Demencia frontotemporal

  • 文章类型: Journal Article
    背景:先前已报道GRN基因中的变异c.1414-1G>T可能在美洲大陆的西班牙裔受试者中致病。
    方法:我们报告了五个西班牙血统的家族携带这种变体,包括临床,神经影像学,和实验室发现。
    结果:表型明显不同,包括表现为额颞叶痴呆行为变异的病例,具有原发性进行性失语症的语义变异,患有快速进行性运动神经元疾病(病理记录),以震颤为主的帕金森病.仅在纯合携带者中发现了视网膜变性。离体剪接实验证实,突变c.1414-1G>T影响外显子的剪接,导致外显子11中20个氨基酸丢失.
    结论:我们得出结论,变异c.1414-1G>TnGRN基因是致病性的,可以导致各种临床表现和基因剂量效应,可能有西班牙创始人的影响。
    BACKGROUND: The variant c.1414-1G>T in the GRN gene has previously been reported as probably pathogenic in subjects of Hispanic origin in the American continent.
    METHODS: We report 5 families of Spanish origin carrying this variant, including the clinical, neuroimaging, and laboratory findings.
    RESULTS: Phenotypes were strikingly different, including cases presenting with behavioral variant frontotemporal dementia, semantic variant primary progressive aphasia, rapidly progressive motor neuron disease (pathologically documented), and tremor-dominant parkinsonism. Retinal degeneration has been found in homozygous carriers only. Ex vivo splicing assays confirmed that the mutation c.1414-1G>T affects the splicing of the exon, causing a loss of 20 amino acids in exon 11.
    CONCLUSIONS: We conclude that variant c.1414-1G>T of the GRN gene is pathogenic, can lead to a variety of clinical presentations and to gene dosage effect, and probably has a Spanish founder effect.
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  • 文章类型: Journal Article
    背景:尽管在区分阿尔茨海默病(AD)和额颞叶痴呆(bvFTD)的行为变异的诊断标准中考虑了记忆障碍的缺失,当前和越来越多的证据表明,相当比例的bvFTD病例存在情景记忆缺陷。为了比较AD和bvFTD患者的命名能力和情景记忆的表现,设计了本研究。
    方法:对照组(32人)的横断面和分析研究。该研究包括42名可能患有AD的人和22名可能患有bvFTD的人,都超过60岁。使用西班牙语验证的统一数据集工具:多语言命名测试(MINT),Craft-21的历史和本森的复杂人物,在其他人中。
    结果:AD患者的平均年龄更高。BvFTD患者的命名能力远低于AD患者,根据MINT和名词/动词命名系数测量。所有患有bvFTD的患者,73.81%的AD患者和只有31.25%的对照组未能识别Benson的复杂数字。所有差异均具有统计学意义(p<0.001)。
    结果:这项研究证实了AD患者的健忘症特征,并揭示了bvFTD患者的命名能力下降,通常在执行功能早期受到影响的语言领域,根据最近的调查结果。
    结论:AD患者在言语和视觉情景记忆任务中表现较差,而bvFTD患者在命名任务中表现较差。这些发现为探索前额叶参与情景记忆的机制提供了可能性,通常归因于海马体。
    BACKGROUND: Although the absence of memory impairment was considered among the diagnostic criteria to differentiate Alzheimer\'s disease (AD) from Behavioural Variant of Frontotemporal Dementia (bvFTD), current and growing evidence indicates that a significant percentage of cases of bvFTD present with episodic memory deficits. In order to compare the performance profile of the naming capacity and episodic memory in patients with AD and bvFTD the present study was designed.
    METHODS: Cross-sectional and analytical study with control group (32 people). The study included 42 people with probable AD and 22 with probable bvFTD, all over 60 years old. Uniform Data Set instruments validated in Spanish were used: Multilingual Naming Test (MINT), Craft-21 history and Benson\'s complex figure, among others.
    RESULTS: A higher average age was observed among the patients with AD. The naming capacity was much lower in patients with bvFTD compared to patients with AD, measured according to the MINT and the nouns/verbs naming coefficient. All patients with bvFTD, 73.81% of those with AD and only 31.25% of the control group failed to recognise Benson\'s complex figure. All differences were statistically significant (p < 0.001).
    RESULTS: This study confirms the amnesic profile of patients with AD and reveals the decrease in naming capacity in patients with bvFTD, an area of ​​language that is typically affected early on with executive functions, according to recent findings.
    CONCLUSIONS: Patients with AD perform worse in verbal and visual episodic memory tasks, while patients with bvFTD perform worse in naming tasks. These findings open the possibility of exploring the mechanisms of prefrontal participation in episodic memory, typically attributed to the hippocampus.
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  • 文章类型: Journal Article
    背景:多项调查显示,患有额颞叶痴呆(bvFTD)行为变异的患者在多种处理方式中难以识别情绪信号(例如,面孔,韵律)。很少有研究评估这些患者对音乐情绪的识别。这项研究旨在评估bvFTD受试者识别具有积极和消极情绪的音乐刺激的能力,与健康受试者相比。
    方法:bvFTD(n=12)和健康对照(n=24)参与者进行了音乐情感识别测试:随机复制了56个钢琴音乐片段,14每种情绪(幸福,悲伤,恐惧,和和平)。
    结果:在bvFTD受试者中,与对照组相比,平均正确答案为23.6(42.26%),其中正确答案的平均数量为36.3(64.8%)。在进行的测试中,每种评估的音乐情绪和总分均存在统计学上的显着差异(P<0.01)。组内分析显示,两组在识别负面音乐情绪(悲伤,恐惧),bvFTD受试者表现较差。
    结论:我们的结果表明,对音乐刺激的识别具有积极的(幸福,平静)和消极(悲伤,恐惧)在bvFTD患者中情绪受损。对这些人来说,负面音乐情绪的处理是最困难的。
    BACKGROUND: Multiple investigations have revealed that patients with behavioral variant of frontotemporal dementia (bvFTD) experience difficulty recognizing emotional signals in multiple processing modalities (e.g., faces, prosody). Few studies have evaluated the recognition of musical emotions in these patients. This research aims to evaluate the ability of subjects with bvFTD to recognize musical stimuli with positive and negative emotions, in comparison with healthy subjects.
    METHODS: bvFTD (n=12) and healthy control participants (n=24) underwent a test of musical emotion recognition: 56 fragments of piano music were randomly reproduced, 14 for each of the emotions (happiness, sadness, fear, and peacefulness).
    RESULTS: In the subjects with bvFTD, a mean of correct answers of 23.6 (42.26%) was observed in contrast to the control subjects, where the average number of correct answers was 36.3 (64.8%). Statistically significant differences were found for each of the evaluated musical emotions and in the total score on the performed test (P<.01). The within-group analysis showed greater difficulty for both groups in recognizing negative musical emotions (sadness, fear), with the subjects with bvFTD exhibiting worse performance.
    CONCLUSIONS: Our results indicate that the recognition of musical stimuli with positive (happiness, peacefulness) and negative (sadness, fear) emotions are compromised in patients with bvFTD. The processing of negative musical emotions is the most difficult for these individuals.
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  • 文章类型: Journal Article
    BACKGROUND: Multiple investigations have revealed that patients with behavioral variant of frontotemporal dementia (bvFTD) experience difficulty recognizing emotional signals in multiple processing modalities (e.g., faces, prosody). Few studies have evaluated the recognition of musical emotions in these patients. This research aims to evaluate the ability of subjects with bvFTD to recognize musical stimuli with positive and negative emotions, in comparison with healthy subjects.
    METHODS: bvFTD (n=12) and healthy control participants (n=24) underwent a test of musical emotion recognition: 56 fragments of piano music were randomly reproduced, 14 for each of the emotions (happiness, sadness, fear, and peacefulness).
    RESULTS: In the subjects with bvFTD, a mean of correct answers of 23.6 (42.26%) was observed in contrast to the control subjects, where the average number of correct answers was 36.3 (64.8%). Statistically significant differences were found for each of the evaluated musical emotions and in the total score on the performed test (P<.01). The within-group analysis showed greater difficulty for both groups in recognizing negative musical emotions (sadness, fear), with the subjects with bvFTD exhibiting worse performance.
    CONCLUSIONS: Our results indicate that the recognition of musical stimuli with positive (happiness, peacefulness) and negative (sadness, fear) emotions are compromised in patients with bvFTD. The processing of negative musical emotions is the most difficult for these individuals.
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  • 文章类型: Journal Article
    背景:尽管在区分阿尔茨海默病(AD)和额颞叶痴呆(bvFTD)的行为变异的诊断标准中考虑了记忆障碍的缺失,当前和越来越多的证据表明,相当比例的bvFTD病例存在情景记忆缺陷。为了比较AD和bvFTD患者的命名能力和情景记忆的表现,设计了本研究。
    方法:对照组(32人)的横断面和分析研究。该研究包括42名可能患有AD的人和22名可能患有bvFTD的人,都超过60岁。使用西班牙语验证的统一数据集工具:多语言命名测试(MINT),Craft-21的历史和本森的复杂人物,在其他人中。
    结果:AD患者的平均年龄更高。BvFTD患者的命名能力远低于AD患者,根据MINT和名词/动词命名系数测量。所有患有bvFTD的患者,73.81%的AD患者和只有31.25%的对照组未能识别Benson的复杂数字。所有差异均具有统计学意义(p<0.001)。
    结果:这项研究证实了AD患者的健忘症特征,并揭示了bvFTD患者的命名能力下降,通常在执行功能早期受到影响的语言领域,根据最近的调查结果。
    结论:AD患者在言语和视觉情景记忆任务中表现较差,而bvFTD患者在命名任务中表现较差。这些发现为探索前额叶参与情景记忆的机制提供了可能性,通常归因于海马体。
    BACKGROUND: Although the absence of memory impairment was considered among the diagnostic criteria to differentiate Alzheimer\'s disease (AD) from Behavioural Variant of Frontotemporal Dementia (bvFTD), current and growing evidence indicates that a significant percentage of cases of bvFTD present with episodic memory deficits. In order to compare the performance profile of the naming capacity and episodic memory in patients with AD and bvFTD the present study was designed.
    METHODS: Cross-sectional and analytical study with control group (32 people). The study included 42 people with probable AD and 22 with probable bvFTD, all over 60 years old. Uniform Data Set instruments validated in Spanish were used: Multilingual Naming Test (MINT), Craft-21 history and Benson\'s complex figure, among others.
    RESULTS: A higher average age was observed among the patients with AD. The naming capacity was much lower in patients with bvFTD compared to patients with AD, measured according to the MINT and the nouns/verbs naming coefficient. All patients with bvFTD, 73.81% of those with AD and only 31.25% of the control group failed to recognise Benson\'s complex figure. All differences were statistically significant (p <0.001).
    RESULTS: This study confirms the amnesic profile of patients with AD and reveals the decrease in naming capacity in patients with bvFTD, an area of language that is typically affected early on with executive functions, according to recent findings.
    CONCLUSIONS: Patients with AD perform worse in verbal and visual episodic memory tasks, while patients with bvFTD perform worse in naming tasks. These findings open the possibility of exploring the mechanisms of prefrontal participation in episodic memory, typically attributed to the hippocampus.
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  • 文章类型: Journal Article
    OBJECTIVE: To describe and illustrate the key findings on structural magnetic resonance imaging (MRI) in the most common dementias of neurodegenerative origin: Alzheimer\'s disease, vascular dementia, dementia with Lewy bodies, variants of frontotemporal dementia, progressive supranuclear palsy, variants of multiple system atrophy, Parkinson dementia, and corticobasal degeneration.
    CONCLUSIONS: Today the role of MRI is no longer limited to ruling out underlying causes of cognitive deterioration. MRI can show patterns of atrophy with a predictive value for certain dementias which, although not specific or unique to each disease, can help to confirm diagnostic suspicion or to identify certain processes. For this reason, it is important for radiologists to know the characteristic findings of the most common dementias.
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  • 文章类型: Journal Article
    BACKGROUND: The Addenbrooke\'s Cognitive Examination III (ACE-III), an adaptation of the ACE cognitive screening test, has been demonstrated to have high sensitivity and specificity in detecting cognitive impairment in patients with dementia and other neurological and psychiatric disorders. Although the Spanish-language version of the ACE-III has already been validated in Spain, it is yet to be validated in Latin America. The aim of this study was to validate the ACE-III test in an Argentinean and Chilean population.
    METHODS: ACE-III was administered to 70 patients with Alzheimer disease, 31 patients with behavioural variant frontotemporal dementia, and a control group of 139 healthy volunteers. Participants were recruited at centres in both countries.
    RESULTS: The Spanish-language version of ACE-III was found to have good internal consistency (Cronbach\'s alpha=0.87). We found significant differences in total ACE-III scores between patients with Alzheimer disease and controls (p< .05) and between patients with Alzheimer disease and bvFTD (p< .05). With a cut-off point of 86, 98.6% of AD patients, 83.9% of behavioural variant frontotemporal dementia patients, and 84.2% of controls were correctly classified.
    CONCLUSIONS: This study shows that the Spanish-language version of ACE-III continues to be an effective tool for detecting cognitive dysfunction in patients with dementia.
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  • 文章类型: Journal Article
    BACKGROUND: The Frontotemporal Dementia Rating Scale (FTD-FRS) is a tool designed to aid with clinical staging and assessment of the progression of frontotemporal dementia (FTD-FRS).
    OBJECTIVE: Present a multicentre adaptation and validation study of a Spanish version of the FRS.
    METHODS: The adapted version was created using 2 translation-back translation processes (English to Spanish, Spanish to English) and verified by the scale\'s original authors. We validated the adapted version in a sample of consecutive patients diagnosed with FTD. The procedure included evaluating internal consistency, testing unidimensionality with the Rasch model, analysing construct validity and discriminant validity, and calculating the degree of agreement between the Clinical Dementia Rating scale (CDR) and FTD-FRS for FTD cases.
    RESULTS: The study included 60 patients with DFT. The mean score on the FRS was 12.1 points (SD=6.5; range, 2-25) with inter-group differences (F=120.3; df=3; P<.001). Cronbach\'s alpha was 0.897 and principal component analysis of residuals delivered an acceptable eigenvalue for 5 contrasts (1.6-2.7) and 36.1% raw variance. FRS was correlated with the Mini-mental State Examination (r=0.572; P<.001) and functional capacity (DAD; r=0.790; P<.001). FTD-FRS also showed a significant correlation with CDR (r=-0.641; P<.001), but we did observe variability in the severity levels; cases appeared to be less severe according to the CDR than when measured with the FTD-FRS (kappa=0.055).
    CONCLUSIONS: This process of validating the Spanish translation of the FTD-FRS yielded satisfactory results for validity and unidimensionality (severity) in the assessment of patients with FTD.
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  • 文章类型: English Abstract
    Patients with schizophrenia and Frontotemporal Dementia (FTD) in their linguistic variants share some language characteristics such as the lexical access difficulties, disordered speech with disruptions, many pauses, interruptions and reformulations. For the schizophrenia patients it reflects a difficulty of affect expression, while for the FTD patients it reflects a linguistic issue.
    METHODS: This study, through an analysis of a series of cases assessed Clinic both in memory and on the Mental Health Unit of HUSI-PUJ (Hospital Universitario San Ignacio), with additional language assessment (analysis speech and acoustic analysis), present distinctive features of the DFT in its linguistic variants and schizophrenia that will guide the specialist in finding early markers of a differential diagnosis.
    RESULTS: In patients with FTD language variants, in 100% of cases there is a difficulty understanding linguistic structure of complex type; and important speech fluency problems. In patients with schizophrenia, there are significant alterations in the expression of the suprasegmental elements of speech, as well as disruptions in discourse.
    CONCLUSIONS: We present how depth language assessment allows to reassess some of the rules for the speech and prosody analysis of patients with dementia and schizophrenia; we suggest how elements of speech are useful in guiding the diagnosis and correlate functional compromise in everyday psychiatrist\'s practice.
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  • 文章类型: Journal Article
    BACKGROUND: Addenbrooke\'s Cognitive Examination is a screening test used to diagnose dementia. The third edition of this test (ACE-III) was recently developed. The aim of this study was to translate and validate the ACE-III in Spanish.
    METHODS: The ACE-III was translated and adapted to Spanish. It was then administered to a group of healthy subjects as well as a group of patients with different types of mild dementia treated in 2 hospitals in Spain.
    RESULTS: Internal reliability (Cronbach\'s alpha = 0.927), inter-rater reliability (intraclass correlation coefficient = 0.976) and test-retest reliability (kappa 0.995) were excellent. Age (r = -0.512) and education (r = 0.659) showed a significant correlation with total test scores. The diagnostic accuracy of ACE-III was higher than that of the Mini-Mental State Examination, particularly for the group with the highest educational level. Researchers obtained normative data and cut-off points for the diagnosis of dementia.
    CONCLUSIONS: The Spanish version of the ACE-III is a reliable and valid test for diagnosing dementia. Its diagnostic accuracy is high, especially in patients with a higher level of education.
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