Abstract

Dementia of vascular origin is a distinct variety with a heterogeneous neuropsychological profile. Very few studies have compared the behavioral dysfunction in the large vessel and small vessel vascular dementia (VaD) and studied the association between executive dysfunction and behavioral dysfunction documented in these patients, between the white matter load in small vessel disease (SVD) and the behavioral dysfunction. 76 patients having a modified Hachinski Ischemic Scale score of ≥ 4 were recruited and categorized into a small vessel and large vessel VaD. The Neuropsychiatric Inventory (NPI) score ≥ 4 per domain for defining clinically relevant symptoms and the Clinical Dementia Rating Scale (CDR) for evaluating the severity of dementia were used. Behavioral and Psychological Symptoms of Dementia (BPSD) were present in 66.67% of patients with SVD and 53.57% of those having large vessel disease. Apathy, euphoria, and disinhibition were more common in SVD, while appetite alterations were more common in large vessel disease. Behavioral dysfunction was also associated with executive dysfunction in both the VaD subtypes and with white matter loads in SVD. We conclude that different VaD subtypes have different behavioral profiles. This might help in understanding the underlying pathophysiology, diagnosis and thus better management of this disorder.

摘要

血管源性痴呆是一种具有异质性神经心理学特征的独特类型。很少有研究比较大血管和小血管血管性痴呆 (VaD) 的行为功能障碍，并研究这些患者记录的执行功能障碍与行为功能障碍之间的关联，以及小血管病 (SVD) 的白质负荷与行为功能障碍之间的关联功能障碍。招募了 76 名改良 Hachinski 缺血量表评分≥ 4 的患者，并将其分为小血管 VaD 和大血管 VaD。使用神经精神病学量表 (NPI) 得分≥ 4 来定义临床相关症状，并使用临床痴呆量表 (CDR) 来评估痴呆的严重程度。66 人出现痴呆症的行为和心理症状 (BPSD)。67% 的 SVD 患者和 53.57% 的大血管疾病患者。冷漠、欣快和去抑制在 SVD 中更常见，而食欲改变在大血管疾病中更常见。行为功能障碍也与 VaD 亚型中的执行功能障碍和 SVD 中的白质负荷相关。我们得出结论，不同的 VaD 亚型具有不同的行为特征。这可能有助于了解潜在的病理生理学、诊断，从而更好地管理这种疾病。我们得出结论，不同的 VaD 亚型具有不同的行为特征。这可能有助于了解潜在的病理生理学、诊断，从而更好地管理这种疾病。我们得出结论，不同的 VaD 亚型具有不同的行为特征。这可能有助于了解潜在的病理生理学、诊断，从而更好地管理这种疾病。