一例额叶变异型阿尔茨海默病患者神经心理学和行为症状的临床分析  

Clinical analysis of neuropsychological and behavioral symptoms in a patient of frontal variant Alzheimer disease

作　　者：李攀[1] 权伟[2] 张惠红 周玉颖 Li Pan;Quan Wei;Zhang Huihong;Zhou Yuying(Department of Neurology,Tianjin Huanhu Hospital Affifiliated to Nankai University,Tianjin University Huanhu Hospital,Tianjin 300350,China;Department of Neurosurgery,General Hospital of Tianjin Medical University,Tianjin 300052,China)

机构地区：[1]南开大学附属环湖医院,天津大学环湖医院神经内科,300350 [2]天津医科大学总医院神经外科,300052

出　　处：《中国综合临床》2021年第5期453-457,共5页Clinical Medicine of China

基　　金：国家自然科学基金项目(81801076);天津市自然科学项目(18JCQNJC11400)。

摘　　要：虽然阿尔茨海默病的诊断标准已经建立,但临床症状差异很大,其特殊类型额叶变异型与行为变异型额颞叶痴呆在临床症状上非常相似,这为鉴别诊断带来了重大挑战。为此,我们报道1例患者表现为进行性认知障碍,早期显著的执行功能障碍行为异常,磁共振成像显示明显的额颞叶萎缩,初步诊断极易误诊为行为变异型额颞叶痴呆。然而,多模态功能神经影像学结果显示神经病理改变更倾向为可能的额叶变异型阿尔茨海默病。本研究表明,使用详细的神经心理测试、生物学标记物和多模态神经成像来识别这些非典型综合征,将有助于提高诊断和患者管理的准确性。Although the neuropathologic changes and diagnostic criteria for the neurodegenerative disorder Alzheimer′s diseasehave been established,the clinical symptoms are very different largely.The clinical symptoms of its special type frontal lobe variant and behavioral variant frontotemporal dementia are very similar,which brings great challenges to the differential diagnosis.Therefore,we report a patient with progressive cognitive impairment,early significant executive dysfunction and abnormal behavior,and magnetic resonance imaging showed significant frontotemporal atrophy.It is easy to be misdiagnosed as behavioral variant frontotemporal dementia.However,multimodal functional neuroimaging results show that neuropathological changes are more likely to be frontal variant Alzheimer′s disease.This study shows that the use of detailed neuropsychological tests,biological markers and multimodal neuroimaging to identify these atypical syndromes will help to improve the accuracy of diagnosis and patient management.

关 键 词：阿尔茨海默病 额叶变异型阿尔茨海默病 执行功能障碍 行为障碍 多模式影像学 

分 类 号：R749.16[医药卫生—神经病学与精神病学]