Neurobiology of neuropsychiatric symptoms in Alzheimer's disease: A critical review with a focus on neuroimaging

Neurobiologia dos sintomas neuropsiquiátricos na doença de alzheimer: uma revisão crítica com foco na neuroimagem

Lyssandra dos Santos Tascone Cássio Machado de Campos Bottino About the authors

ABSTRACT

The objective of this critical review of the literature was to reveal the neural circuits involved in the occurrence of neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) patients through the association of these symptoms with neuroimaging findings. The search for articles was performed on PUBMED from January 2000 to May 2013, using the key words: Dementia AND BPSD; Dementia AND Neuropsychiatric Symptoms; and Dementia AND Psychosis, Delusions, Hallucinations, Agitation, Depression, Anxiety, Apathy, Euphoria, Disinhibition, Irritability, Aberrant Motor Behavior, Sleep or Eating Disorders. Forty-six articles were reviewed and important contributions, especially regarding the psychopathological concepts discussed, were also considered even if not included in this time period. The available evidence suggests the three most relevant neurobiological models for neuropsychiatric symptoms in Alzheimer's disease are the frontal-subcortical circuits, the cortico-cortical networks, and the monoaminergic system. We discussed the association of the individual symptoms or syndromes with these models.

Key words:
dementia; Alzheimer's disease; neuroimaging; neuropsychiatric symptoms; BPSD

RESUMO

O objetivo dessa revisão crítica da literatura é investigar os circuitos neurais envolvidos na ocorrência dos sintomas neuropsiquiátricos nos pacientes com doença de Alzheimer através da associação destes sintomas com achados de neuroimagem. A procura dos artigos foi feita no PUBMED de Janeiro de 2000 a Maio de 2013, usando as palavras-chave: Demência E BPSD; Demência E Sintomas Neuropsiquiátricos; e Demência E Psicose, Delírios, Alucinações, Agitação, Depressão, Anxiedade, Apatia, Euforia, Desinibição, Irritabilidade, Comportamento Motor Aberrante, Distúrbios do Sono ou Apetite. Quarenta e seis artigos foram revisados e contribuições importantes, especialmente considerando os conceitos psicopatológicos discutidos, foram também discutidos, mesmo se não incluídos neste periodo de tempo. As evidências disponíveis sugerem que os três modelos neurobiológicos mais relevantes para os sintomas neuropsiquiátricos na doença de Alzheimer são os circuitos frontal-subcorticais, as redes cortico-corticais, e o sistema monoaminérgico. Nós discutimos a associação dos sintomas individuais ou síndromes com esses modelos.

Palavras-chave:
demência; doença de alzheimer; neuroimagem; sintomas neuropsiquiátricos; BPSD

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Publication Dates

  • Publication in this collection
    Jul-Sep 2013

History

  • Received
    02 May 2013
  • Accepted
    04 Aug 2013
Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br