Neuropsychiatric symptoms (NPSs) are common in patients with Alzheimer’s disease (AD) and are associated with accelerated cognitive impairment and earlier deaths. This review aims to explore the neural pathogenesis of NPSs in AD and its association with the progression of AD. We first provide a literature overview on the onset times of NPSs. Different NPSs occur in different disease stages of AD, but most symptoms appear in the preclinical AD or mild cognitive impairment stage and develop progressively. Next, we describe symptom-general and -specific patterns of brain lesions. Generally, the anterior cingulate cortex is a commonly damaged region across all symptoms, and the prefrontal cortex, especially the orbitofrontal cortex, is also a critical region associated with most NPSs. In contrast, the anterior cingulate-subcortical circuit is specifically related to apathy in AD, the frontal-limbic circuit is related to depression, and the amygdala circuit is related to anxiety. Finally, we elucidate the associations between the NPSs and AD by combining the onset time with the neural basis of NPSs.

中文翻译：

---

阿尔茨海默病神经精神症状的脑机制：对一般症状和特异性病变模式的系统评价

神经精神症状 (NPS) 在阿尔茨海默病 (AD) 患者中很常见，并且与加速认知障碍和早期死亡有关。本综述旨在探讨 NPS 在 AD 中的神经发病机制及其与 AD 进展的关系。我们首先提供有关 NPS 发病时间的文献综述。不同的NPSs出现在AD的不同疾病阶段，但大多数症状出现在AD临床前或轻度认知障碍阶段并逐渐发展。接下来，我们描述了脑损伤的一般症状和特定模式。一般来说，前扣带皮层是所有症状中常见的受损区域，前额叶皮层，尤其是眶额叶皮层，也是与大多数 NPS 相关的关键区域。相比之下，前扣带-皮层下回路与AD的冷漠有关，额叶-边缘回路与抑郁有关，杏仁核回路与焦虑有关。最后，我们通过将发病时间与 NPS 的神经基础相结合来阐明 NPS 和 AD 之间的关联。