| BackgroundWith the rapid development of economy, the chronic diseases have become the leading cause of death than infectious diseases, coupled with the aging of the population, dementia has become the focus of global concern. Dementia, however, remains an under-recognized and under-diagnosed disorder.Alzheimer’s disease is the most common neurodegenerative dementia, study showed pathological changes precede the clinical symptoms many years, to find out the sensitive clinical markers has become an urgent need. Large scale epidemiological of frontotemporal dementia are abscent, progressive non fluent aphasia and semantic dementia are much rare.although degeneration diseases have their own clinical and imaging features,in early stage,semantic dementia may show the memory impairment due to the lose of sementia knowledge,easily misdiagnosed as AD. the early diagnosis and differential diagnosis are difficult. We hope to find out a neuropsychological tool for the detection of Alzheimer’s disease early based on community elderly. to Analyze neuropsycho logical characteristics and imaging in temporal lobe variant semantic dementia,FHS and NACC neuropsycho logical scales were used to give a guide to future neuropsycho logical tests, to raise awareness of this disease.The first studyObjective To find out neuropsycho logical markers for early detection of cognitive impairment in Chinese cultural, so as to provide a basis for further community cohort studyMethods387healthy residents over50years of age from5communities in Beijing.FHS neuropsycho logical test, risk factors and head MRI are tested, to descript the distribution of the neuropsycho logical test, Pearson correlation is used for correlation analysis between the cognitive tests, to analyze the influence of age, gender and education by multiple linear regression modelResultsthe distribution characteristics of psychological test:MMSE as a screening scale has ceiling effect, FOM has no difference in each age and education groups, and the other neuropsycho logical tests are better in young age and high education group.Correlation analysis:correlation between MMSE and general cognitive test is low, MOCA and cognitive test has moderate correlation, correlation coefficient>0.5,the correlation coefficient of each memory test and total memory are range from0.52to 0.81,the correlation of logical memory and total memory is higher than PVLT then visual memory then paired memory, then FOM. correlation between TMT and total execution function is highest. memory, language and execution in Ecog are low correlation with cognitive tests, the correlation coefficient was range from negative0.16to0.19, correlated with depression scores ranged from0.22to0.26. there is no correlation between Digital span and FOM, VST and logical memory.the correlation coefficient between memory and executive function scales rangefrom0.11to0.45. while Stratified analysis showed that memory and executive functions are irrelevant or low correlationMultiple regression analysis of influencing factors of neuropsychological tests:age has an impact on all cognitive tests, education for all except FOM, age has an impact on cognitive tests in frontal lobe function, male perform better than the female in language tests.Conclusion FHS neuropsychological tests show the cognitive function in many ways, Because of different neural circuits in the cognitive tests,different neuropsychological scales can be used in the same cognitive domain independently. The combined use of can reflect the globle cognitive with for Cognitive asymmetry. The informant Ecog may serve as a early marker,need to pay attention.Screening scale can not be used as the diagnostic and differential diagnostic tool in study of dementia. The unique Chinese cultural features will affect the tests related to word, the changes of PVLT, TMT and Boston naming in Chinese culture maybe Suitable for China.The second studyObjective to identify the clinical profile and neuro-imaging findings of the right temporal lobe variant of semantic dementia (RTLV), and to understand the relationship between anatomic and function by comparison to the left temporal lobe atrophy.to explore the future use in neuropsychological tests.Methods Of14patients with semantic dementia from82patients with diagnosis of frontotemporal dementia in our memory Clinic, four patients with right temporal lobe atrophy were identified based on the MRI scans. We obtained the profile of cognitive function, behavior,personality changes and FHS neuropsychological tests and NACC tests in these4patients and compared them with those in10semantic dementia (SD) patients with predominant left-sided temporal lobe atrophy. We also compared F18-FDG positron emission tomography with Statistical Parametric Mapping(SPM) analysis in5patients.Results In RTLV patients, the most prominent cognitive deficits were impairment of prosopagnosia, and getting lost. Variety behavioral symptoms including apathy, social disinhibition, stereotypy, compulsive behaviors were more prevalent in early course for patients with RTLV,there were different from SD Patients with semantic loss began with anomia or single-word comprehension. F18-FDG-PET scan showed decreased metabolism mainly in right temporal lobe and in other brain regions with varying degrees. FHS neuropsychological tests can find out patients with normal conventional memory test, Boston naming can dectect impairment of naming, SD group is relatively worse in verbal memory,while graphics-related semantic knowledge in RTLVConclusion The RTLV was clinical heterogeneous, prosopagnosia, behavioral changes and getting lost were the main features in the early course.it therefore, might be proposed a separate clinical entity that need to be confirmed. neuropsychological research according to its early signs should be set up. |
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