阿尔茨海默病淡漠症状研究进展
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摘要
淡漠是阿尔茨海默病最常见的精神行为症状。淡漠的出现会降低患者生命质量、增加照料者负担。文章主要综述了AD淡漠临床表现、影像学特点及治疗等相关研究进展。
Apathy is the most common neuropsychiatric symptom in patients with Alzheimer's disease(AD). The presence of apathy has been related to decreased quality of life, greater caregiver distress. The article mainly reviews the research progress in this neuropsychiatric syndrome, focusing on its clinical characteristic, neuroimaging studies and treatment options.
Apathy is the most common neuropsychiatric symptom in patients with Alzheimer's disease(AD). The presence of apathy has been related to decreased quality of life, greater caregiver distress. The article mainly reviews the research progress in this neuropsychiatric syndrome, focusing on its clinical characteristic, neuroimaging studies and treatment options.
引文
[1]Lyketsos C G,Carrillo M C,Ryan J M,et al.Neuropsychiatric symptoms in Alzheimer’s disease[J].Alzheimer’s&Dementia,2011,7(5):532-539.
[2]Lanctot K L,Aguera-Ortiz L,Brodaty H,et al.Apathy associated with neurocognitive disorders:Recent progress and future directions[J].Alzheimers Dement,2017,13(1):84-100.
[3]唐秋碧,周英,汪国成,等.老年痴呆患者情感淡漠与生命质量的相关性[J].中国老年学杂志,2018(16):4065-4068.
[4]Marin R S.Differential diagnosis and classification of apathy[J].Am J Psychiatry,1990,147(1):22-30.
[5]Marin R S,Biedrzycki R C,Firinciogullari S.Reliability and validity of the apathy evaluation scale[J].Psychiatry Research,1991,38(2):143-162.
[6]Levy R,Dubois B.Apathy and the Functional Anatomy of the Prefrontal Cortex-Basal Ganglia Circuits[J].Cerebral Cortex,2006,16(7):916-928.
[7]Robert P,Onyike C U,Leentjens A F G,et al.Proposed diagnostic criteria for apathy in Alzheimer’s disease and other neuropsychiatric disorders[J].European Psychiatry,2009,24(2):98-104.
[8]Zhao Q F,Tan L,Wang H F,et al.The prevalence of neuropsychiatric symptoms in Alzheimer’s disease:Systematic review and meta-analysis[J].J Affect Disord,2016,190:264-271.
[9]Starkstein S E.A prospective longitudinal study of apathy in Alzheimer’s disease[J].Journal of Neurology,Neurosurgery&Psychiatry,2006,77(1):8-11.
[10]Ballarini T,Iaccarino L,Magnani G,et al.Neuropsychiatric subsyndromes and brain metabolic network dysfunctions in early onset Alzheimer’s disease[J].Human Brain Mapping,2016,37(12):4234-4247.
[11]Tunnard C,Whitehead D,Hurt C,et al.Apathy and cortical atrophy in Alzheimer’s disease[J].2011,26(7):741-748.
[12]Mori T,Shimada H,Shinotoh H,et al.Apathy correlates with prefrontal amyloid deposition in Alzheimer’s disease[J].Journal of Neurology,Neurosurgery&Psychiatry,2014,85(4):449-455.
[13]Clarke D E,Ko J Y,Kuhl E A,et al.Are the available apathy measures reliable and valid?A review of the psychometric evidence[J].Journal of Psychosomatic Research,2011,70(1):73-97.
[14]Lueken U,Seidl U,Volker L,et al.Development of a short version of the Apathy Evaluation Scale specifically adapted for demented nursing home residents[J].Am J Geriatr Psychiatry,2007,15(5):376-385.
[15]Cummings J L,Mega M,Gray K,et al.The Neuropsychiatric Inventory:comprehensive assessment of psychopathology in dementia[J].Neurology,1994,44(12):2308-2314.
[16]Robert P H,Clairet S,Benoit M,et al.The Apathy Inventory:assessment of apathy and awareness in Alzheimer’s disease,Parkinson’s disease and mild cognitive impairment[J].International Journal of Geriatric Psychiatry,2002,17(12):1099-1105.
[17]Radakovic R,Starr J M,Abrahams S.A Novel Assessment and Profiling of Multidimensional Apathy in Alzheimer’s Disease[J].J Alzheimers Dis,2017,60(1):57-67.
[18]Spalletta G,Long J D,Robinson R G,et al.Longitudinal Neuropsychiatric Predictors of Death in Alzheimer’s Disease[J].J Alzheimers Dis,2015,48(3):627-636.
[19]You S C,Walsh C M,Chiodo L A,et al.Neuropsychiatric Symptoms Predict Functional Status in Alzheimer’s Disease[J].J Alzheimers Dis,2015,48(3):863-869.
[20]Tagariello P,Girardi P,Amore M.Depression and apathy in dementia:Same syndrome or different constructs?A critical review[J].Archives of Gerontology and Geriatrics,2009,49(2):246-249.
[21]Levy M L,Cummings J L,Fairbanks L A,et al.Apathy is not depression[J].J Neuropsychiatry Clin Neurosci,1998,10(3):314-319.
[22]Theleritis C,Politis A,Siarkos K,et al.A review of neuroimaging findings of apathy in Alzheimer’s disease[J].International Psychogeriatrics,2014,26(02):195-207.
[23]David R,Koulibaly M,Benoit M,et al.Striatal dopamine transporter levels correlate with apathy in neurodegenerative diseases A SPECT study with partial volume effect correction[J].Clin Neurol Neurosurg,2008,110(1):19-24.
[24]Forstl H,Burns A,Levy R,et al.Neuropathological correlates of behavioural disturbance in confirmed Alzheimer’s disease[J].Br J Psychiatry,1993,163:364-368.
[25]Marshall G A,Fairbanks L A,Tekin S,et al.Neuropathologic correlates of apathy in Alzheimer’s disease[J].Dement Geriatr Cogn Disord,2006,21(3):144-147.
[26]Moon Y,Moon W,Kim H,et al.Regional Atrophy of the Insular Cortex Is Associated with Neuropsychiatric Symptoms in Alzheimer’s Disease Patients[J].European Neurology,2014,71(5-6):223-229.
[27]Donovan N J,Wadsworth L P,Lorius N,et al.Regional Cortical Thinning Predicts Worsening Apathy and Hallucinations Across the Alzheimer Disease Spectrum[J].The American Journal of Geriatric Psychiatry,2014,22(11):1168-1179.
[28]Hahn C,Lim H K,Won W Y,et al.Apathy and white matter integrity in Alzheimer’s disease:a whole brain analysis with tract-based spatial statistics[J].PLoS One,2013,8(1):e53493.
[29]Fernandez-Matarrubia M,Matias-Guiu J A,CabreraMartin M N,et al.Different apathy clinical profile and neural correlates in behavioral variant frontotemporal dementia and Alzheimer’s disease[J].Int J Geriatr Psychiatry,2018,33(1):141-150.
[30]赵弘铁.Alzheimer病患者淡漠综合征的临床研究[D].第二军医大学神经内科,2012.
[31]Balthazar M L F,Pereira F R S,Lopes T M,et al.Neuropsychiatric symptoms in Alzheimer’s disease are related to functional connectivity alterations in the salience network[J].Human Brain Mapping,2014,35(4):1237-1246.
[32]Lopez O L,Mackell J A,Sun Y,et al.Effectiveness and safety of donepezil in Hispanic patients with Alzheimer’s disease:a 12-week open-label study[J].J Natl Med Assoc,2008,100(11):1350-1358.
[33]Waldemar G,Gauthier S,Jones R,et al.Effect of donepezil on emergence of apathy in mild to moderate Alzheimer’s disease[J].Int J Geriatr Psychiatry,2011,26(2):150-157.
[34]Padala P R,Padala K P,Lensing S Y,et al.Methylphenidate for Apathy in Community-Dwelling Older Veterans With Mild Alzheimer’s Disease:A DoubleBlind,Randomized,Placebo-Controlled Trial[J].Am JPsychiatry,2018,175(2):159-168.
[35]Bachinskaya N,Hoerr R,Ihl R.Alleviating neuropsychiatric symptoms in dementia:the effects of Ginkgo biloba extract EGb 761.Findings from a randomized controlled trial[J].Neuropsychiatr Dis Treat,2011,7:209-215.
[36]Zhang N,Wei C,Du H,et al.The Effect of Memantine on Cognitive Function and Behavioral and Psychological Symptoms in Mild-to-Moderate Alzheimer’s Disease Patients[J].Dement Geriatr Cogn Disord,2015,40(1-2):85-93.
[37]Sanchez A,Marante-Moar M P,Sarabia C,et al.Multisensory Stimulation as an Intervention Strategy for Elderly Patients With Severe Dementia:A Pilot Randomized Controlled Trial[J].Am J Alzheimers Dis Other Demen,2016,31(4):341-350.
[38]Ohmana H,Savikko N R N,Strandberg T E,et al.Effects of frequent and long-term exercise on neuropsychiatric symptoms in patients with Alzheimer’s diseaseSecondary analyses of a randomized,controlled trial(FINALEX)[J].European Geriatric Medicine,2017,8(2):153-157.
[2]Lanctot K L,Aguera-Ortiz L,Brodaty H,et al.Apathy associated with neurocognitive disorders:Recent progress and future directions[J].Alzheimers Dement,2017,13(1):84-100.
[3]唐秋碧,周英,汪国成,等.老年痴呆患者情感淡漠与生命质量的相关性[J].中国老年学杂志,2018(16):4065-4068.
[4]Marin R S.Differential diagnosis and classification of apathy[J].Am J Psychiatry,1990,147(1):22-30.
[5]Marin R S,Biedrzycki R C,Firinciogullari S.Reliability and validity of the apathy evaluation scale[J].Psychiatry Research,1991,38(2):143-162.
[6]Levy R,Dubois B.Apathy and the Functional Anatomy of the Prefrontal Cortex-Basal Ganglia Circuits[J].Cerebral Cortex,2006,16(7):916-928.
[7]Robert P,Onyike C U,Leentjens A F G,et al.Proposed diagnostic criteria for apathy in Alzheimer’s disease and other neuropsychiatric disorders[J].European Psychiatry,2009,24(2):98-104.
[8]Zhao Q F,Tan L,Wang H F,et al.The prevalence of neuropsychiatric symptoms in Alzheimer’s disease:Systematic review and meta-analysis[J].J Affect Disord,2016,190:264-271.
[9]Starkstein S E.A prospective longitudinal study of apathy in Alzheimer’s disease[J].Journal of Neurology,Neurosurgery&Psychiatry,2006,77(1):8-11.
[10]Ballarini T,Iaccarino L,Magnani G,et al.Neuropsychiatric subsyndromes and brain metabolic network dysfunctions in early onset Alzheimer’s disease[J].Human Brain Mapping,2016,37(12):4234-4247.
[11]Tunnard C,Whitehead D,Hurt C,et al.Apathy and cortical atrophy in Alzheimer’s disease[J].2011,26(7):741-748.
[12]Mori T,Shimada H,Shinotoh H,et al.Apathy correlates with prefrontal amyloid deposition in Alzheimer’s disease[J].Journal of Neurology,Neurosurgery&Psychiatry,2014,85(4):449-455.
[13]Clarke D E,Ko J Y,Kuhl E A,et al.Are the available apathy measures reliable and valid?A review of the psychometric evidence[J].Journal of Psychosomatic Research,2011,70(1):73-97.
[14]Lueken U,Seidl U,Volker L,et al.Development of a short version of the Apathy Evaluation Scale specifically adapted for demented nursing home residents[J].Am J Geriatr Psychiatry,2007,15(5):376-385.
[15]Cummings J L,Mega M,Gray K,et al.The Neuropsychiatric Inventory:comprehensive assessment of psychopathology in dementia[J].Neurology,1994,44(12):2308-2314.
[16]Robert P H,Clairet S,Benoit M,et al.The Apathy Inventory:assessment of apathy and awareness in Alzheimer’s disease,Parkinson’s disease and mild cognitive impairment[J].International Journal of Geriatric Psychiatry,2002,17(12):1099-1105.
[17]Radakovic R,Starr J M,Abrahams S.A Novel Assessment and Profiling of Multidimensional Apathy in Alzheimer’s Disease[J].J Alzheimers Dis,2017,60(1):57-67.
[18]Spalletta G,Long J D,Robinson R G,et al.Longitudinal Neuropsychiatric Predictors of Death in Alzheimer’s Disease[J].J Alzheimers Dis,2015,48(3):627-636.
[19]You S C,Walsh C M,Chiodo L A,et al.Neuropsychiatric Symptoms Predict Functional Status in Alzheimer’s Disease[J].J Alzheimers Dis,2015,48(3):863-869.
[20]Tagariello P,Girardi P,Amore M.Depression and apathy in dementia:Same syndrome or different constructs?A critical review[J].Archives of Gerontology and Geriatrics,2009,49(2):246-249.
[21]Levy M L,Cummings J L,Fairbanks L A,et al.Apathy is not depression[J].J Neuropsychiatry Clin Neurosci,1998,10(3):314-319.
[22]Theleritis C,Politis A,Siarkos K,et al.A review of neuroimaging findings of apathy in Alzheimer’s disease[J].International Psychogeriatrics,2014,26(02):195-207.
[23]David R,Koulibaly M,Benoit M,et al.Striatal dopamine transporter levels correlate with apathy in neurodegenerative diseases A SPECT study with partial volume effect correction[J].Clin Neurol Neurosurg,2008,110(1):19-24.
[24]Forstl H,Burns A,Levy R,et al.Neuropathological correlates of behavioural disturbance in confirmed Alzheimer’s disease[J].Br J Psychiatry,1993,163:364-368.
[25]Marshall G A,Fairbanks L A,Tekin S,et al.Neuropathologic correlates of apathy in Alzheimer’s disease[J].Dement Geriatr Cogn Disord,2006,21(3):144-147.
[26]Moon Y,Moon W,Kim H,et al.Regional Atrophy of the Insular Cortex Is Associated with Neuropsychiatric Symptoms in Alzheimer’s Disease Patients[J].European Neurology,2014,71(5-6):223-229.
[27]Donovan N J,Wadsworth L P,Lorius N,et al.Regional Cortical Thinning Predicts Worsening Apathy and Hallucinations Across the Alzheimer Disease Spectrum[J].The American Journal of Geriatric Psychiatry,2014,22(11):1168-1179.
[28]Hahn C,Lim H K,Won W Y,et al.Apathy and white matter integrity in Alzheimer’s disease:a whole brain analysis with tract-based spatial statistics[J].PLoS One,2013,8(1):e53493.
[29]Fernandez-Matarrubia M,Matias-Guiu J A,CabreraMartin M N,et al.Different apathy clinical profile and neural correlates in behavioral variant frontotemporal dementia and Alzheimer’s disease[J].Int J Geriatr Psychiatry,2018,33(1):141-150.
[30]赵弘铁.Alzheimer病患者淡漠综合征的临床研究[D].第二军医大学神经内科,2012.
[31]Balthazar M L F,Pereira F R S,Lopes T M,et al.Neuropsychiatric symptoms in Alzheimer’s disease are related to functional connectivity alterations in the salience network[J].Human Brain Mapping,2014,35(4):1237-1246.
[32]Lopez O L,Mackell J A,Sun Y,et al.Effectiveness and safety of donepezil in Hispanic patients with Alzheimer’s disease:a 12-week open-label study[J].J Natl Med Assoc,2008,100(11):1350-1358.
[33]Waldemar G,Gauthier S,Jones R,et al.Effect of donepezil on emergence of apathy in mild to moderate Alzheimer’s disease[J].Int J Geriatr Psychiatry,2011,26(2):150-157.
[34]Padala P R,Padala K P,Lensing S Y,et al.Methylphenidate for Apathy in Community-Dwelling Older Veterans With Mild Alzheimer’s Disease:A DoubleBlind,Randomized,Placebo-Controlled Trial[J].Am JPsychiatry,2018,175(2):159-168.
[35]Bachinskaya N,Hoerr R,Ihl R.Alleviating neuropsychiatric symptoms in dementia:the effects of Ginkgo biloba extract EGb 761.Findings from a randomized controlled trial[J].Neuropsychiatr Dis Treat,2011,7:209-215.
[36]Zhang N,Wei C,Du H,et al.The Effect of Memantine on Cognitive Function and Behavioral and Psychological Symptoms in Mild-to-Moderate Alzheimer’s Disease Patients[J].Dement Geriatr Cogn Disord,2015,40(1-2):85-93.
[37]Sanchez A,Marante-Moar M P,Sarabia C,et al.Multisensory Stimulation as an Intervention Strategy for Elderly Patients With Severe Dementia:A Pilot Randomized Controlled Trial[J].Am J Alzheimers Dis Other Demen,2016,31(4):341-350.
[38]Ohmana H,Savikko N R N,Strandberg T E,et al.Effects of frequent and long-term exercise on neuropsychiatric symptoms in patients with Alzheimer’s diseaseSecondary analyses of a randomized,controlled trial(FINALEX)[J].European Geriatric Medicine,2017,8(2):153-157.
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