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JNNP: 内心深处,疾病之下:肌萎缩性侧索硬化-额颞谱障碍的社会认知

2020-09-27 MedSci原创 MedSci原创

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肌萎缩侧索硬化症(ALS)和额颞部痴呆(FTD)在临床和病理上特征上都有相似之处。与ALS相关的认知障碍与行为变异性FTD(bvFTD)中的前额叶功能障碍相似,表明两种情况之间存在连续性。肌萎缩侧索硬化-额颞叶频谱障碍(ALS-FTSD)标准根据认知和/或行为症状将ALS患者分为:(1)伴有认知障碍的ALS(ALSci),(2)伴有行为障碍的ALS(ALSbi),(3) ALS合并认知和行为障碍(ALScbi)和(4)ALS合并FTD。作者比较肌萎缩侧索硬化症(ALS)与行为变异性额颞部痴呆(bvFTD)患者的社会认知能力。社会认知是指在社会情境中适应行为所需要的一系列认知能力,如心理理论、情绪识别和心理化。在ALS-FTSD5-9和bvFTD中,社会认知缺陷和执行功能障碍都很常见。

方法:62名参与者来自巴西和智利的两个神经科诊所。对21例ALS患者、20例bvFTD患者和21例健康对照者进行了综合认知测试,包括面部情绪识别测试(FERT)、简易心理状态检查、正面评估词汇流畅性(F-A-S)、数字广度(直接和向后)测试和Hayling测试。没有一个参与者符合抑郁症或其他神经(如失语症)或精神疾病的标准。ALS患者没有出现呼吸功能障碍。对ALS患者进行事后分析,将其分为两个亚组:无认知障碍患者(ALScn;n=13)和认知障碍患者(ALSci;n=8)。

结果:两组受试者在年龄、性别、文化程度上无显著差异。ALS总组与bvFTD患者病程相似。与对照组相比,ALSci患者在FERT(p<0.001)、faux pas(p<0.004)和Mini-SEA(p<0.002)总分方面表现较差。此外,与对照组相比,bvFTD患者在执行和社会认知测试中表现较差。ALSci患者的表现与bvFTD患者相似,而ALScn患者的表现与对照组相似。

作者的发现支持了ALS和bvFTD之间的认知连续性,并揭示了ALS的认知异质性,扩展了其可能的神经心理学特征。

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    2020-10-14 yangchou

    难治疾病的新希望在哪

    0

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