La variante frontal de la enfermedad de Alzheimer y la enfermedad de Alzheimer típicaun estudio comparativo

  1. Fernández Calvo, Bernardino
  2. Ramos Campos, Francisco
  3. Menezes de Lucena Carvalho, Virginia A.
Revista:
Anales de psicología

ISSN: 0212-9728,  1695-2294

Año de publicación: 2013

Volumen: 29

Número: 1

Páginas: 293-300

Tipo: Artículo

DOI: 10.6018/ANALESPS.29.1.138231 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Anales de psicología

Resumen

Una de las características de la Enfermedad de Alzheimer (EA) es su heterogeneidad clínica. Así, la presentación atípica frontal o disejecutiva es cada vez más conocida, aunque los factores subyacentes se desconocen. En este estudio se comparó el rendimiento neuropsicológico de dos grupos de pacientes con EA (variante frontal -EAvf- y típica -EAT-). El grupo EAvf (n = 13) fue seleccionado por la existencia de una hipocaptación frontal. Los resultados revelaron que el grupo EAvf manifestó un trastorno disejecutivo grave, una sintomatología neuropsiquiátrica más severa (desinhibición y apatía), mayor deterioro funcional y generó mayor sobrecarga en el cuidador que el grupo EAT sin afectación frontal (n = 47). A pesar de que el grupo EAvf rindió más bajo en todos los test neuropsicológicos, solo se encontraron diferencias significativas entre ambos grupos en las tareas de velocidad de procesamiento y visuoconstrucción. El análisis de regresión logística reveló que las puntuaciones de velocidad de procesamiento y flexibilidad mental predicen significativamente el diagnostico de EAvf. La existencia de reflejo de graspin, anosognosia y la no posesión del APOE e4 también fue más prevalente en el grupo EAvf. Este grupo mostró una predominancia de varones y fue más propenso a tener una historia familiar positiva para la EA. Para concluir, el estudio sugiere que la EAvf representa un subtipo de EA que parece tener características clínicas, neuropsicológicas y genéticas diferentes a la EAT.

Referencias bibliográficas

  • Alladi, S., Xuereb, J., Bak, T., Nestor, P., Knibb, J., Patterson, K., & Hodges, J. R. (2007). Focal cortical presentations of Alzheimer's disease. Brain, 130, 2636-2645.
  • Amanzio, M., Torta, D. M. E., Sacco, K., Cauda, F., D' Agata, F., Duca, S., Geminiani, G. C. (2011). Unawareness of deficits in Alzheimer's disease: role of the cingulate cortex. Brain, 134, 1061-1076.
  • American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders: DSM-IV-TR (4th ed.). Washington, DC: American Psychiatric Press.
  • Back-Madruga, C., Boone, K. B, Briere, J., Cummings, J., McPherson, S., Fairbanks, L., & Thompson, E. (2002). Functional ability in executive variant Alzheimer's disease and typical Alzheimer's disease. The Clinical Neuropsychologist, 16, 331-340.
  • Balasa, M., Gelpi, E., Antonell, A., Rey, M. J., Sánchez-Valle, R., Molinuevo, J. L., & Lladó, A. (2011). Clinical features and APOE genotype of pathologically proven early-onset Alzheimer disease. Neurology, 76(20), 1720-1725.
  • Becker, J. T., Huff, F. J., Nebes, R. D., Holland, A. & Boller, F., (1988). Neuropsychological function in Alzheimer's disease: pattern of impairment and rates of progression. Archives of Neurology, 45, 263-268.
  • Benton, A. L. (1981). El Test de Retención Visual. Ediciones TEA. Madrid.
  • Binetti, G., Magni, E., Padovani, A., Cappa, S. F., Bianchetti, A., & Trabucchi, M. (1996). Executive dysfunction in early Alzheimer's disease. Journal of Neurology, Neurosurgery, and Psychiatry, 60, 91-93.
  • Böhm, P., Peña-Casanova, J., Aguilar, M., Hernández, G., Sol, J. M., & lesa, R. (1998). Clinical validity and utility of the Interview for Deterioration of Daily Living in Dementia for Spanish-speaking communities. International Psychogeriatric, 10, 261-270.
  • Braak, H., & Braak, E. (1991). Neuropathological staging of Alzheimerrelated changes. Acta Neuropathologica, 82, 239-259.
  • Bruen, P. D., McGeown, W. J., Shanks, M. F., & Venneri, A. (2008). Neuroanatomical correlates of neuropsychiatric symptoms in Alzheimer's disease. Brain. 131, 2455-2463.
  • Brun, A. (1987). Frontal lobe degeneration of non-Alzheimer type. I. Neuropathology. Archives of Gerontology Geriatric, 6, 193-208.
  • Cacho, J. L., García-García, R., Arcaya, J., Gay, F. J., Guerrero, A. L., & Gómez, J. C. (1996). El test del reloj en ancianos sanos. Revista de Neurología, 24, 1525-1528.
  • Chase, T. N., Burrows, G. H., & Mohr, E. (1987). Cortical glucose utilization patterns in primary degenerative dementias of the anterior and posterior type. Archives of Gerontology and Geriatrics, 6, 289-292.
  • Chen, S. T., Sultzer, D. L., Hinkin, C. H., Mahler, M. E. & Cummings, J. L. (1998). Executive dysfunction in Alzheimer's disease: Association with neuropsychiatric symptoms and functional impairment. Journal of Neuropsychiatry and Clinical Neurosciences, 10, 426-43.
  • Contador, I., Fernández-Calvo, B., Cacho, J., Ramos, F., & Hernández-Martín, L. (2009). La depresión en la demencia tipo Alzheimer: ¿Existe algún efecto sobre la cognición?. Revista de neurología, 49(10), 505-510.
  • Fink, G. R., Marshall, J. C., Halligan, P. W., Frith, C. D., Driver, J., Frackowiak, R. S., & Dolan, R. J. (1999). The neural consequences of conflict between intention and the senses. Brain, 122, 497-512.
  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-Mental State: A practical method for grading the state of patients for the clinician. Journal of Psychiatric Research, 12, 189-198.
  • Galton, C. J., Patterson, K., Xuereb, J. H., & Hodges, J. R. (2000). Atypical and typical presentations of Alzheimer's disease: A clinical, neuropsychological, neuroimaging and pathological study of 13 cases. Brain, 123, 484-498.
  • Grady, C. L, Haxby, J. V, Horwitz, B., Sundaram, M., Berg, G., Schapiro, M.B., Rapoport, S.I. (1988). Longitudinal study of the early neuropsychological and cerebral metabolic changes in dementia of the Alzheimer type. Journal of Clinical and Experimental Neuropsychology, 10, 576-596.
  • Grady, C. L., Haxby, J. V., Schapiro, M. B., Gonzalez-Aviles, A., Kumar, A., Ball, M. J., Rapoport, S. I. (1990). Subgroups in dementia of the Alzheimer type identified using positron emission tomography. Journal of Neuropsychiatry and Clinical Neuroscience, 2, 373-384.
  • Habek, M., Hajnsek, S., Zarkovic, K., Chudy, D., & Mubrin, Z. (2010). Frontal variant of Alzheimer's disease: clinico-CSF-pathological correlation. Canadian Journal of Neurological Sciences, 37(1), 118-120.
  • Hachinski, V. C., Iliff, L. D., Zinhla, E., DuBoulay, G. H., McAllister, V., Marshall, L., Symon, L. (1975). Cerebral Blood flow in dementia. Archives of Neurology, 32, 632-637.
  • Holman, B.L., Johnson, K.A., Gerada, B., Carvalho, P.A., & Satlin, A., (1992). The scintigraphic appearance of Alzheimer's disease: A prospective study using Technetium-99m-HMPAO SPECT. Journal of Nuclear Medicine 33 (2), 181-185.
  • Hughes, C. P., Berg, L., Danziger, W. L., Cohen, L. A., & Martin, R. L. (1982). A new clinical scale for staging of dementia. British Journal of Psychiatry, 140, 566-572
  • Hutchinson, A. & Mathias, J. L. (2007). Neuropsychological deficits in frontotemporal dementia and Alzheimer's disease: A meta-analytic review. Journal of Neurology, Neurosurgery, and Psychiatry, 78, 917-928.
  • Izal, M., & Montorio, I. (1994). Evaluación del medio y del cuidador del demente. En T. Del Ser y J. Peña Casanova (eds.). Evaluación neuropsicológica y funcional de la demencia, (pp. 201-212). Barcelona: Prous Science.
  • Jeong, Y., Han, D. H., Yi, H. A., Cho, S. S., Chin, J., Kang, S. J., Na, D. L. (2003). Neuropsychological and Neuroimaging Findings of Frontal Variant of Alzheimer's Disease. Journal of the Korean Neurological Association, 21(1), 32-40.
  • Johnson, J. K., Head, E., Kim, R., Starr, A., & Cotman, C. W. (1999). Clinical and pathological evidence for a frontal variant of Alzheimer's disease. Archives of Neurology, 56, 1233-1239.
  • Kanne, S. M., Balota, D. A., Storandt, M., McKeel, Jr., D. W., & Morris, J. C. (1998). Relating anatomy to function in Alzheimer's disease: neuropsychological profiles predict regional neuropathology 5 years later. Neurology, 50, 979-985.
  • Lafleche, G., & Albert, M. S. (1995). Executive function deficits in mild Alzheimer's disease. Neuropsychology, 9, 313-320.
  • Lambon, M. A., Patterson, K., Graham, N., Dawson, K., & Hodges, J. R. (2003). Homogeneity and heterogeneity in mild cognitive impairment and Alzheimer's disease: a cross-sectional and longitudinal study of 55 cases. Brain, 126, 2350-2362.
  • Larner, A. J. (2006). Frontal variant Alzheimer's disease: A reappraisal. Clinical Neurology and Neurosurgery, 108(7), 705-708.
  • Mann, U. M., Mohr, E., Gearing, M., & Chase, T. (1992). Heterogeneity in Alzheimer's disease: Progression rate segregated by distinct neuropsychological and cerebral metabolic profiles. Journal of Neurology, Neurosurgery, and Psychiatry, 55, 956-959.
  • McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E.M. (1984). Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA work group under the auspices of the Department of Health and Human Services task force on Alzheimer's disease. Neurology, 34, 939-944.
  • Mega, M. S., Lee L., Dinov, I. D., Mishkin, F., Toga, A. W., & Cummings, J. L. (2000). Cerebral correlates of psychotic symptoms in Alzheimer's disease. Journal of Neurology, Neurosurgery, and Psychiatry. 69(2), 167-171.
  • Mohamed, S., Rosenheck, R., Lyketsos, C.G., & Schneider, L.S. (2010). Caregiver burden in Alzheimer disease: Cross-sectional and longitudinal patient correlates. American Journal of Geriatric Psychiatry, 18, 917-927.
  • Palmer, K., Lupo, F., Perri, R., Salamone, G., Fadda, L., Caltagirone, C., Cravello, L. (2011). Predicting disease progression in Alzheimer's disease: the role of neuropsychiatric syndromes on functional and cognitive decline. Journal of Alzheimer's Disease, 24(1), 35-345.
  • Perani, D., Di Piero, V., Vallar, G., Cappa, S., Messa, C., Bottini, G., Fazio, F. (1998). Technetium-99m HM-PAO-SPECT study of regional cerebral perfusion in early Alzheimer's disease. Journal of Nuclear Medicine, 29, 1507-1514.
  • Reed, B. R., Jagust, W. J., & Coulter, L. (1993). Anosognosia in Alzheimer's disease: Relationships to depression, cognitive function, and cerebral perfusion. Journal of Clinical Experimental Neuropsychology, 15(2), 231-244.
  • Rey A (1987). Test de copia de la figura compleja. Madrid: TEA.
  • Ricci, M., Guidoni, S. V., Sepe-Monti, M., Bomboi, G., Antonini, G., Blundo, C., & Giubilei, F. (2009). Clinical findings, functional abilities and caregiver distress in the early stage of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). Archives of Gerontology and Geriatrics, 49(2), e101-e104.
  • Rinaldi, M. C., Piras, F., & Pizzamiglio, L. (2010). Lack of awareness for spatial and verbal constructive apraxia. Neuropsychologia, 48(6), 1574-1582.
  • Snowden, J. S., Stopford, C. L., Julien, C. L., Thompson, J. C., Davidson, Y., Gibbons, L., Mann, D. M. A. (2007). Cognitive phenotypes in Alzheimer's disease and genetic risk. Cortex, 43(7), 835-845.
  • Starkstein, S.E., Brockman, S., Bruce, D., & Petracca, G. (2010). Anosognosia Is a Significant Predictor of Apathy in Alzheimer's disease. The Journal of Neuropsychiatry and Clinical Neurosciences, 378-383.
  • Starkstein, S. E., Jorge, R., Mizrahi, R., Adrian, J., & Robinson, R. G. (2007). Insight and danger in Alzheimer's disease. European journal of neurology, 14(4), 455-460.
  • Stopford, C. L., Snowden, J. S., Thompson, J. C., & Neary, D. (2008). Variability in cognitive presentation of Alzheimer's disease. Cortex, 44(2), 185-195.
  • Strauss, E., Sherman, E. M. S., & Spreen, O. (2006). A Compendium of neuropsychological tests: Administration, norms, and commentary. (3rd. ed.). NY. Oxford University Press.
  • Strub, R. L & Black, F. W. (2000). The Mental Status Examination in Neurology. F.A. Davis Company.
  • Swanberg, M. M., Tractenberg, R. E., Mohs, R., Thal, L. J. & Cummings, J. L., (2004). Executive dysfunction in Alzheimer disease. Archives of Neurology, 61, 556-560.
  • Taylor, K. I., Probst, A., Miserez, A. R., Monsch, A. U., & Tolnay, M. (2008). Clinical course of neuropathologically confirmed frontal-variant Alzheimer's disease. Nature Clinical Practice Neurology 4, 226-232.
  • Vilalta-Franch, J., Lozano-Gallego, M., Hernández-Ferrándiz, M., LlinàsReglà, J., López-Pousa, S., & López, O.L. (1999). El inventario neuropsiquiátrico: propiedades psicométricas de su adaptación al castellano. Revista de Neurología, 29, 15-19.
  • Wallin, A., & Blennow, K. (1996). Clinical subgroups of the Alzheimer syndrome. Acta neurologica Scandinavica Supplementum, 165, 51-57.
  • Perry, R. J., Watson, P., & Hodges, J. R. (2000). The nature and staging of attention dysfunction in early (minimal and mild) Alzheimer's disease: Relationship to episodic and semantic memory impairment. Neuropsychologia 38, 252-271.
  • Wechsler, D. (1981). Wechsler Adult Intelligence Scale Revised. The Psychological Corporation, New York.
  • Wolk, D. A., Dickerson, B. C., Weiner, M., Aiello, M., Aisen, P., Albert, M. S., Wilks, K. L. (2010). Apolipoprotein E (APOE) genotype has dissociable effects on memory and attentional-executive network function in Alzheimer disease. Proceedings of the National Academy of Sciences of the United States of America, 107(22), 10256-10261.
  • Woodward, M., Brodaty, H., Boundy, K., Ames, D., Blanch, G., Balshaw, R., and PRIME Study Group (2010a). Does executive impairment define a frontal variant of Alzheimer's disease?. International Psychogeriatrics, 22, 1280-1290.
  • Woodward, M., Jacova, C., Black, S. E., Kertesz, A., Mackenzie, I. R., & Feldman, H. (2010b). Differentiating the frontal variant of Alzheimer's disease. International Journal of Geriatric Psychiatry, 25(7), 732-738.
Fuente de los datos: Dialnet