额颞叶痴呆和阿尔茨海默病的神经心理学特征比较

摘要

目的：比较不同痴呆程度的额颞叶痴呆（FTD）和阿尔茨海默病（AD）患者神经心理学特征的差异。方法应用神经心理学量表评价27例 FTD 患者和36例 AD 患者的认知功能。结果无论何种痴呆程度，FTD 组患者神经精神问卷（NPI）评分均显著高于 AD 组（P ＜0．05）。轻度 AD 组患者日常活动能力量表（ADL）评分略高于 FTD 组（ P ＝0．046），中重度 FTD 组患者的简易精神状态检查量表（ MMSE）评分（P＝0．021）和画钟测验（CDT）评分（P＝0．004）均低于 AD 组。在临床痴呆评定量表（CDR）各功能域评分中，轻度 AD 患者定向力（P ＝0．030）与工作和社会交往能力（P ＝0．039）评分高于 FTD 组，中重度 FTD 患者在CDR 总分（P＝0．011）和判断与解决问题的能力评分上高于 AD（P＝0．007）。结论临床工作中对痴呆患者进行全面的神经心理学检查有助于鉴别 FTD 和 AD。%Objective To compare the differences of neuropsychological profile between the patients with frontotemporal dementia (FTD) and Alzheimer’s disease (AD) in different dementia stage.Methods A total of 27 FTD patients and 36 AD patients were recruited in this study.Neuropsychological tests were used to evaluate the cognitive level.Result s Whatever the severity of dementia, The neuropsychiatric inventory (NPI) score in FTD group was significantly higher than that in AD group.The activities of daily living scale (ADL) score was slightly higher in mild AD group than that in FTD ( P =0.046).The mini-mental state examination ( MMSE) score (P=0.021) and the clock-drawing test ( CDT) score ( P =0.004) in moderate and severe FTD group were significantly lower than AD.In each cognitive domain score of clinical dementia rate (CDR), the orientation (P =0.030) and the social function (P=0.039) scores were higher in mild AD group than FTD.The overall CDR score (P=0.011) and the judgment and problem-solving ability score (P=0.007) were higher in moderate and severe FTD group than AD.Conclusion Comprehensive neuropsychological tests in clinical practice can help to distinguish FTD and AD.