RESUMO
We studied mood disorders (MD) and psychotic symptoms (PS) in patients with fronto -temporal dementia (FTD) and Alzheimer's disease (AD) by means of different diagnostic instruments. These were: a subjective scale (subsets of survey psychiatric assessment schedule: SPAS), an objective scale (subsets of neuropsychiatric inventory: NPI) and a projective task (Wartegg completion task: WCT). A general tendency of NPI to over estimate the presence of symptoms compared to SPAS was observed, but distribution and severity of symptoms were quite homogeneous in the two dementia-groups, independently of the diagnostic scales. At variance with the scales, the WCT showed a more severe impairment in FTD than in AD. The regression analysis selected neuropsychological models able to predict behavioral disorders only in FTD, in particular, a planning deficit predicted PS. These data confirm the hypothesis that a damage in the frontal areas constitutes the neurobiological basis of PS in degenerative brain diseases. Furthermore, they suggest that mostly in FTD, behavioral disorders, as well as cognitive deficits, should be considered a direct expression of neural damage.
Assuntos
Demência , Lobo Frontal/fisiopatologia , Transtornos Mentais/epidemiologia , Transtornos do Humor/epidemiologia , Degeneração Neural/fisiopatologia , Transtornos Psicóticos/epidemiologia , Lobo Temporal/fisiopatologia , Idoso , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/fisiopatologia , Demência/diagnóstico , Demência/epidemiologia , Demência/fisiopatologia , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/patologia , Humanos , Imageamento por Ressonância Magnética , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Transtornos do Humor/psicologia , Testes Neuropsicológicos , Valor Preditivo dos Testes , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/psicologia , Índice de Gravidade de Doença , Inquéritos e Questionários , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/patologia , Tomografia Computadorizada por Raios XRESUMO
Object and action naming and comprehension were tested in frontotemporal dementia (frontal variant, FTD), in Alzheimer's disease (AD) and in controls. Although lower scores were obtained by all groups, we can confirm that actions were proportionally more impaired in FTD. The correlation between action naming deficit and severity of dementia was stronger in this group than in AD. The correlation analysis also suggested that the naming disorder was different in nature in FTD (mostly a dysexecutive deficit) and in AD (mostly a linguistic disorder). Our explanation is that since verbs are supposed to be more demanding of executive resources than nouns, a higher sensitivity to verbs should be expected in any brain pathology, but mostly in FTD in which executive resources are typically reduced.