面孔情绪识别测验在行为变异型额颞叶痴呆早期诊断中的价值  

The value of Facial Emotion Recognition Test in the early diagnosis of behavioral variant frontotemporal dementia

作　　者：王芬[1] 周爱红[1] 马晓伟[2] 赵丽娜[1] 靳红梅[1] 李妍[1] 贾建平[1] Wang Fen;Zhou Aihong;Ma Xiaowei;Zhao Lina;Jin Hongmei;Li Yan;Jia Jianping(Innovation Center for Neurological Disorders,Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Neurology,the First Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China)

机构地区：[1]首都医科大学宣武医院神经内科,神经疾病高创中心,北京100053 [2]河北医科大学附属第一医院神经内科,石家庄050000

出　　处：《中华神经科杂志》2021年第3期191-198,共8页Chinese Journal of Neurology

基　　金：国家自然科学青年基金(81100797);北京市卫生系统高层次卫生技术人才计划(2015-3-068)。

摘　　要：目的评价面孔情绪识别测验(FERT)在行为变异型额颞叶痴呆(bvFTD)患者早期诊断中的价值。方法连续收集2018年1月至2019年7月就诊于首都医科大学宣武医院神经内科记忆门诊且符合入组条件的轻度bvFTD患者27例、轻度阿尔茨海默病(AD)患者27例和正常对照者54名。采用FERT以及简易精神状态检查量表、额叶功能评定量表(FAB)和听觉词语学习测验(AVLT)等多个神经心理测验对受试者进行评估;采用受试者工作特征曲线(ROC)来评价FERT的诊断效能。结果bvFTD组的FERT得分为18.00(14.00,21.00)分,明显低于对照组[28.00(26.00,30.00)分,H=-55.278,P<0.001]和AD组[25.00(21.00,28.00)分,H=-28.407,P=0.002]。ROC显示,FERT区分bvFTD组和对照组的曲线下面积(AUC)为0.969(95%CI 0.931~1.000,P<0.001),最佳分界值为24分,敏感度为92.6%,特异度为92.6%;FERT区分bvFTD组和AD组的AUC为0.850(95%CI 0.749~0.951,P<0.001),最佳分界值为22分,敏感度为81.5%,特异度为71.4%。FERT区分bvFTD组和AD组的AUC值(0.850)高于FAB和AVLT-延迟回忆(分别为0.776和0.714),但差异无统计学意义。结论bvFTD在疾病早期具有情绪加工损害,FERT是早期诊断bvFTD的敏感而特异的神经心理学指标之一。Objective To evaluate the value of Facial Emotion Recognition Test(FERT)in the early diagnosis of behavioral variant frontotemporal dementia(bvFTD).Methods A total of 27 patients with mild bvFTD,27 patients with mild Alzheimer′s disease(AD)and 54 normal controls were successively collected in the Memory Clinic of Department of Neurology,Xuanwu Hospital,Capital Medical University from January 2018 to July 2019.The subjects were assessed by the FERT and a battery of neuropsychological background tests including Mini-Mental State Examination,Frontal Assessment Battery(FAB),and Auditory Verbal Learning Test(AVLT),etc.The discriminatory power of the FERT was evaluated using the receiver operating characteristic curve(ROC).Results The average FERT scores of bvFTD,AD and control groups were 18.00(14.00,21.00),25.00(21.00,28.00)and 28.00(26.00,30.00)respectively.The FERT scores of bvFTD group were significantly lower than those of control groups(H=-55.278,P<0.001)and AD groups(H=-28.407,P=0.002).ROC results showed that the FERT had a high discriminatory power for differentiating bvFTD from the controls,with an area under the curve(AUC)value of 0.969(95%CI 0.931-1.000,P<0.001).Both the sensitivity and specificity were 92.6%with a cut-off value at 24.For differentiating bvFTD group from AD group,the AUC value for the FERT was 0.850(95%CI 0.749-0.951,P<0.001),with sensitivity of 81.5%and specificity of 71.4%with a cut-off value of 22.Compared with the AUC values for the FAB and AVLT-Delayed Recall(0.776 and 0.714),the AUC value for the FERT was slightly higher,though the differences among them were not statistically significant.Conclusions Disturbance of emotion processing is presented in the early stage of bvFTD.FERT is one of the sensitive and specific neuropsychological indicators for the early diagnosis of bvFTD.

关 键 词：额颞痴呆 阿尔茨海默病 早期诊断 面孔情绪识别测验 受试者工作特征曲线 

分 类 号：R749.1[医药卫生—神经病学与精神病学]