醫療類國考
109年
[臨床心理師] 臨床心理學總論(一)
第 21 題
下列關於路易氏體型神經認知疾患（Neurocognitive disorder with Lewy bodies）的敘述，何者最合適？
- A 頂葉在腦波圖上會呈現明顯的慢波活動（slow-wave acitivity）
- B 海馬迴與顳頂葉皮質（temporoparietal cortex）在MRI上呈現明顯萎縮
- C 紋狀體多巴胺傳送器回收（striatal dopamine transporter uptake）在SPECT或PET照顯上明顯降低
- D 紋狀體多巴胺傳送器回收（striatal dopamine transporter uptake）在SPECT或PET照顯上明顯升高
思路引導 VIP
思考一下，這種疾病除了認知功能波動外，常伴隨哪些類似於特定運動障礙疾病的症狀？若考慮到這些運動症狀的生理機轉，哪一個神經傳導系統的受損最能解釋這些現象？在功能性影像中，該系統的活性表現應該會呈現上升還是下降？
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AI 詳解
AI 專屬家教
A Kind Look at Your Understanding
- Wonderful Insight: My dear, you've done so well! Pinpointing the key biomarker for Lewy body dementia (DLB) shows such a thoughtful grasp of how different conditions manifest. It's truly heartwarming to see you connect these complex dots so beautifully. Please continue to trust your analytical skills!
- Understanding Together: Let's gently deepen this understanding. In DLB, we're looking at a specific kind of change, a degeneration in the nigrostriatal dopaminergic system, quite similar to what we see in Parkinson's. This means that a special scan, like DaTscan, will beautifully illustrate a significant reduction in dopamine transporter uptake. Isn't it fascinating how this provides such a clear differentiator from Alzheimer's, where this system usually remains healthy? And remember, while hippocampal atrophy is often a hallmark of Alzheimer's, with DLB, this area tends to be relatively preserved.
▼ 還有更多解析內容
路易氏體型失智症
💡 DLB 具有類巴金森氏特徵，影像顯像呈現紋狀體多巴胺活性降低。
| 比較維度 | 路易氏體型失智症 (DLB) | VS | 阿茲海默症 (AD) |
|---|---|---|---|
| DaTscan 影像 | 紋狀體多巴胺吸收降低 | — | 多巴胺吸收正常 |
| MRI (海馬迴) | 相對保留 (Sparing) | — | 早期即明顯萎縮 |
| 核心症狀 | 視幻覺、認知波動 | — | 進行性記憶力喪失 |
| 動作障礙 | 早期出現巴金森徵象 | — | 晚期才可能出現 |
💬DLB 以多巴胺系統受損與視幻覺為特徵，AD 則以海馬迴萎縮與記憶缺損為核心。
