额颞叶痴呆及阿尔茨海默病神经心理学的定性表现  

Qualitative neuropsychological performance characteristics in frontotemporal dementia and Alzheimer’s disease

作　　者：Thompson J.C. Stopford C.L. Snowden J.S. Neary D. 陈云春 

机构地区：[1]Cerebral Function Unit, Greater Manchester Neuroscience Centre, Hope Hospital, Salford M6 8 HD, United Kingdom

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第10期24-24,共1页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Background: Frontotemporal dementia (FTD) and Alzhei- mer’ s disease are clinically distinct disorders, yet neuropsychological stu dies have had variable success in distinguishing them. A possible reason is that studies typically rely on overall accuracy scores, which may obscure difference s in reasons for failure. Objectives: To explore the hypothesis that analysis of qualitative performance characteristics and error types, in addition to overall numerical scores, would enhance the neuropsychological distinction between FTD and Alzheimer’ s disease. Methods: 38 patients with FTD and 73 with Alzheimer’ s disease underwent assessment of language, visuospatial abilities, memory, and executive function, using a neuropsychological screening instrument and standar d neuropsychological tests. In each of these cognitive domains, performance char acteristics and error types were documented, in addition to numerical scores on tests. Results: Whereas comparison of neuropsychological test scores revealed so me group differences, these did not occur consistently across tests within cogni tive domains. However, analysis of performance characteristics and error types r evealed qualitative differences between the two groups. In particular, FTD patie nts displayed features associated with frontal lobe dysfunction, such as concret e thought, perseveration, confabulation, and poor organisation, which disrupted performance across the range of neuropsychological tests. Conclusions: Numerical scores on neuropsychological tests alone are of limited value in differentiatin g FTD and Alzheimer’ s disease, but performance characteristics and error types enhance the distinction between the two disorders. FTD is associated with a pro found behavioural syndrome that affects performance on cognitive assessment, obs curing group differences. Qualitative information should be included in neuropsy chological research and clinical assessments.Background: Frontotemporal dementia (FTD) and Alzhei- mer’ s disease are clinically distinct disorders, yet neuropsychological stu dies have had variable success in distinguishing them. A possible reason is that studies typically rely on overall accuracy scores, which may obscure difference s in reasons for failure. Objectives: To explore the hypothesis that analysis of qualitative performance characteristics and error types, in addition to overall numerical scores, would enhance the neuropsychological distinction between FTD and Alzheimer’ s disease. Methods: 38 patients with FTD and 73 with Alzheimer’ s disease underwent assessment of language, visuospatial abilities, memory, and executive function, using a neuropsychological screening instrument and standar d neuropsychological tests. In each of these cognitive domains, performance char acteristics and error types were documented, in addition to numerical scores on tests. Results: Whereas comparison of neuropsychological test scores revealed so me group differences, these did not occur consistently across tests within cogni tive domains. However, analysis of performance characteristics and error types r evealed qualitative differences between the two groups. In particular, FTD patie nts displayed features associated with frontal lobe dysfunction, such as concret e thought, perseveration, confabulation, and poor organisation, which disrupted performance across the range of neuropsychological tests. Conclusions: Numerical scores on neuropsychological tests alone are of limited value in differentiatin g FTD and Alzheimer’ s disease, but performance characteristics and error types enhance the distinction between the two disorders. FTD is associated with a pro found behavioural syndrome that affects performance on cognitive assessment, obs curing group differences. Qualitative information should be included in neuropsy chological research and clinical assessments.

关 键 词：神经心理学 额颞叶痴呆 阿尔茨海默病 认知功能 筛查工具 神经心理测试 执行功能 缺陷原因 虚构症 行为表现 

分 类 号：R749.16[医药卫生—神经病学与精神病学]