0.05);while the incidence of apathy, disinhibition, euphoria, aberrant motor behavior and appetite/eating was higher in bvFTD group than in AD group (65.0%vs 33.3%, 80.0% vs 5.5%, 70.0% vs 5.6%, 40.0% vs 11.1%, 50.0% vs 5.6%, all P<0.05). Conclusion Comprehensive neuropsychological assessment and evaluation of behavioral and psychological symptoms of patients with dementia are helpful in distinguishing AD from bvFTD.%目的 比较和分析阿尔茨海默病(AD)和行为变异型额颞叶痴呆(bvFTD)患者的认知功能和精神行为症状特点.方法 连续收集2014年7月至2016年11月天津医科大学总医院神经内科认知障碍门诊经PET确认的36例轻中度AD和20例轻中度bvFTD患者,进行多项神经心理量表测评和神经精神问卷(NPI)评估.比较两组人群的记忆、语言、信息加工速度和执行功能等不同认知领域的改变,以及精神行为症状的特点.结果 AD患者较bvFTD患者在即刻回忆、延迟回忆以及再认能力方面受损显著(P均<0.05),而bvFTD患者较AD患者在语言和执行功能方面表现更差(P均<0.05).bvFTD患者的NPI总分高于AD组患者[(17.5±5.7)分比(9.3±3.5)分,P<0.05].NPI子项分析显示,AD患者激越和易激惹的发生率明显高于bvFTD患者(72.2%比35.0%,55.6%比20.0%,P均<0.05),而bvFTD患者的淡漠(65.0%比33.3%)、脱抑制(80.0%比5.5%)、欣快(70.0%比5.6%)、异常运动行为(40.0%比11.1%)和进食改变(50.0%比5.6%)的发生率显著高于AD患者(P均<0.05).结论 对早、中期认知障碍患者进行包括记忆、语言和执行功能等的全面认知评估和NPI量表的子项目分析有助于对AD和bvFTD的临床鉴别.
【总页数】6页(903-908)
【关键词】阿尔茨海默病;额颞叶痴呆;认知功能;精神行为症状;正电子发射断层显像术
【作者】张丽玲;王颖;程焱;张楠
【作者单位】300052 天津医科大学总医院神经内科;300052 天津医科大学总医院神经内科;300052 天津医科大学总医院神经内科;300052 天津医科大学总医院 PET功能影像诊断科 【正文语种】中文 【中图分类】 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_chinese-journal-internal-medicine_thesis/0201232482362.html 【相关文献】
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