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Mirzai N, Polet K, Morisot A, Hesse S, Pesce A, Louchart de la Chapelle S, Iakimova G. Can the Ability to Recognize Facial Emotions in Individuals With Neurodegenerative Disease be Improved? A Systematic Review and Meta-analysis. Cogn Behav Neurol 2023; 36:202-218. [PMID: 37410880 PMCID: PMC10683976 DOI: 10.1097/wnn.0000000000000348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 03/30/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Facial emotion recognition (FER) is commonly impaired in individuals with neurodegenerative disease (NDD). This impairment has been linked to an increase in behavioral disorders and caregiver burden. OBJECTIVE To identify interventions targeting the improvement of FER ability in individuals with NDD and investigate the magnitude of the efficacy of the interventions. We also wanted to explore the duration of the effects of the intervention and their possible impacts on behavioral and psychological symptoms of dementia and caregiver burden. METHOD We included 15 studies with 604 individuals who had been diagnosed with NDD. The identified interventions were categorized into three types of approach (cognitive, neurostimulation, and pharmacological) as well as a combined approach (neurostimulation with pharmacological). RESULTS The three types of approaches pooled together had a significant large effect size for FER ability improvement (standard mean difference: 1.21, 95% CI = 0.11, 2.31, z = 2.15, P = 0.03). The improvement lasted post intervention, in tandem with a decrease in behavioral disorders and caregiver burden. CONCLUSION A combination of different approaches for FER ability improvement may be beneficial for individuals with NDD and their caregivers.
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Affiliation(s)
- Naz Mirzai
- Clinical Research Unit–Memory Clinic, Princess Grace Hospital, Monaco
- Cote d’Azur University, Laboratory of Clinical, Cognitive and Social Anthropology and Psychology, Nice, France
| | - Kévin Polet
- Clinical Research Unit–Memory Clinic, Princess Grace Hospital, Monaco
| | - Adeline Morisot
- Clinical Research Unit–Memory Clinic, Princess Grace Hospital, Monaco
- Public Health Department, Cote d’Azur University, University Hospital Center of Nice, Nice, France
| | - Solange Hesse
- Clinical Research Unit–Memory Clinic, Princess Grace Hospital, Monaco
| | - Alain Pesce
- Bibliographic Research Association for Neurosciences, Nice, France
| | | | - Galina Iakimova
- Cote d’Azur University, Laboratory of Clinical, Cognitive and Social Anthropology and Psychology, Nice, France
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Sokołowski A, Roy ARK, Goh SM, Hardy EG, Datta S, Cobigo Y, Brown JA, Spina S, Grinberg L, Kramer J, Rankin KP, Seeley WW, Sturm VE, Rosen HJ, Miller BL, Perry DC. Neuropsychiatric symptoms and imbalance of atrophy in behavioral variant frontotemporal dementia. Hum Brain Mapp 2023; 44:5013-5029. [PMID: 37471695 PMCID: PMC10502637 DOI: 10.1002/hbm.26428] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/25/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023] Open
Abstract
Behavioral variant frontotemporal dementia is characterized by heterogeneous frontal, insular, and anterior temporal atrophy patterns that vary along left-right and dorso-ventral axes. Little is known about how these structural imbalances impact clinical symptomatology. The goal of this study was to assess the frequency of frontotemporal asymmetry (right- or left-lateralization) and dorsality (ventral or dorsal predominance of atrophy) and to investigate their clinical correlates. Neuropsychiatric symptoms and structural images were analyzed for 250 patients with behavioral variant frontotemporal dementia. Frontotemporal atrophy was most often symmetric while left-lateralized (9%) and right-lateralized (17%) atrophy were present in a minority of patients. Atrophy was more often ventral (32%) than dorsal (3%) predominant. Patients with right-lateralized atrophy were characterized by higher severity of abnormal eating behavior and hallucinations compared to those with left-lateralized atrophy. Subsequent analyses clarified that eating behavior was associated with right atrophy to a greater extent than a lack of left atrophy, and hallucinations were driven mainly by right atrophy. Dorsality analyses showed that anxiety, euphoria, and disinhibition correlated with ventral-predominant atrophy. Agitation, irritability, and depression showed greater severity with a lack of regional atrophy, including in dorsal regions. Aberrant motor behavior and apathy were not explained by asymmetry or dorsality. This study provides additional insight into how anatomical heterogeneity influences the clinical presentation of patients with behavioral variant frontotemporal dementia. Behavioral symptoms can be associated not only with the presence or absence of focal atrophy, but also with right/left or dorsal/ventral imbalance of gray matter volume.
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Affiliation(s)
- Andrzej Sokołowski
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Ashlin R. K. Roy
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Sheng‐Yang M. Goh
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Emily G. Hardy
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Samir Datta
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Jesse A. Brown
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Salvatore Spina
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Lea Grinberg
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Joel Kramer
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Katherine P. Rankin
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - William W. Seeley
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Department of PathologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Virginia E. Sturm
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Bruce L. Miller
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - David C. Perry
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
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Ohm DT, Rhodes E, Bahena A, Capp N, Lowe M, Sabatini P, Trotman W, Olm CA, Phillips J, Prabhakaran K, Rascovsky K, Massimo L, McMillan C, Gee J, Tisdall MD, Yushkevich PA, Lee EB, Grossman M, Irwin DJ. Neuroanatomical and cellular degeneration associated with a social disorder characterized by new ritualistic belief systems in a TDP-C patient vs. a Pick patient. Front Neurol 2023; 14:1245886. [PMID: 37900607 PMCID: PMC10600461 DOI: 10.3389/fneur.2023.1245886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/15/2023] [Indexed: 10/31/2023] Open
Abstract
Frontotemporal dementia (FTD) is a spectrum of clinically and pathologically heterogenous neurodegenerative dementias. Clinical and anatomical variants of FTD have been described and associated with underlying frontotemporal lobar degeneration (FTLD) pathology, including tauopathies (FTLD-tau) or TDP-43 proteinopathies (FTLD-TDP). FTD patients with predominant degeneration of anterior temporal cortices often develop a language disorder of semantic knowledge loss and/or a social disorder often characterized by compulsive rituals and belief systems corresponding to predominant left or right hemisphere involvement, respectively. The neural substrates of these complex social disorders remain unclear. Here, we present a comparative imaging and postmortem study of two patients, one with FTLD-TDP (subtype C) and one with FTLD-tau (subtype Pick disease), who both developed new rigid belief systems. The FTLD-TDP patient developed a complex set of values centered on positivity and associated with specific physical and behavioral features of pigs, while the FTLD-tau patient developed compulsive, goal-directed behaviors related to general themes of positivity and spirituality. Neuroimaging showed left-predominant temporal atrophy in the FTLD-TDP patient and right-predominant frontotemporal atrophy in the FTLD-tau patient. Consistent with antemortem cortical atrophy, histopathologic examinations revealed severe loss of neurons and myelin predominantly in the anterior temporal lobes of both patients, but the FTLD-tau patient showed more bilateral, dorsolateral involvement featuring greater pathology and loss of projection neurons and deep white matter. These findings highlight that the regions within and connected to anterior temporal lobes may have differential vulnerability to distinct FTLD proteinopathies and serve important roles in human belief systems.
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Affiliation(s)
- Daniel T. Ohm
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Emma Rhodes
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Alejandra Bahena
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Noah Capp
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - MaKayla Lowe
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Philip Sabatini
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Winifred Trotman
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Christopher A. Olm
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Jeffrey Phillips
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Karthik Prabhakaran
- Penn Image Computing and Science Lab, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Katya Rascovsky
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Lauren Massimo
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Corey McMillan
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - James Gee
- Penn Image Computing and Science Lab, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - M. Dylan Tisdall
- Center for Advanced Magnetic Resonance Imaging and Spectroscopy, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Paul A. Yushkevich
- Penn Image Computing and Science Lab, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Edward B. Lee
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - David J. Irwin
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
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Hua AY, Roy ARK, Kosik EL, Morris NA, Chow TE, Lukic S, Montembeault M, Borghesani V, Younes K, Kramer JH, Seeley WW, Perry DC, Miller ZA, Rosen HJ, Miller BL, Rankin KP, Gorno-Tempini ML, Sturm VE. Diminished baseline autonomic outflow in semantic dementia relates to left-lateralized insula atrophy. Neuroimage Clin 2023; 40:103522. [PMID: 37820490 PMCID: PMC10582496 DOI: 10.1016/j.nicl.2023.103522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/28/2023] [Accepted: 09/30/2023] [Indexed: 10/13/2023]
Abstract
In semantic dementia (SD), asymmetric degeneration of the anterior temporal lobes is associated with loss of semantic knowledge and alterations in socioemotional behavior. There are two clinical variants of SD: semantic variant primary progressive aphasia (svPPA), which is characterized by predominant atrophy in the anterior temporal lobe and insula in the left hemisphere, and semantic behavioral variant frontotemporal dementia (sbvFTD), which is characterized by predominant atrophy in those structures in the right hemisphere. Previous studies of behavioral variant frontotemporal dementia, an associated clinical syndrome that targets the frontal lobes and anterior insula, have found impairments in baseline autonomic nervous system activity that correlate with left-lateralized frontotemporal atrophy patterns and disruptions in socioemotional functioning. Here, we evaluated whether there are similar impairments in resting autonomic nervous system activity in SD that also reflect left-lateralized atrophy and relate to diminished affiliative behavior. A total of 82 participants including 33 people with SD (20 svPPA and 13 sbvFTD) and 49 healthy older controls completed a laboratory-based assessment of respiratory sinus arrhythmia (RSA; a parasympathetic measure) and skin conductance level (SCL; a sympathetic measure) during a two-minute resting baseline period. Participants also underwent structural magnetic resonance imaging, and informants rated their current affiliative behavior on the Interpersonal Adjective Scale. Results indicated that baseline RSA and SCL were lower in SD than in healthy controls, with significant impairments present in both svPPA and sbvFTD. Voxel-based morphometry analyses revealed left-greater-than-right atrophy related to diminished parasympathetic and sympathetic outflow in SD. While left-lateralized atrophy in the mid-to-posterior insula correlated with lower RSA, left-lateralized atrophy in the ventral anterior insula correlated with lower SCL. In SD, lower baseline RSA, but not lower SCL, was associated with lower gregariousness/extraversion. Neither autonomic measure related to warmth/agreeableness, however. Through the assessment of baseline autonomic nervous system physiology, the present study contributes to expanding conceptualizations of the biological basis of socioemotional alterations in svPPA and sbvFTD.
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Affiliation(s)
- Alice Y Hua
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Ashlin R K Roy
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Eena L Kosik
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Nathaniel A Morris
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Tiffany E Chow
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Sladjana Lukic
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Maxime Montembeault
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | | | - Kyan Younes
- Department of Neurology, Stanford Neuroscience Health Center, Palo Alto, CA, USA
| | - Joel H Kramer
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - William W Seeley
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - David C Perry
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Zachary A Miller
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Howard J Rosen
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Bruce L Miller
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Katherine P Rankin
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Maria Luisa Gorno-Tempini
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Virginia E Sturm
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA.
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Roy ARK, Datta S, Hardy E, Sturm VE, Kramer JH, Seeley WW, Rankin KP, Rosen HJ, Miller BL, Perry DC. Behavioural subphenotypes and their anatomic correlates in neurodegenerative disease. Brain Commun 2023; 5:fcad038. [PMID: 36910420 PMCID: PMC9999361 DOI: 10.1093/braincomms/fcad038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 11/11/2022] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
Patients with neurodegenerative disorders experience a range of neuropsychiatric symptoms. The neural correlates have been explored for many individual symptoms, such as apathy and disinhibition. Atrophy patterns have also been associated with broadly recognized syndromes that bring together multiple symptoms, such as the behavioural variant of frontotemporal dementia. There is substantial heterogeneity of symptoms, with partial overlap of behaviour and affected neuroanatomy across and within dementia subtypes. It is not well established if there are anatomically distinct behavioural subphenotypes in neurodegenerative disease. The objective of this study was to identify shared behavioural profiles in frontotemporal dementia-spectrum and Alzheimer's disease-related syndromes. Additionally, we sought to determine the underlying neural correlates of these symptom clusters. Two hundred and eighty-one patients diagnosed with one of seven different dementia syndromes, in addition to healthy controls and individuals with mild cognitive impairment, completed a 109-item assessment capturing the severity of a range of clinical behaviours. A principal component analysis captured distinct clusters of related behaviours. Voxel-based morphometry analyses were used to identify regions of volume loss associated with each component. Seven components were identified and interpreted as capturing the following behaviours: Component 1-emotional bluntness, 2-emotional lability and disinhibition, 3-neuroticism, 4-rigidity and impatience, 5-indiscriminate consumption, 6-psychosis and 7-Geschwind syndrome-related behaviours. Correlations with structural brain volume revealed distinct neuroanatomical patterns associated with each component, including after controlling for diagnosis, suggesting that localized neurodegeneration can lead to the development of behavioural symptom clusters across various dementia syndromes.
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Affiliation(s)
- Ashlin R K Roy
- Department of Neurology, University of California, San Francisco 94158, USA
| | - Samir Datta
- Department of Neurology, University of California, San Francisco 94158, USA
| | - Emily Hardy
- Department of Neurology, University of California, San Francisco 94158, USA
| | - Virginia E Sturm
- Department of Neurology, University of California, San Francisco 94158, USA
- Department of Psychiatry, University of California, San Francisco 94143, USA
| | - Joel H Kramer
- Department of Neurology, University of California, San Francisco 94158, USA
| | - William W Seeley
- Department of Neurology, University of California, San Francisco 94158, USA
| | - Katherine P Rankin
- Department of Neurology, University of California, San Francisco 94158, USA
| | - Howard J Rosen
- Department of Neurology, University of California, San Francisco 94158, USA
| | - Bruce L Miller
- Department of Neurology, University of California, San Francisco 94158, USA
| | - David C Perry
- Department of Neurology, University of California, San Francisco 94158, USA
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6
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Abstract
OBJECTIVE Behavioral variant frontotemporal dementia (bvFTD) is associated with social and criminal transgressions; studies from countries around the world have documented such behavior in persons with this condition. An overview and analysis of social and criminal transgressions in bvFTD and their potential neurobiological mechanisms can provide a window for understanding the relationship of antisocial behavior and the brain. METHODS This review evaluated the literature on the frequency of social and criminal transgressions in bvFTD and the neurobiological disturbances that underlie them. RESULTS There is a high frequency of transgressions among patients with bvFTD due to impairments in neurocognition, such as social perception, behavioral regulation, and theory of mind, and impairments in social emotions, such as self-conscious emotions and empathy. Additionally, there is significant evidence for a specific impairment in an innate sense of morality. Alterations in these neurobiological processes result from predominantly right-hemisphere pathology in frontal (ventromedial, orbitofrontal, inferolateral frontal), anterior temporal (amygdala, temporal pole), limbic (anterior cingulate, amygdala), and insular regions. CONCLUSIONS Overlapping disturbances in neurocognition, social emotions, and moral reasoning result from disease in the mostly mesial and right-sided frontotemporal network necessary for responding emotionally to others and for behavioral control. With increased sophistication in neurobiological interventions, future goals may be the routine evaluation of these processes among individuals with bvFTD who engage in social and criminal transgressions and the targeting of these neurobiological mechanisms with behavioral, pharmacological, and other interventions.
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Affiliation(s)
- Mario F Mendez
- Departments of Neurology and Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles; and Neurology Service, Neurobehavior Unit, VA Greater Los Angeles Healthcare System
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Shdo SM, Roy ARK, Datta S, Sible IJ, Lukic S, Perry DC, Rankin KP, Kramer JH, Rosen HJ, Miller BL, Seeley WW, Holley SR, Gorno-Tempini ML, Sturm VE. Enhanced positive emotional reactivity in frontotemporal dementia reflects left-lateralized atrophy in the temporal and frontal lobes. Cortex 2022; 154:405-420. [PMID: 35930892 PMCID: PMC9867572 DOI: 10.1016/j.cortex.2022.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/03/2022] [Accepted: 02/16/2022] [Indexed: 01/26/2023]
Abstract
In frontotemporal dementia (FTD), left-lateralized atrophy patterns have been associated with elevations in certain positive emotions. Here, we investigated whether positive emotional reactivity was enhanced in semantic variant primary progressive aphasia (svPPA), an FTD syndrome that targets the left anterior temporal lobe. Sixty-one participants (16 people with svPPA, 24 people with behavioral variant FTD, and 21 healthy controls) viewed six 90-sec trials that were comprised of a series of photographs; each trial was designed to elicit a specific positive emotion, negative emotion, or no emotion. Participants rated their positive emotional experience after each trial, and their smiling behavior was coded with the Facial Action Coding System. Results indicated that positive emotional experience and smiling were elevated in svPPA in response to numerous affective and non-affective stimuli. Voxel-based morphometry analyses revealed that greater positive emotional experience and greater smiling in the patients were both associated with smaller gray matter volume in the left superior temporal gyrus (pFWE < .05), among other left-lateralized frontotemporal regions. Whereas enhanced positive emotional experience related to atrophy in middle superior temporal gyrus and structures that promote cognitive control and emotion regulation, heightened smiling related to atrophy in posterior superior temporal gyrus and structures that support motor control. Our results suggest positive emotional reactivity is elevated in svPPA and offer new evidence that atrophy in left-lateralized emotion-relevant systems relates to enhanced positive emotions in FTD.
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Affiliation(s)
- Suzanne M Shdo
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA; University of California, Berkeley, Department of Psychology, Berkeley, CA, USA.
| | - Ashlin R K Roy
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
| | - Samir Datta
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
| | - Isabel J Sible
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
| | - Sladjana Lukic
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
| | - David C Perry
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
| | - Katherine P Rankin
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
| | - William W Seeley
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
| | - Sarah R Holley
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA; San Francisco State University, Department of Psychology, San Francisco, CA, USA.
| | - Maria L Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
| | - Virginia E Sturm
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
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Chen KH, Hua AY, Toller G, Lwi SJ, Otero MC, Haase CM, Rankin KP, Rosen HJ, Miller BL, Levenson RW. Diminished preparatory physiological responses in frontotemporal lobar degeneration syndromes. Brain Commun 2022; 4:fcac075. [PMID: 35441132 PMCID: PMC9014451 DOI: 10.1093/braincomms/fcac075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/13/2021] [Accepted: 04/02/2022] [Indexed: 11/12/2022] Open
Abstract
Researchers typically study physiological responses either after stimulus onset or when the emotional valence of an upcoming stimulus is revealed. Yet, participants may also respond when they are told that an emotional stimulus is about to be presented even without knowing its valence. Increased physiological responding during this time may reflect a 'preparation for action'. The generation of such physiological responses may be supported by frontotemporal regions of the brain that are vulnerable to damage in frontotemporal lobar degeneration. We examined preparatory physiological responses and their structural and functional neural correlate in five frontotemporal lobar degeneration clinical subtypes (behavioural variant frontotemporal dementia, n = 67; semantic variant primary progressive aphasia, n = 35; non-fluent variant primary progressive aphasia, n = 30; corticobasal syndrome, n = 32; progressive supranuclear palsy, n = 30). Comparison groups included patients with Alzheimer's disease (n = 56) and healthy controls (n = 35). Preparatory responses were quantified as cardiac interbeat interval decreases (i.e. heart rate increases) from baseline to an 'instruction period', during which participants were told to watch the upcoming emotional film but not provided the film's valence. Patients' behavioural symptoms (apathy and disinhibition) were also evaluated via a caregiver-reported measure. Compared to healthy controls and Alzheimer's disease, the frontotemporal lobar degeneration group showed significantly smaller preparatory responses. When comparing each frontotemporal lobar degeneration clinical subtype with healthy controls and Alzheimer's disease, significant group differences emerged for behavioural variant frontotemporal dementia and progressive supranuclear palsy. Behavioural analyses revealed that frontotemporal lobar degeneration patients showed greater disinhibition and apathy compared to Alzheimer's disease patients. Further, these group differences in disinhibition (but not apathy) were mediated by patients' smaller preparatory responses. Voxel-based morphometry and resting-state functional MRI analyses revealed that across patients and healthy controls, smaller preparatory responses were associated with smaller volume and lower functional connectivity in a circuit that included the ventromedial prefrontal cortex and cortical and subcortical regions of the salience network. Diminished preparatory physiological responding in frontotemporal lobar degeneration may reflect a lack of preparation for actions that are appropriate for an upcoming situation, such as approaching or withdrawing from emotional stimuli. The ventromedial prefrontal cortex and salience network are critical for evaluating stimuli, thinking about the future, triggering peripheral physiological responses, and processing and interpreting interoceptive signals. Damage to these circuits in frontotemporal lobar degeneration may impair preparatory responses and help explain often-observed clinical symptoms such as disinhibition in these patients.
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Affiliation(s)
- Kuan-Hua Chen
- Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, Berkeley, CA 94720-1650, USA
| | - Alice Y. Hua
- Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, Berkeley, CA 94720-1650, USA
- Memory & Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Gianina Toller
- Memory & Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Sandy J. Lwi
- Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, Berkeley, CA 94720-1650, USA
| | - Marcela C. Otero
- Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, Berkeley, CA 94720-1650, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
- Sierra Pacific Mental Illness, Research, Education and Clinical Centers (MIRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Claudia M. Haase
- Department of Human Development and Social Policy, Northwestern University, Evanston, IL 60208, USA
| | - Katherine P. Rankin
- Memory & Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Howard J. Rosen
- Memory & Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Bruce L. Miller
- Memory & Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Robert W. Levenson
- Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, Berkeley, CA 94720-1650, USA
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9
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Behnke M, Kreibig SD, Kaczmarek LD, Assink M, Gross JJ. Autonomic Nervous System Activity During Positive Emotions: A Meta-Analytic Review. EMOTION REVIEW 2022. [DOI: 10.1177/17540739211073084] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Autonomic nervous system (ANS) activity is a fundamental component of emotional responding. It is not clear, however, whether positive emotional states are associated with differential ANS reactivity. To address this issue, we conducted a meta-analytic review of 120 articles (686 effect sizes, total N = 6,546), measuring ANS activity during 11 elicited positive emotions, namely amusement, attachment love, awe, contentment, craving, excitement, gratitude, joy, nurturant love, pride, and sexual desire. We identified a widely dispersed collection of studies. Univariate results indicated that positive emotions produce no or weak and highly variable increases in ANS reactivity. However, the limitations of work to date – which we discuss – mean that our conclusions should be treated as empirically grounded hypotheses that future research should validate.
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Affiliation(s)
- Maciej Behnke
- Faculty of Psychology and Cognitive Science, Adam Mickiewicz University
| | | | | | - Mark Assink
- Research Institute of Child Development and Education, University of Amsterdam
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10
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Saraiva R, Proença F, Gonçalves M, Sereijo C, Barandas R, Coentre R, Levy P. Poststroke Bipolar Disorder. J Nerv Ment Dis 2021; 209:851-854. [PMID: 34698700 DOI: 10.1097/nmd.0000000000001410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Various diseases that impact different systems and organs in the body may trigger manic episodes. Strokes are often associated with psychiatric symptoms, particularly depressive and, more rarely, manic. We herein report a case of bipolar disorder secondary to cerebrovascular disease in a 67-year-old man with no personal or family history of psychiatric illness who, at the age of 64, had a bilateral ischemic stroke in the middle cerebral artery territory. About 20 days after this stroke, he experienced a manic episode. Three years later, he experienced a second manic episode, with another hospitalization in a psychiatric ward. With this case, we intend to emphasize that, although rare, the diagnosis of mania after stroke should not be forgotten, and most important, one should be aware of the recurrence of affective episodes just as in non-medical-caused bipolar disorder.
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Affiliation(s)
| | - Filipa Proença
- Psychiatry and Mental Health Department, Centro Hospitalar Universitário Lisboa Norte
| | | | - Carolina Sereijo
- Psychiatry and Mental Health Department, Centro Hospitalar Universitário Lisboa Norte
| | | | | | - Pedro Levy
- Psychiatry and Mental Health Department, Centro Hospitalar Universitário Lisboa Norte
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11
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Fathy YY, Hoogers SE, Berendse HW, van der Werf YD, Visser PJ, de Jong FJ, van de Berg WDJ. Differential insular cortex sub-regional atrophy in neurodegenerative diseases: a systematic review and meta-analysis. Brain Imaging Behav 2021; 14:2799-2816. [PMID: 31011951 PMCID: PMC7648006 DOI: 10.1007/s11682-019-00099-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The insular cortex is proposed to function as a central brain hub characterized by wide-spread connections and diverse functional roles. As a result, its centrality in the brain confers high metabolic demands predisposing it to dysfunction in disease. However, the functional profile and vulnerability to degeneration varies across the insular sub-regions. The aim of this systematic review and meta-analysis is to summarize and quantitatively analyze the relationship between insular cortex sub-regional atrophy, studied by voxel based morphometry, with cognitive and neuropsychiatric deficits in frontotemporal dementia (FTD), Alzheimer’s disease (AD), Parkinson’s disease (PD), and dementia with Lewy bodies (DLB). We systematically searched through Pubmed and Embase and identified 519 studies that fit our criteria. A total of 41 studies (n = 2261 subjects) fulfilled the inclusion criteria for the meta-analysis. The peak insular coordinates were pooled and analyzed using Anatomic Likelihood Estimation. Our results showed greater left anterior insular cortex atrophy in FTD whereas the right anterior dorsal insular cortex showed larger clusters of atrophy in AD and PD/DLB. Yet contrast analyses did not reveal significant differences between disease groups. Functional analysis showed that left anterior insular cortex atrophy is associated with speech, emotion, and affective-cognitive deficits, and right dorsal atrophy with perception and cognitive deficits. In conclusion, insular sub-regional atrophy, particularly the anterior dorsal region, may contribute to cognitive and neuropsychiatric deficits in neurodegeneration. Our results support anterior insular cortex vulnerability and convey the differential involvement of the insular sub-regions in functional deficits in neurodegenerative diseases.
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Affiliation(s)
- Yasmine Y Fathy
- Department of Anatomy and Neurosciences, Section Clinical Neuroanatomy and Biobanking, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1108, 1081 HZ, Amsterdam, Netherlands.
| | - Susanne E Hoogers
- Department of Neurology, Erasmus Medical Center, Postbus, 2040 3000, Rotterdam, CA, Netherlands
| | - Henk W Berendse
- Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, 1081 HZ, Amsterdam, The Netherlands
| | - Ysbrand D van der Werf
- Department of Anatomy and Neurosciences, Section Neuropsychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1108, 1081 HZ, Amsterdam, The Netherlands
| | - Pieter J Visser
- Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, 1081 HZ, Amsterdam, The Netherlands.,Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Frank J de Jong
- Department of Neurology, Erasmus Medical Center, Postbus, 2040 3000, Rotterdam, CA, Netherlands
| | - Wilma D J van de Berg
- Department of Anatomy and Neurosciences, Section Clinical Neuroanatomy and Biobanking, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1108, 1081 HZ, Amsterdam, Netherlands
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12
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Piña-Escudero SD, López L, Sriram S, Longoria Ibarrola EM, Miller B, Lanata S. Neurodegenerative Disease and the Experience of Homelessness. Front Neurol 2021; 11:562218. [PMID: 33519660 PMCID: PMC7838483 DOI: 10.3389/fneur.2020.562218] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 12/15/2020] [Indexed: 12/21/2022] Open
Abstract
Introduction: Today, half of the American homeless population is older than 50 years of age. This shift in age distribution among people experiencing homelessness has challenged our long-held views of the causes of homelessness. Age-related neurological diseases, especially neurodegenerative diseases of the brain (NDDB), may play a role eliciting homelessness in a significant proportion of vulnerable older adults. This article aims to explore relationships between homelessness and NDDB in a cohort of research participants enrolled in observational studies on NDDB at an academic center. Methods: We reviewed charts of the Memory and Aging Center (MAC) of the University of California, San Francisco's database searching for research participants with NDDB that had direct relationship to homelessness. We reviewed all research visits conducted between 2004 and 2018 (N = 5,300). Research participants who had any relationship to homelessness were included in this analysis. NDDB was diagnosed via comprehensive neurological, functional, neuropsychological, and biomarker assessments. Non-parametric tests were used for analysis. Thirteen participants were found to have a direct relationship with homelessness. Seven were female and the median of education was 16 (IR: 12.0–19.5) years. Participants were divided into two groups: Those who experienced homelessness while symptomatic from a NDDB but before formal diagnosis (n = 5, Group 1); and participants with formally diagnosed NDDB who exhibited a new propensity toward homelessness (n = 8, Group 2). Compared to Group 2, participants in Group 1 were younger (p = 0.021) and showed similar results in the neuropsychological evaluation. In both groups, the most prevalent diagnosis was frontotemporal dementia. In Group 1, the majority of participants became homeless in the setting of a fragile socioeconomic situation and informants believed that NDDB contributed or caused their homeless state. In Group 2, a new propensity toward homelessness became manifest in different ways and it stood out that all of these participants were well-supported by family and friends during their illness. Conclusions and Relevance: This case series highlights the role that NDDB may have in precipitating homelessness among vulnerable older adults, particularly in the setting of challenging socioeconomic circumstances and unsupportive living environments. Social ramifications of these findings, particularly pertaining to challenges around rehousing these individuals is discussed.
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Affiliation(s)
- Stefanie Danielle Piña-Escudero
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College, Dublin, Ireland
| | - Lucía López
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Sandeepa Sriram
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Erika Mariana Longoria Ibarrola
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College, Dublin, Ireland
| | - Bruce Miller
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Serggio Lanata
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
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13
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Mendez MF. Degenerative dementias: Alterations of emotions and mood disorders. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:261-281. [PMID: 34389121 DOI: 10.1016/b978-0-12-822290-4.00012-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Degenerative dementias such as Alzheimer's disease and frontotemporal dementia result in distinct alterations in emotional processing, emotional experiences, and mood. The neuropathology of these dementias extends to structures involved in emotional processing, including the basolateral limbic network (orbitofrontal cortex, anterior temporal lobe, amygdala, and thalamus), the insula, and ventromedial frontal lobe. Depression is the most common emotion and mood disorder affecting patients with Alzheimer's disease. The onset of depression can be a prodromal sign of this dementia. Anxiety can also be present early in the course of Alzheimer's disease and especially among patients with early-onset forms of the disease. In contrast, patients with behavioral variant frontotemporal dementia demonstrate hypoemotionality, deficits in the recognition of emotion, and decreased psychophysiological reactivity to emotional stimuli. They typically have a disproportionate impairment in emotional and cognitive empathy. One other unique feature of behavioral variant frontotemporal dementia is the frequent occurrence of bipolar disorder. The management strategies for these alterations of emotion and mood in degenerative dementias primarily involve the judicious use of the psychiatric armamentarium of medications.
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Affiliation(s)
- Mario F Mendez
- Behavioral Neurology Program, Department of Neurology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States; Neurology Service, Veteran Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States.
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14
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Chen KH, Hua AY, Lwi SJ, Haase CM, Rosen HJ, Miller BL, Levenson RW. Smaller Volume in Left-Lateralized Brain Structures Correlates with Greater Experience of Negative Non-target Emotions in Neurodegenerative Diseases. Cereb Cortex 2021; 31:15-31. [PMID: 32820325 DOI: 10.1093/cercor/bhaa193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/27/2020] [Accepted: 06/11/2020] [Indexed: 12/11/2022] Open
Abstract
Subjective emotional experience that is congruent with a given situation (i.e., target emotions) is critical for human survival (e.g., feeling disgusted in response to contaminated food motivates withdrawal behaviors). Neurodegenerative diseases including frontotemporal dementia and Alzheimer's disease affect brain regions critical for cognitive and emotional functioning, resulting in increased experience of emotions incongruent with the situation (i.e., non-target emotions, such as feeling happy when seeing someone grieving). We examined neuroanatomical correlates of subjective experience of non-target emotions in 147 patients with neurodegenerative diseases and 26 healthy individuals. Participants watched three films intended to elicit particular target emotions and rated their experience of negative and positive target and non-target emotions after watching each film. We found that smaller volume in left hemisphere regions (e.g., caudate, putamen, and dorsal anterior insula) was associated with greater experience of negative non-target emotions. Follow-up analyses confirmed that these effects were left-lateralized. No correlates emerged for positive non-target emotions. These findings suggest that volume loss in left-hemisphere regions produces a more diffuse, incongruent experience of non-target emotions. These findings provide a potential neuroanatomical basis for understanding how subjective emotional experience is constructed in the brain and how this can be disrupted in neurodegenerative disease.
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15
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Russell LL, Greaves CV, Bocchetta M, Nicholas J, Convery RS, Moore K, Cash DM, van Swieten J, Jiskoot L, Moreno F, Sanchez-Valle R, Borroni B, Laforce R, Masellis M, Tartaglia MC, Graff C, Rotondo E, Galimberti D, Rowe JB, Finger E, Synofzik M, Vandenberghe R, de Mendonça A, Tagliavini F, Santana I, Ducharme S, Butler C, Gerhard A, Levin J, Danek A, Otto M, Warren JD, Rohrer JD. Social cognition impairment in genetic frontotemporal dementia within the GENFI cohort. Cortex 2020; 133:384-398. [PMID: 33221702 PMCID: PMC7754789 DOI: 10.1016/j.cortex.2020.08.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/06/2020] [Accepted: 08/22/2020] [Indexed: 12/12/2022]
Abstract
A key symptom of frontotemporal dementia (FTD) is difficulty interacting socially with others. Social cognition problems in FTD include impaired emotion processing and theory of mind difficulties, and whilst these have been studied extensively in sporadic FTD, few studies have investigated them in familial FTD. Facial Emotion Recognition (FER) and Faux Pas (FP) recognition tests were used to study social cognition within the Genetic Frontotemporal Dementia Initiative (GENFI), a large familial FTD cohort of C9orf72, GRN, and MAPT mutation carriers. 627 participants undertook at least one of the tasks, and were separated into mutation-negative healthy controls, presymptomatic mutation carriers (split into early and late groups) and symptomatic mutation carriers. Groups were compared using a linear regression model with bootstrapping, adjusting for age, sex, education, and for the FP recognition test, language. Neural correlates of social cognition deficits were explored using a voxel-based morphometry (VBM) study. All three of the symptomatic genetic groups were impaired on both tasks with no significant difference between them. However, prior to onset, only the late presymptomatic C9orf72 mutation carriers on the FER test were impaired compared to the control group, with a subanalysis showing differences particularly in fear and sadness. The VBM analysis revealed that impaired social cognition was mainly associated with a left hemisphere predominant network of regions involving particularly the striatum, orbitofrontal cortex and insula, and to a lesser extent the inferomedial temporal lobe and other areas of the frontal lobe. In conclusion, theory of mind and emotion processing abilities are impaired in familial FTD, with early changes occurring prior to symptom onset in C9orf72 presymptomatic mutation carriers. Future work should investigate how performance changes over time, in order to gain a clearer insight into social cognitive impairment over the course of the disease.
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Affiliation(s)
- Lucy L Russell
- Dementia Research Centre, Department of Neurodegenerative Disease, London, UK
| | - Caroline V Greaves
- Dementia Research Centre, Department of Neurodegenerative Disease, London, UK
| | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, London, UK
| | - Jennifer Nicholas
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK; Institute of Prion Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Rhian S Convery
- Dementia Research Centre, Department of Neurodegenerative Disease, London, UK
| | - Katrina Moore
- Dementia Research Centre, Department of Neurodegenerative Disease, London, UK
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, London, UK; Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - John van Swieten
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Lize Jiskoot
- Dementia Research Centre, Department of Neurodegenerative Disease, London, UK; Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Fermin Moreno
- Cognitive Disorders Unit, Department of Neurology, Donostia University Hospital, San Sebastian, Gipuzkoa, Spain
| | - Raquel Sanchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques du CHU de Québec, Université Laval, Québec, Canada
| | - Mario Masellis
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Canada
| | - Caroline Graff
- Department of Geriatric Medicine, Karolinska University Hospital-Huddinge, Stockholm, Sweden
| | | | - Daniela Galimberti
- University of Milan, Centro Dino Ferrari, Milan, Italy; Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | | | - Fabrizio Tagliavini
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta, Milano, Italy
| | - Isabel Santana
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Simon Ducharme
- Department of Psychiatry, McGill University, Montreal, Québec, Canada
| | - Chris Butler
- Department of Clinical Neurology, University of Oxford, Oxford, UK
| | - Alex Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK; Departments of Geriatric Medicine and Nuclear Medicine, University of Duisburg- Essen, Germany
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
| | - Adrian Danek
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Jason D Warren
- Dementia Research Centre, Department of Neurodegenerative Disease, London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, London, UK.
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16
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Steward T, Davey CG, Jamieson AJ, Stephanou K, Soriano-Mas C, Felmingham KL, Harrison BJ. Dynamic Neural Interactions Supporting the Cognitive Reappraisal of Emotion. Cereb Cortex 2020; 31:961-973. [DOI: 10.1093/cercor/bhaa268] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 12/11/2022] Open
Abstract
Abstract
The cognitive reappraisal of emotion is hypothesized to involve frontal regions modulating the activity of subcortical regions such as the amygdala. However, the pathways by which structurally disparate frontal regions interact with the amygdala remains unclear. In this study, 104 healthy young people completed a cognitive reappraisal task. Dynamic causal modeling (DCM) was used to map functional interactions within a frontoamygdalar network engaged during emotion regulation. Five regions were identified to form the network: the amygdala, the presupplementary motor area (preSMA), the ventrolateral prefrontal cortex (vlPFC), dorsolateral prefrontal cortex (dlPFC), and ventromedial prefrontal cortex (vmPFC). Bayesian Model Selection was used to compare 256 candidate models, with our winning model featuring modulations of vmPFC-to-amygdala and amygdala-to-preSMA pathways during reappraisal. Moreover, the strength of amygdala-to-preSMA modulation was associated with the habitual use of cognitive reappraisal. Our findings support the vmPFC serving as the primary conduit through which prefrontal regions directly modulate amygdala activity, with amygdala-to-preSMA connectivity potentially acting to shape ongoing affective motor responses. We propose that these two frontoamygdalar pathways constitute a recursive feedback loop, which computes the effectiveness of emotion-regulatory actions and drives model-based behavior.
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Affiliation(s)
- Trevor Steward
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Victoria 3053, Australia
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Christopher G Davey
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Victoria 3053, Australia
| | - Alec J Jamieson
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Victoria 3053, Australia
| | - Katerina Stephanou
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Victoria 3053, Australia
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge Biomedical Research Institute/IDIBELL and CIBERSAM, Barcelona 08907, Spain
- Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Barcelona 08193, Spain
| | - Kim L Felmingham
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Ben J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Victoria 3053, Australia
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17
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Brown CL, Hua AY, De Coster L, Sturm VE, Kramer JH, Rosen HJ, Miller BL, Levenson RW. Comparing two facets of emotion perception across multiple neurodegenerative diseases. Soc Cogn Affect Neurosci 2020; 15:511-522. [PMID: 32363385 PMCID: PMC7328026 DOI: 10.1093/scan/nsaa060] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/25/2020] [Accepted: 04/27/2020] [Indexed: 12/30/2022] Open
Abstract
Deficits in emotion perception (the ability to infer others' emotions accurately) can occur as a result of neurodegeneration. It remains unclear how different neurodegenerative diseases affect different forms of emotion perception. The present study compares performance on a dynamic tracking task of emotion perception (where participants track the changing valence of a film character's emotions) with performance on an emotion category labeling task (where participants label specific emotions portrayed by film characters) across seven diagnostic groups (N = 178) including Alzheimer's disease (AD), behavioral variant frontotemporal dementia (bvFTD), semantic variant primary progressive aphasia (svPPA), non-fluent variant primary progressive aphasia (nfvPPA), progressive supranuclear palsy (PSP), corticobasal syndrome and healthy controls. Consistent with hypotheses, compared to controls, the bvFTD group was impaired on both tasks. The svPPA group was impaired on the emotion labeling task, whereas the nfvPPA, PSP and AD groups were impaired on the dynamic tracking task. Smaller volumes in bilateral frontal and left insular regions were associated with worse labeling, whereas smaller volumes in bilateral medial frontal, temporal and right insular regions were associated with worse tracking. Findings suggest labeling and tracking facets of emotion perception are differentially affected across neurodegenerative diseases due to their unique neuroanatomical correlates.
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Affiliation(s)
- Casey L Brown
- Berkeley Psychophysiology Laboratory, Department of Psychology, University of California, Berkeley, CA 94720-1650, USA
- Department of Psychiatry, University of California, San Francisco, CA 94115, USA
| | - Alice Y Hua
- Berkeley Psychophysiology Laboratory, Department of Psychology, University of California, Berkeley, CA 94720-1650, USA
| | - Lize De Coster
- Department of Psychiatry, University of California, San Francisco, CA 94115, USA
| | - Virginia E Sturm
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94115, USA
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94115, USA
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94115, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94115, USA
| | - Robert W Levenson
- Berkeley Psychophysiology Laboratory, Department of Psychology, University of California, Berkeley, CA 94720-1650, USA
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18
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Yang S, Zhang Y, Xie S, Chen Y, Jiang D, Luo Y, Zhao Q, Yang B. Predictors of Perceived Social Support for Patients with Dementia: A Mixed-Methods Study. Clin Interv Aging 2020; 15:595-607. [PMID: 32431493 PMCID: PMC7201008 DOI: 10.2147/cia.s249223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 04/11/2020] [Indexed: 01/26/2023] Open
Abstract
Purpose Perceived social support (PSS) is closely linked to health outcomes in dementia patients. However, its continuous benefits are unclear. This mixed-methods study examined the impact of social support perceptions and differentiation among patients and carers during disease progression. Patients and Methods Persons with dementia (PWDs), family caregivers, and community family physicians were recruited from nine community health centers. Semi-structured interviews conducted with 12 PWDs (7 PWDs in mild dementia and 5 in moderate dementia), 12 family caregivers, and 6 community family physicians and conventional content analysis were used to explore social support perspectives at different dementia stages. A total of 470 PWDs were divided into mild (n=224), moderate (n=190), and severe (n=56) groups. Demographic, physical, and psychological factors related to PSS were examined by the group using multiple regression analysis. The group-based characteristics were entered into three prediction models. Results In the qualitative study, three themes of social support were identified: two viewpoints refer to social support; different needs and preferences in each stage; non-personalized support services. Quantitatively, the mild group scored lowest in perceived social support, while the severe group scored highest (χ2=64.70, P<0.001). The mild group PSS was predicted by depression (β=−0.07, P=0.04), cognitive capacity (β=−0.18, P<0.001), and instrumental ability (β=−0.78, P<0.001), which differed from the moderate and severe groups. Conclusion This study provided comprehensive insight into PSS from PWDs’ perspective at different stages of the disease. Results indicated the need for a stratified care approach and direction for further research on intervention.
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Affiliation(s)
- Siyuan Yang
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, Yuzhong District, People's Republic of China
| | - Yunmei Zhang
- School of Nursing, Chongqing Medical University, Chongqing, Yuzhong District, People's Republic of China
| | - Shiqi Xie
- School of Nursing, Chongqing Medical University, Chongqing, Yuzhong District, People's Republic of China
| | - Yanhan Chen
- School of Nursing, Chongqing Medical University, Chongqing, Yuzhong District, People's Republic of China
| | - Dengbi Jiang
- Community Health Center of Daxigou, Chongqing, Yuzhong District, People's Republic of China
| | - Yetao Luo
- Department of Biostatistics, School of Public Health and Management, Chongqing Medical University, Chongqing, Yuzhong District, People's Republic of China
| | - Qinghua Zhao
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, Yuzhong District, People's Republic of China
| | - Bing Yang
- School of Nursing, Chongqing Medical University, Chongqing, Yuzhong District, People's Republic of China
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19
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Positive Emotions from Brain Injury: The Emergence of Mirth and Happiness. Case Rep Psychiatry 2020; 2020:5702578. [PMID: 32082679 PMCID: PMC7008292 DOI: 10.1155/2020/5702578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 01/16/2020] [Indexed: 12/05/2022] Open
Abstract
Brain injury can result in an increase in positive emotions. We describe a 63-year-old man who presented with a prominent personality change after a gunshot wound to the head. He became “content,” light-hearted, and prone to joking and punning. Prior to his brain injury, he suffered from frequent depression and suicidal ideation, which subsequently resolved. Examination showed a large right calvarial defect and right facial weakness, along with memory impairment and variable executive functions. Further testing was notable for excellent performance on joke comprehension, good facial emotional recognition, adequate Theory of Mind, and elevated happiness. Neuroimaging revealed loss of much of the right frontal and right anterior lobes and left orbitofrontal injury. This patient, and the literature, suggests that frontal predominant injury can facilitate the emergence of mirth along with a sense of increased happiness possibly from disinhibited activation of the subcortical reward/pleasure centers of the ventral striatal limbic area.
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20
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Hua AY, Chen KH, Brown CL, Lwi SJ, Casey JJ, Rosen HJ, Miller BL, Levenson RW. Physiological, behavioral and subjective sadness reactivity in frontotemporal dementia subtypes. Soc Cogn Affect Neurosci 2019; 14:1453-1465. [PMID: 31993653 PMCID: PMC7137727 DOI: 10.1093/scan/nsaa007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 10/29/2019] [Accepted: 01/08/2020] [Indexed: 12/15/2022] Open
Abstract
Frontotemporal dementia (FTD), a neurodegenerative disease broadly characterized by socioemotional impairments, includes three clinical subtypes: behavioral variant FTD (bvFTD), semantic variant primary progressive aphasia (svPPA) and non-fluent variant primary progressive aphasia (nfvPPA). Emerging evidence has shown emotional reactivity impairments in bvFTD and svPPA, whereas emotional reactivity in nfvPPA is far less studied. In 105 patients with FTD (49 bvFTD, 31 svPPA and 25 nfvPPA) and 27 healthy controls, we examined three aspects of emotional reactivity (physiology, facial behavior and subjective experience) in response to a sad film. In a subset of the sample, we also examined the neural correlates of diminished aspects of reactivity using voxel-based morphometry. Results indicated that all three subtypes of FTD showed diminished physiological responding in respiration rate and diastolic blood pressure; patients with bvFTD and svPPA also showed diminished subjective experience, and no subtypes showed diminished facial behavior. Moreover, there were differences among the clinical subtypes in brain regions where smaller volumes were associated with diminished sadness reactivity. These results show that emotion impairments extend to sadness reactivity in FTD and underscore the importance of considering different aspects of sadness reactivity in multiple clinical subtypes for characterizing emotional deficits and associated neurodegeneration in FTD.
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Affiliation(s)
- Alice Y Hua
- Berkeley Psychophysiology Laboratory, Department of Psychology, University of California, Berkeley, USA
| | - Kuan-Hua Chen
- Berkeley Psychophysiology Laboratory, Department of Psychology, University of California, Berkeley, USA
| | - Casey L Brown
- Berkeley Psychophysiology Laboratory, Department of Psychology, University of California, Berkeley, USA
| | - Sandy J Lwi
- Berkeley Psychophysiology Laboratory, Department of Psychology, University of California, Berkeley, USA
| | - James J Casey
- Berkeley Psychophysiology Laboratory, Department of Psychology, University of California, Berkeley, USA
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, USA
| | - Robert W Levenson
- Berkeley Psychophysiology Laboratory, Department of Psychology, University of California, Berkeley, USA
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21
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Chen Y, Kumfor F, Landin-Romero R, Irish M, Piguet O. The Cerebellum in Frontotemporal Dementia: a Meta-Analysis of Neuroimaging Studies. Neuropsychol Rev 2019; 29:450-464. [PMID: 31428914 DOI: 10.1007/s11065-019-09414-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 08/05/2019] [Indexed: 12/12/2022]
Abstract
Frontotemporal dementia (FTD) is a neurodegenerative brain disorder primarily affecting the frontal and/or temporal lobes. Three main subtypes have been recognized: behavioural-variant FTD (bvFTD), semantic dementia (SD), and progressive nonfluent aphasia (PNFA), each of which has a distinct clinical and cognitive profile. Although the role of the cerebellum in cognition is increasingly accepted, knowledge of cerebellar changes across neuroimaging modalities and their contribution to behavioural and cognitive changes in FTD syndromes is currently scant. We conducted an anatomical/activation likelihood estimation (ALE) meta-analysis in 53 neuroimaging studies (structural MRI: 42; positron emission tomography: 6; functional MRI: 4; single-photon emission computed tomography: 1) to identify the patterns of cerebellar changes and their relations to profiles of behavioural and cognitive deficits in FTD syndromes. Overall, widespread bilateral cerebellar changes were found in FTD and notably the patterns were subtype specific. In bvFTD, ALE peaks were identified in the bilateral Crus, left lobule VI, right lobules VIIb and VIIIb. In SD, focal cerebellar changes were located in the left Crus I and lobule VI. A separate ALE meta-analysis on PNFA studies was not performed due to the limited number of studies available. In addition, the ALE analysis indicated that bilateral Crus I and Crus II were associated with behavioural disruption and cognitive dysfunction. This ALE meta-analysis provides the quantification of the location and extent of cerebellar changes across the main FTD syndromes, which in turn provides evidence of cerebellar contributions to behavioural and cognitive changes in FTD. These results bring new insights into the mechanisms mediating FTD symptomatology.
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Affiliation(s)
- Yu Chen
- The University of Sydney, School of Psychology, Brain & Mind Centre, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Fiona Kumfor
- The University of Sydney, School of Psychology, Brain & Mind Centre, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Ramon Landin-Romero
- The University of Sydney, School of Psychology, Brain & Mind Centre, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Muireann Irish
- The University of Sydney, School of Psychology, Brain & Mind Centre, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Olivier Piguet
- The University of Sydney, School of Psychology, Brain & Mind Centre, Sydney, NSW, Australia.
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia.
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22
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Behavioural variant frontotemporal dementia: At the interface of interoception, emotion and social cognition? Cortex 2019; 115:335-340. [DOI: 10.1016/j.cortex.2017.08.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/18/2017] [Accepted: 08/01/2017] [Indexed: 01/30/2023]
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23
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Carr AR, Jimenez EE, Thompson PM, Mendez MF. Frontotemporal asymmetry in socioemotional behavior: A pilot study in frontotemporal dementia. Soc Neurosci 2019; 15:15-24. [PMID: 31064266 DOI: 10.1080/17470919.2019.1614478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Clinical studies report abnormal socioemotional behavior in patients with right frontotemporal disease, but neuroimaging studies of socioemotional behavior usually show bilateral activations in normal subjects. This discrepancy suggests that impaired interhemispheric collaboration for socioemotional functions results from asymmetric frontotemporal disease. Behavioral variant frontotemporal dementia (bvFTD) can clarify the contribution of direction-independent frontotemporal asymmetry. In a two-part study, we evaluated bvFTD patients using socioemotional scales and magnetic and resonance imaging measures. Part A compared 18 patients on scales of social dysfunction and emotional intelligence with degree of asymmetry in frontal lobe volumes and analyzed differences between lower and higher asymmetry groups. Part B compared 24 patients on scales of social observation and emotional blunting with degree of asymmetry in frontotemporal cortical thickness using multiple linear regression. Both results showed that left or right hemispheric-specific contributions did not account for all socioemotional differences and that frontal lobe and frontotemporal differences in atrophy between the hemispheres accounted for significant variance in abnormalities in social and emotional behavior. These preliminary results indicate that the degree of frontal lobe and frontotemporal asymmetric involvement, regardless of direction or laterality, significantly contribute to socioemotional dysfunction and support the hypothesis that interhemispheric collaboration is important for complex socioemotional behavior.
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Affiliation(s)
- Andrew R Carr
- Neurology Service, V.A. Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,Departments of Neurology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Elvira E Jimenez
- Neurology Service, V.A. Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,Departments of Neurology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, University of Southern California, Marina del Rey, CA, USA
| | - Mario F Mendez
- Neurology Service, V.A. Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,Departments of Neurology, University of California at Los Angeles, Los Angeles, CA, USA.,Psychiatry & Biobehavioral Sciences, and Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
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24
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Abstract
Previous studies have found that people with schizophrenia report more negative affect (NA) in response to positive and neutral stimuli (incongruent NA) than people without schizophrenia, perhaps related to heightened overall NA. We sought to decrease NA and increase positive affect (PA) using the Broad-Minded Affective Coping (BMAC) procedure in people with (n = 29) and without (n = 26) schizophrenia. We also investigated whether decreased NA would contribute to a decrease in incongruent NA in people with schizophrenia. The BMAC procedure increased PA but did not decrease NA in participants, nor did it influence reports of incongruent NA (in response to positive and neutral films) in people with schizophrenia. Baseline NA in people with schizophrenia was correlated with incongruent NA and symptom severity. Results indicate that people with schizophrenia report heightened NA that does not readily diminish in the face of heightened PA.
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25
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Gainotti G. The Role of the Right Hemisphere in Emotional and Behavioral Disorders of Patients With Frontotemporal Lobar Degeneration: An Updated Review. Front Aging Neurosci 2019; 11:55. [PMID: 30941030 PMCID: PMC6433967 DOI: 10.3389/fnagi.2019.00055] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 02/22/2019] [Indexed: 12/12/2022] Open
Abstract
Background: Two main models have been advanced to explain the asymmetries observed in the representation and processing of emotions. The first model, labeled “the right hemisphere hypothesis,” assumes a general dominance of the right hemisphere for all emotions, regardless of affective valence. The second model, named “the valence hypothesis,” assumes an opposite dominance of the left hemisphere for positive emotions and the right hemisphere for negative emotions. Patients with frontotemporal lobar degeneration (FTLD) could contribute to clarifying this issue, because disorders of emotional and social behavior are very common in FTLD and because atrophy, which affects the antero-ventral part of the frontal and temporal lobes, can be clearly asymmetric in the early stages of this disease. Objective: The main scope of the present review therefore consists of evaluating if results of investigations conducted on emotional and behavioral disorders of patients with right and left FTLD, support the “right hemisphere” or the “valence” hypothesis. Method: A thorough review of behavioral and emotional disorders in FTLD patients, found that 177 possible studies, but only 32 papers met the requested criteria for inclusion in our review. Results: Almost all (25 out of 26) studies were relevant with respect to the “right hemisphere hypothesis” and supported the assumption of a general dominance of the right hemisphere for emotional functions, whereas only one of the six investigations were relevant with respect to the “valence hypothesis” and were in part consistent with this hypothesis, though these are also open to interpretation in terms of the “right hemisphere” hypothesis. Conclusions: This study, therefore, clearly supports the model of a general dominance of the right hemisphere for all emotions, regardless of affective valence.
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Affiliation(s)
- Guido Gainotti
- Institute of Neurology of the IRCCS Fondazione Policlinico Gemelli, Catholic University of Rome, Rome, Italy.,Department of Clinical and Behavioral Neurology, IRCCS Fondazione Santa Lucia, Rome, Italy
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26
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Nordvig AS, Goldberg DJ, Huey ED, Miller BL. The cognitive aspects of sexual intimacy in dementia patients: a neurophysiological review. Neurocase 2019; 25:66-74. [PMID: 30990123 DOI: 10.1080/13554794.2019.1603311] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Changes in higher-order cognitive behaviors such as reward recognition, salience processing, novelty perception, decision-making, emotional contagion, motivation, and empathy may contribute to intimacy dysfunction. Network circuitry underlying these cognitive functions is often activated in sexually intimate behavior. We propose that sexual dysfunction in AD and bvFTD is more nuanced than is commonly believed, and propose how AD and bvFTD atrophy may correlate neuroanatomically to brain regions and networks that contribute to the higher-order cognitive aspects of intimacy. The characterization of sexual intimacy in dementias must be expanded to meet the needs of our dementia patients and their romantic partners.
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Affiliation(s)
- Anna Starikovsky Nordvig
- a Department of Neurology, College of Physicians and Surgeons , Columbia University , New York, NY , USA
| | - Daniel J Goldberg
- b Department of Pharmacology, College of Physicians and Surgeons , Columbia University , New York, NY , USA
| | - Edward D Huey
- c Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain , Columbia University Medical Center , New York, NY , USA
| | - Bruce L Miller
- d Memory and Aging Center and Department of Neurology , University of California , San Francisco, CA , USA
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27
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Arai H, Matsumoto S, Sekiyama R, Fukuoka T. Secondary Mania after Cerebral Infarction in the Recovery Phase: Case Report. Prog Rehabil Med 2018; 3:20180021. [PMID: 32789246 DOI: 10.2490/prm.20180021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/26/2018] [Indexed: 11/09/2022] Open
Abstract
Introduction Although patients commonly experience psychological disorders such as depression following cerebrovascular events, mania is extremely rare. Here we present a patient who experienced secondary mania while being hospitalized in a convalescent rehabilitation ward following cerebral infarction. Case The patient was a 70-year-old man who was hospitalized at our hospital for convalescent rehabilitation after suffering mild right hemiplegia and higher brain dysfunction following cerebral infarction. During hospitalization, the patient experienced a progression-free course. Upon awakening on day 26 after hospitalization, the patient suddenly showed signs of mania. The symptoms included elevated mood, pressured speech, hyperactivity, insomnia, and agitation; these symptoms caused problems in his daily life at the hospital. On day 29 after hospitalization, the patient was referred to a psychiatric hospital as an outpatient. He was diagnosed with organic manic disorder and was hospitalized. The patient was administered lithium carbonate (Limas®; 400 mg daily) and risperidone (Risperdal®; 2 mg daily). Because the mania persisted for more than 1 week, he was diagnosed with secondary mania. His manic state gradually improved, and he was transferred to our hospital. He was able to undergo rehabilitation without any problem and with no exacerbation of mania. The patient was discharged on day 139 after readmission. Discussion In cases where patients with cerebrovascular disorders display abnormal behavior, it becomes necessary to differentiate between secondary mania and social behavior disorder. Because mania has a negative impact on the patient's hospitalization and convalescence, if secondary mania is suspected, early consideration of psychiatric treatment is required.
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28
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Hua AY, Sible IJ, Perry DC, Rankin KP, Kramer JH, Miller BL, Rosen HJ, Sturm VE. Enhanced Positive Emotional Reactivity Undermines Empathy in Behavioral Variant Frontotemporal Dementia. Front Neurol 2018; 9:402. [PMID: 29915557 PMCID: PMC5994409 DOI: 10.3389/fneur.2018.00402] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/15/2018] [Indexed: 12/12/2022] Open
Abstract
Behavioral variant frontotemporal dementia (bvFTD) is a neurodegenerative disease characterized by profound changes in emotions and empathy. Although most patients with bvFTD become less sensitive to negative emotional cues, some patients become more sensitive to positive emotional stimuli. We investigated whether dysregulated positive emotions in bvFTD undermine empathy by making it difficult for patients to share (emotional empathy), recognize (cognitive empathy), and respond (real-world empathy) to emotions in others. Fifty-one participants (26 patients with bvFTD and 25 healthy controls) viewed photographs of neutral, positive, negative, and self-conscious emotional faces and then identified the emotions displayed in the photographs. We used facial electromyography to measure automatic, sub-visible activity in two facial muscles during the task: Zygomaticus major (ZM), which is active during positive emotional reactions (i.e., smiling), and Corrugator supercilii (CS), which is active during negative emotional reactions (i.e., frowning). Participants rated their baseline positive and negative emotional experience before the task, and informants rated participants' real-world empathic behavior on the Interpersonal Reactivity Index. The majority of participants also underwent structural magnetic resonance imaging. A mixed effects model found a significant diagnosis X trial interaction: patients with bvFTD showed greater ZM reactivity to neutral, negative (disgust and surprise), self-conscious (proud), and positive (happy) faces than healthy controls. There was no main effect of diagnosis or diagnosis X trial interaction on CS reactivity. Compared to healthy controls, patients with bvFTD had impaired emotion recognition. Multiple regression analyses revealed that greater ZM reactivity predicted worse negative emotion recognition and worse real-world empathy. At baseline, positive emotional experience was higher in bvFTD than healthy controls and also predicted worse negative emotion recognition. Voxel-based morphometry analyses found that smaller volume in the thalamus, midcingulate cortex, posterior insula, anterior temporal pole, amygdala, precentral gyrus, and inferior frontal gyrus—structures that support emotion generation, interoception, and emotion regulation—was associated with greater ZM reactivity in bvFTD. These findings suggest that dysregulated positive emotional reactivity may relate to reduced empathy in bvFTD by making patients less likely to tune their reactions to the social context and to share, recognize, and respond to others' feelings and needs.
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Affiliation(s)
- Alice Y Hua
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Isabel J Sible
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - David C Perry
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Katherine P Rankin
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Joel H Kramer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Howard J Rosen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Virginia E Sturm
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
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29
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Social Cognition Dysfunctions in Neurodegenerative Diseases: Neuroanatomical Correlates and Clinical Implications. Behav Neurol 2018; 2018:1849794. [PMID: 29854017 PMCID: PMC5944290 DOI: 10.1155/2018/1849794] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 04/03/2018] [Accepted: 04/11/2018] [Indexed: 02/07/2023] Open
Abstract
Social cognitive function, involved in the perception, processing, and interpretation of social information, has been shown to be crucial for successful communication and interpersonal relationships, thereby significantly impacting mental health, well-being, and quality of life. In this regard, assessment of social cognition, mainly focusing on four key domains, such as theory of mind (ToM), emotional empathy, and social perception and behavior, has been increasingly evaluated in clinical settings, given the potential implications of impairments of these skills for therapeutic decision-making. With regard to neurodegenerative diseases (NDs), most disorders, characterized by variable disease phenotypes and progression, although similar for the unfavorable prognosis, are associated to impairments of social cognitive function, with consequent negative effects on patients' management. Specifically, in some NDs these deficits may represent core diagnostic criteria, such as for behavioral variant frontotemporal dementia (bvFTD), or may emerge during the disease course as critical aspects, such as for Parkinson's and Alzheimer's diseases. On this background, we aimed to revise the most updated evidence on the neurobiological hypotheses derived from network-based approaches, clinical manifestations, and assessment tools of social cognitive dysfunctions in NDs, also prospecting potential benefits on patients' well-being, quality of life, and outcome derived from potential therapeutic perspectives of these deficits.
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30
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Chen J, Chen Y, Gao Q, Chen G, Dai Y, Yao Z, Lu Q. Impaired Prefrontal-Amygdala Pathway, Self-Reported Emotion, and Erection in Psychogenic Erectile Dysfunction Patients With Normal Nocturnal Erection. Front Hum Neurosci 2018; 12:157. [PMID: 29740301 PMCID: PMC5928255 DOI: 10.3389/fnhum.2018.00157] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 04/05/2018] [Indexed: 12/31/2022] Open
Abstract
Background: Neuroimaging studies have demonstrated that the prefrontal cortex and amygdala play an important role in sexual arousal (SA). However, little is known about the interactions between the prefrontal and cortex amygdala, which mediate the cognitive regulation of emotion and SA. Objective: We seek to determine whether nocturnal erection of psychogenic erectile dysfunction (pED) patients are normal and whether there are changes of topological organization in the prefrontal-amygdala pathway of brain network in pED. In addition, whether there are correlations between network property changes and self-reported emotion and erection. Design, setting, and participants: We used the RigiScan device to evaluate erectile function of patients and employed diffusion MRI and graph theory to construct brain networks of 21 pED patients and 24 healthy controls. Outcome measurements and statistical analysis: We considered four nodal metrics and their asymmetry scores, and nocturnal penile tumescence (NPT) parameters, to evaluate the topological properties of brain networks of pED and their relationships with the impaired self-reported emotion and erection. Results and limitations: All the pED patients showed normal nocturnal penile erection, however impaired self-reported erection and negative emotion. In addition, patients showed lower connectivity degree and strength in the left prefrontal-amygdala pathway. We also found that pED exhibited lower leftward asymmetry in the inferior frontal gyrus. Furthermore, patients showed more hub regions and fewer pivotal connections. Moreover, the degree of the left amygdala of pED showed significantly negative correlation with the self-reported erection and positive correlation with the self-reported negative emotion. Conclusions: Together, these results suggest normal nocturnal erection in pED. However, abnormalities of brain network organization in pED, particularly in the left prefrontal-amygdala pathway, are associated with the impaired self-reported erection and negative emotion.
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Affiliation(s)
- Jianhuai Chen
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yun Chen
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Qingqiang Gao
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Guotao Chen
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yutian Dai
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Zhijian Yao
- Department of Psychiatry, Nanjing Brain Hospital, The Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qing Lu
- Key Laboratory of Child Development and Learning Science, Research Centre for Learning Science, Southeast University, Nanjing, China
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31
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dos Santos SB, Rocha GP, Fernandez LL, de Padua AC, Reppold CT. Association of Lower Spiritual Well-Being, Social Support, Self-Esteem, Subjective Well-Being, Optimism and Hope Scores With Mild Cognitive Impairment and Mild Dementia. Front Psychol 2018; 9:371. [PMID: 29666594 PMCID: PMC5891611 DOI: 10.3389/fpsyg.2018.00371] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/06/2018] [Indexed: 01/08/2023] Open
Abstract
Introduction: Positive psychology (PP) constructs contribute significantly to a better quality of life for people with various diseases. There are still few studies that have evaluated the evolution of these aspects during the progression of dementia. Objective: To compare the scores for self-esteem, life satisfaction, affect, spirituality, hope, optimism and perceived support network between elderly people with mild cognitive impairment (MCI), mild dementia and moderate dementia and control group. Methods: Cross-sectional study. The sample consisted of 66 healthy controls, 15 elderly people with MCI, 25 with mild dementia and 22 with moderate dementia matched by age, gender, and schooling. The instruments used were: Spirituality Self Rating Scale (SSRS), Rosenberg Self-Esteem Scale, Medical Outcomes Study's Social Support Scale, Life Satisfaction Scale (LSS), Positive and Negative Affect Schedule (PANAS), Revised Life Orientation Test (LOT-R), and Adult Dispositional Hope Scale (ADHS). Results: The scores for spiritual well-being, social support, self-esteem, life satisfaction, positive affect, optimism, negative affect, and hope differed significantly between the groups (p < 0.05). The individuals with MCI and mild dementia had lower spiritual well-being, social support, self-esteem, life satisfaction, positive affect, optimism and hope scores, and higher negative affect scores compared with the controls. The scores for PP constructs did not differ between the group of people with moderate dementia and the control group. Conclusion: Dementia was found to impact several PP constructs in the early stages of the disease. For individuals with greater cognitive impairment, anosognosia appears to suppress the disease's impact on these constructs.
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Affiliation(s)
- Sabrina B. dos Santos
- Postgraduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Gabrielli P. Rocha
- Department of Psychology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Liana L. Fernandez
- Department of Basic Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Analuiza C. de Padua
- Department of Medical Clinics, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Caroline T. Reppold
- Department of Psychology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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32
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Clark CN, Golden HL, McCallion O, Nicholas JM, Cohen MH, Slattery CF, Paterson RW, Fletcher PD, Mummery CJ, Rohrer JD, Crutch SJ, Warren JD. Music models aberrant rule decoding and reward valuation in dementia. Soc Cogn Affect Neurosci 2018; 13:192-202. [PMID: 29186630 PMCID: PMC5827340 DOI: 10.1093/scan/nsx140] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 11/06/2017] [Accepted: 11/19/2017] [Indexed: 01/03/2023] Open
Abstract
Aberrant rule- and reward-based processes underpin abnormalities of socio-emotional behaviour in major dementias. However, these processes remain poorly characterized. Here we used music to probe rule decoding and reward valuation in patients with frontotemporal dementia (FTD) syndromes and Alzheimer's disease (AD) relative to healthy age-matched individuals. We created short melodies that were either harmonically resolved ('finished') or unresolved ('unfinished'); the task was to classify each melody as finished or unfinished (rule processing) and rate its subjective pleasantness (reward valuation). Results were adjusted for elementary pitch and executive processing; neuroanatomical correlates were assessed using voxel-based morphometry. Relative to healthy older controls, patients with behavioural variant FTD showed impairments of both musical rule decoding and reward valuation, while patients with semantic dementia showed impaired reward valuation but intact rule decoding, patients with AD showed impaired rule decoding but intact reward valuation and patients with progressive non-fluent aphasia performed comparably to healthy controls. Grey matter associations with task performance were identified in anterior temporal, medial and lateral orbitofrontal cortices, previously implicated in computing diverse biological and non-biological rules and rewards. The processing of musical rules and reward distils cognitive and neuroanatomical mechanisms relevant to complex socio-emotional dysfunction in major dementias.
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Affiliation(s)
- Camilla N Clark
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Hannah L Golden
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Oliver McCallion
- Oxford University Clinical Academic Graduate School, University of Oxford, Oxford, UK
| | - Jennifer M Nicholas
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
- London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Miriam H Cohen
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Catherine F Slattery
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Ross W Paterson
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Phillip D Fletcher
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Catherine J Mummery
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
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Poppa T, Bechara A. The somatic marker hypothesis: revisiting the role of the ‘body-loop’ in decision-making. Curr Opin Behav Sci 2018. [DOI: 10.1016/j.cobeha.2017.10.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Santamaría-García H, Baez S, Reyes P, Santamaría-García JA, Santacruz-Escudero JM, Matallana D, Arévalo A, Sigman M, García AM, Ibáñez A. A lesion model of envy and Schadenfreude: legal, deservingness and moral dimensions as revealed by neurodegeneration. Brain 2017; 140:3357-3377. [PMID: 29112719 PMCID: PMC5841144 DOI: 10.1093/brain/awx269] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 08/21/2017] [Indexed: 12/19/2022] Open
Abstract
The study of moral emotions (i.e. Schadenfreude and envy) is critical to understand the ecological complexity of everyday interactions between cognitive, affective, and social cognition processes. Most previous studies in this area have used correlational imaging techniques and framed Schadenfreude and envy as unified and monolithic emotional domains. Here, we profit from a relevant neurodegeneration model to disentangle the brain regions engaged in three dimensions of Schadenfreude and envy: deservingness, morality, and legality. We tested a group of patients with behavioural variant frontotemporal dementia (bvFTD), patients with Alzheimer’s disease, as a contrastive neurodegeneration model, and healthy controls on a novel task highlighting each of these dimensions in scenarios eliciting Schadenfreude and envy. Compared with the Alzheimer’s disease and control groups, patients with bvFTD obtained significantly higher scores on all dimensions for both emotions. Correlational analyses revealed an association between envy and Schadenfreude scores and greater deficits in social cognition, inhibitory control, and behaviour disturbances in bvFTD patients. Brain anatomy findings (restricted to bvFTD and controls) confirmed the partially dissociable nature of the moral emotions’ experiences and highlighted the importance of socio-moral brain areas in processing those emotions. In all subjects, an association emerged between Schadenfreude and the ventral striatum, and between envy and the anterior cingulate cortex. In addition, the results supported an association between scores for moral and legal transgression and the morphology of areas implicated in emotional appraisal, including the amygdala and the parahippocampus. By contrast, bvFTD patients exhibited a negative association between increased Schadenfreude and envy across dimensions and critical regions supporting social-value rewards and social-moral processes (dorsolateral prefrontal cortex, angular gyrus and precuneus). Together, this study provides lesion-based evidence for the multidimensional nature of the emotional experiences of envy and Schadenfreude. Our results offer new insights into the mechanisms subsuming complex emotions and moral cognition in neurodegeneration. Moreover, this study presents the exacerbation of envy and Schadenfreude as a new potential hallmark of bvFTD that could impact in diagnosis and progression.
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Affiliation(s)
- Hernando Santamaría-García
- Centro de Memoria y Cognición. Intellectus-Hospital Universitario San Ignacio, Bogotá Colombia.,Pontificia Universidad Javeriana, Departments of Physiology, Psychiatry and Aging Institute Bogotá, Colombia.,Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Grupo de Investigación en Cerebro y Cognición Social, Bogotá, Colombia
| | - Sandra Baez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Grupo de Investigación en Cerebro y Cognición Social, Bogotá, Colombia.,Universidad de los Andes, Bogotá, Colombia
| | - Pablo Reyes
- Centro de Memoria y Cognición. Intellectus-Hospital Universitario San Ignacio, Bogotá Colombia.,Pontificia Universidad Javeriana, Departments of Physiology, Psychiatry and Aging Institute Bogotá, Colombia
| | | | - José M Santacruz-Escudero
- Centro de Memoria y Cognición. Intellectus-Hospital Universitario San Ignacio, Bogotá Colombia.,Pontificia Universidad Javeriana, Departments of Physiology, Psychiatry and Aging Institute Bogotá, Colombia.,Departament de Psiquiatria i Medicina Legal, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Diana Matallana
- Centro de Memoria y Cognición. Intellectus-Hospital Universitario San Ignacio, Bogotá Colombia.,Pontificia Universidad Javeriana, Departments of Physiology, Psychiatry and Aging Institute Bogotá, Colombia
| | - Analía Arévalo
- Departamento de Neurologia, Faculdade de Medicina, Universidade de Sao Paulo (FMUSP), Sao Paulo, Brazil
| | - Mariano Sigman
- Universidad Torcuato di Tella, Laboratorio de Neurociencias, Buenos Aires, Argentina
| | - Adolfo M García
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Faculty of Education, National University of Cuyo (UNCuyo), Mendoza, Argentina
| | - Agustín Ibáñez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Universidad Autónoma del Caribe, Barranquilla, Colombia.,Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile.,Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, Australia
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Perry DC, Datta S, Sturm VE, Wood KA, Zakrzewski J, Seeley WW, Miller BL, Kramer JH, Rosen HJ. Reward deficits in behavioural variant frontotemporal dementia include insensitivity to negative stimuli. Brain 2017; 140:3346-3356. [PMID: 29053832 DOI: 10.1093/brain/awx259] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/17/2017] [Indexed: 12/11/2022] Open
Abstract
During reward processing individuals weigh positive and negative features of a stimulus to determine whether they will pursue or avoid it. Though patients with behavioural variant frontotemporal dementia display changes in their pursuit of rewards, such as food, alcohol, money, and sex, the basis for these shifts is not clearly established. In particular, it is unknown whether patients' behaviour results from excessive focus on rewards, insensitivity to punishment, or to dysfunction in a particular stage of reward processing, such as anticipation, consumption, or action selection. Our goal was to determine the nature of the reward deficit in behavioural variant frontotemporal dementia and its underlying anatomy. We devised a series of tasks involving pleasant, unpleasant, and neutral olfactory stimuli, designed to separate distinct phases of reward processing. In a group of 25 patients with behavioural variant frontotemporal dementia and 21 control subjects, diagnosis by valence interactions revealed that patients with behavioural variant frontotemporal dementia rated unpleasant odours as less aversive than did controls and displayed lower skin conductance responses when anticipating an upcoming aversive odour. Subjective pleasantness ratings and skin conductance responses did not differ between behavioural variant frontotemporal dementia and controls for pleasant or neutral smells. In a task designed to measure the effort subjects would expend to smell or avoid smelling a stimulus, patients with behavioural variant frontotemporal dementia were less motivated, and therefore less successful than control subjects, at avoiding what they preferred not to smell, but had equivalent success at obtaining stimuli they found rewarding. Voxel-based morphometry of patients with behavioural variant frontotemporal dementia revealed that the inability to subjectively differentiate the valence of pleasant and unpleasant odours correlated with atrophy in right ventral mid-insula and right amygdala. High pleasantness ratings of unpleasant stimuli correlated with left dorsal anterior insula and frontal pole atrophy. These findings indicate that insensitivity to negative information may be a key component of the reward-seeking behaviours in behavioural variant frontotemporal dementia, and may relate to degeneration of structures that are involved in representing the emotional salience of sensory information.
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Affiliation(s)
- David C Perry
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Samir Datta
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Virginia E Sturm
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Kristie A Wood
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Jessica Zakrzewski
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - William W Seeley
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Bruce L Miller
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Joel H Kramer
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Howard J Rosen
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
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36
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Sturm VE, Perry DC, Wood K, Hua AY, Alcantar O, Datta S, Rankin KP, Rosen HJ, Miller BL, Kramer JH. Prosocial deficits in behavioral variant frontotemporal dementia relate to reward network atrophy. Brain Behav 2017; 7:e00807. [PMID: 29075567 PMCID: PMC5651391 DOI: 10.1002/brb3.807] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/07/2017] [Accepted: 07/20/2017] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Empathy and shared feelings of reward motivate individuals to share resources with others when material gain is not at stake. Behavioral variant frontotemporal dementia (bvFTD) is a neurodegenerative disease that affects emotion- and reward-relevant neural systems. Although there is diminished empathy and altered reward processing in bvFTD, how the disease impacts prosocial behavior is less well understood. METHODS A total of 74 participants (20 bvFTD, 15 Alzheimer's disease [AD], and 39 healthy controls) participated in this study. Inspired by token-based paradigms from animal studies, we developed a novel task to measure prosocial giving (the "Giving Game"). On each trial of the Giving Game, participants decided how much money to offer to the experimenter, and prosocial giving was the total amount that participants gave to the experimenter when it cost them nothing to give. Voxel-based morphometry was then used to identify brain regions that were associated with prosocial giving. RESULTS Prosocial giving was lower in bvFTD than in healthy controls; prosocial giving in AD did not differ significantly from either of the other groups. Whereas lower prosocial giving was associated with atrophy in the right pulvinar nucleus of the thalamus, greater prosocial giving was associated with atrophy in the left ventral striatum. CONCLUSION These findings suggest that simple acts of generosity deteriorate in bvFTD due to lateralized atrophy in reward-relevant neural systems that promote shared feelings of positive affect.
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Affiliation(s)
- Virginia E Sturm
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - David C Perry
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Kristie Wood
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Alice Y Hua
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Oscar Alcantar
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Samir Datta
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Katherine P Rankin
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Howard J Rosen
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Bruce L Miller
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Joel H Kramer
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
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37
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Clark CN, Nicholas JM, Agustus JL, Hardy CJD, Russell LL, Brotherhood EV, Dick KM, Marshall CR, Mummery CJ, Rohrer JD, Warren JD. Auditory conflict and congruence in frontotemporal dementia. Neuropsychologia 2017; 104:144-156. [PMID: 28811257 PMCID: PMC5637159 DOI: 10.1016/j.neuropsychologia.2017.08.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/31/2017] [Accepted: 08/05/2017] [Indexed: 12/14/2022]
Abstract
Impaired analysis of signal conflict and congruence may contribute to diverse socio-emotional symptoms in frontotemporal dementias, however the underlying mechanisms have not been defined. Here we addressed this issue in patients with behavioural variant frontotemporal dementia (bvFTD; n = 19) and semantic dementia (SD; n = 10) relative to healthy older individuals (n = 20). We created auditory scenes in which semantic and emotional congruity of constituent sounds were independently probed; associated tasks controlled for auditory perceptual similarity, scene parsing and semantic competence. Neuroanatomical correlates of auditory congruity processing were assessed using voxel-based morphometry. Relative to healthy controls, both the bvFTD and SD groups had impaired semantic and emotional congruity processing (after taking auditory control task performance into account) and reduced affective integration of sounds into scenes. Grey matter correlates of auditory semantic congruity processing were identified in distributed regions encompassing prefrontal, parieto-temporal and insular areas and correlates of auditory emotional congruity in partly overlapping temporal, insular and striatal regions. Our findings suggest that decoding of auditory signal relatedness may probe a generic cognitive mechanism and neural architecture underpinning frontotemporal dementia syndromes.
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Affiliation(s)
- Camilla N Clark
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Jennifer M Nicholas
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom; London School of Hygiene and Tropical Medicine, University of London, London, United Kingdomt
| | - Jennifer L Agustus
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Christopher J D Hardy
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Lucy L Russell
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Emilie V Brotherhood
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Katrina M Dick
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Charles R Marshall
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Catherine J Mummery
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Jonathan D Rohrer
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom.
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38
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Chen KH, Lwi SJ, Hua AY, Haase CM, Miller BL, Levenson RW. Increased subjective experience of non-target emotions in patients with frontotemporal dementia and Alzheimer's disease. Curr Opin Behav Sci 2017; 15:77-84. [PMID: 29457053 DOI: 10.1016/j.cobeha.2017.05.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Although laboratory procedures are designed to produce specific emotions, participants often experience mixed emotions (i.e., target and non-target emotions). We examined non-target emotions in patients with frontotemporal dementia (FTD), Alzheimer's disease (AD), other neurodegenerative diseases, and healthy controls. Participants watched film clips designed to produce three target emotions. Subjective experience of non-target emotions was assessed and emotional facial expressions were coded. Compared to patients with other neurodegenerative diseases and healthy controls, FTD patients reported more positive and negative non-target emotions, whereas AD patients reported more positive non-target emotions. There were no group differences in facial expressions of non-target emotions. We interpret these findings as reflecting deficits in processing interoceptive and contextual information resulting from neurodegeneration in brain regions critical for creating subjective emotional experience.
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Affiliation(s)
- Kuan-Hua Chen
- Institute of Personality and Social Research, University of California, Berkeley, CA 94720-5050, United States
| | - Sandy J Lwi
- Department of Psychology, University of California, Berkeley, CA 94720-5050, United States
| | - Alice Y Hua
- Department of Psychology, University of California, Berkeley, CA 94720-5050, United States
| | - Claudia M Haase
- School of Education and Social Policy and (by courtesy) Department of Psychology, Northwestern University, Evanston, IL 60208, United States
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94143-1207, United States
| | - Robert W Levenson
- Institute of Personality and Social Research, University of California, Berkeley, CA 94720-5050, United States.,Department of Psychology, University of California, Berkeley, CA 94720-5050, United States
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39
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Pressman PS, Simpson M, Gola K, Shdo SM, Spinelli EG, Miller BL, Gorno-Tempini ML, Rankin K, Levenson RW. Observing conversational laughter in frontotemporal dementia. J Neurol Neurosurg Psychiatry 2017; 88:418-424. [PMID: 28235777 PMCID: PMC5726511 DOI: 10.1136/jnnp-2016-314931] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 12/28/2016] [Accepted: 01/11/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND We performed an observational study of laughter during seminaturalistic conversations between patients with dementia and familial caregivers. Patients were diagnosed with (1) behavioural variant frontotemporal dementia (bvFTD), (2) right temporal variant frontotemporal dementia (rtFTD), (3) semantic variant of primary progressive aphasia (svPPA), (4) non-fluent variant primary progressive aphasia (nfvPPA) or (5) early onset Alzheimer's disease (eoAD). We hypothesised that those with bvFTD would laugh less in response to their own speech than other dementia groups or controls, while those with rtFTD would laugh less regardless of who was speaking. METHODS Patients with bvFTD (n=39), svPPA (n=19), rtFTD (n=14), nfvPPA (n=16), eoAD (n=17) and healthy controls (n=156) were recorded (video and audio) while discussing a problem in their relationship with a healthy control companion. Using the audio track only, laughs were identified by trained coders and then further classed by an automated algorithm as occurring during or shortly after the participant's own vocalisation ('self' context) or during or shortly after the partner's vocalisation ('partner' context). RESULTS Individuals with bvFTD, eoAD or rtFTD laughed less across both contexts of self and partner than the other groups. Those with bvFTD laughed less relative to their own speech comparedwith healthy controls. Those with nfvPPA laughed more in the partner context compared with healthy controls. CONCLUSIONS Laughter in response to one's own vocalisations or those of a conversational partner may be a clinically useful measure in dementia diagnosis.
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Affiliation(s)
- Peter S Pressman
- Rocky Mountain Alzheimer's Disease Center, Department of Neurology, University of Colorado, Denver, Colorado, USA .,Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA.,Berkeley Psychophysiology Laboratory, University of California, Berkeley, California, USA
| | - Michaela Simpson
- Berkeley Psychophysiology Laboratory, University of California, Berkeley, California, USA
| | - Kelly Gola
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Suzanne M Shdo
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Edoardo G Spinelli
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Katherine Rankin
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Robert W Levenson
- Berkeley Psychophysiology Laboratory, University of California, Berkeley, California, USA
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40
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41
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Machado L, Cantilino A. A systematic review of the neural correlates of positive emotions. ACTA ACUST UNITED AC 2016; 39:172-179. [PMID: 27901215 PMCID: PMC7111451 DOI: 10.1590/1516-4446-2016-1988] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 06/14/2016] [Indexed: 11/23/2022]
Abstract
Objective: To conduct a systematic literature review of human studies reporting neural correlates of positive emotions. Methods: The PubMed and Web of Science databases were searched in January 2016 for scientific papers written in English. No restrictions were placed on year of publication. Results: Twenty-two articles were identified and 12 met the established criteria. Five had been published during the last 4 years. Formation and regulation of positive emotions, including happiness, are associated with significant reductions in activity in the right prefrontal cortex and bilaterally in the temporoparietal cortex, as well as with increased activity in the left prefrontal regions. They are also associated with increased activity in the cingulate gyrus, inferior and middle temporal gyri, amygdalae, and ventral striatum. Conclusion: It is too early to claim that there is an established understanding of the neuroscience of positive emotions and happiness. However, despite overlap in the brain regions involved in the formation and regulation of positive and negative emotions, we can conclude that positive emotions such as happiness activate specific brain regions.
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Affiliation(s)
- Leonardo Machado
- Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
| | - Amaury Cantilino
- Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
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42
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Nagata T, Shinagawa S, Nakajima S, Plitman E, Mihashi Y, Hayashi S, Mimura M, Nakayama K. Classification of Neuropsychiatric Symptoms Requiring Antipsychotic Treatment in Patients with Alzheimer's Disease: Analysis of the CATIE-AD Study. J Alzheimers Dis 2016; 50:839-45. [PMID: 26836181 DOI: 10.3233/jad-150869] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The Neuropsychiatric Inventory (NPI) comprises 12 items, which were conventionally determined by psychopathological symptoms of patients with dementia. The clinical rating scales with structured questionnaires have been useful to evaluate neuropsychiatric symptoms (NPSs) of patients with dementia over the past twenty year. OBJECTIVE The aim of this study was to classify the conventional NPSs in patients with Alzheimer's disease (AD) requiring antipsychotic treatment for their NPSs into distinct clusters to simplify assessment of these numerous symptoms. METHODS Twelve items scores (product of severity and frequency of each symptom) in the NPI taken from the baseline visit were classified into subgroups by principle component analysis using data from 421 outpatients with AD enrolled in the Clinical Antipsychotic Trials of Intervention Effectiveness-Alzheimer's Disease (CATIE-AD) Phase 1. Chi square tests were conducted to examine the co-occurrence of the subgroups. RESULTS We found four distinct clusters: aggressiveness (agitation and irritabilities), apathy and eating problems (apathy and appetite/eating disturbance), psychosis (delusions and hallucinations), and emotion and disinhibition (depression, euphoria, and disinhibition). Anxiety, aberrant motor behavior, and sleep disturbance were not included by these clusters. Apathy and eating problems, and emotion and disinhibition co-occurred (p = 0.002), whereas aggressiveness and psychosis occurred independent of the other clusters. CONCLUSIONS Four distinct category clusters were identified from NPSs in patients with AD requiring antipsychotic treatment. Future studies should investigate psychosocial backgrounds or risk factors of each distinct cluster, in addition to their longitudinal course over treatment intervention.
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Affiliation(s)
- Tomoyuki Nagata
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Shinichiro Nakajima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada.,Geriatric Mental Health Division, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Eric Plitman
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Yukiko Mihashi
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada
| | - Shogo Hayashi
- Department of Anatomy, Tokyo Medical University, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Kazuhiko Nakayama
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
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43
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Satzer D, Bond DJ. Mania secondary to focal brain lesions: implications for understanding the functional neuroanatomy of bipolar disorder. Bipolar Disord 2016; 18:205-20. [PMID: 27112231 DOI: 10.1111/bdi.12387] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 02/22/2016] [Accepted: 03/18/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Approximately 3.5 million Americans will experience a manic episode during their lifetimes. The most common causes are psychiatric illnesses such as bipolar I disorder and schizoaffective disorder, but mania can also occur secondary to neurological illnesses, brain injury, or neurosurgical procedures. METHODS For this narrative review, we searched Medline for articles on the association of mania with stroke, brain tumors, traumatic brain injury, multiple sclerosis, neurodegenerative disorders, epilepsy, and neurosurgical interventions. We discuss the epidemiology, features, and treatment of these cases. We also review the anatomy of the lesions, in light of what is known about the neurobiology of bipolar disorder. RESULTS The prevalence of mania in patients with brain lesions varies widely by condition, from <2% in stroke to 31% in basal ganglia calcification. Mania occurs most commonly with lesions affecting frontal, temporal, and subcortical limbic brain areas. Right-sided lesions causing hypo-functionality or disconnection (e.g., stroke; neoplasms) and left-sided excitatory lesions (e.g., epileptogenic foci) are frequently observed. CONCLUSIONS Secondary mania should be suspected in patients with neurological deficits, histories atypical for classic bipolar disorder, and first manic episodes after the age of 40 years. Treatment with antimanic medications, along with specific treatment for the underlying neurologic condition, is typically required. Typical lesion locations fit with current models of bipolar disorder, which implicate hyperactivity of left-hemisphere reward-processing brain areas and hypoactivity of bilateral prefrontal emotion-modulating regions. Lesion studies complement these models by suggesting that right-hemisphere limbic-brain hypoactivity, or a left/right imbalance, may be relevant to the pathophysiology of mania.
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Affiliation(s)
- David Satzer
- Medical School, University of Minnesota, Minneapolis, MN, USA
| | - David J Bond
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
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Dominant hemisphere lateralization of cortical parasympathetic control as revealed by frontotemporal dementia. Proc Natl Acad Sci U S A 2016; 113:E2430-9. [PMID: 27071080 DOI: 10.1073/pnas.1509184113] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The brain continuously influences and perceives the physiological condition of the body. Related cortical representations have been proposed to shape emotional experience and guide behavior. Although previous studies have identified brain regions recruited during autonomic processing, neurological lesion studies have yet to delineate the regions critical for maintaining autonomic outflow. Even greater controversy surrounds hemispheric lateralization along the parasympathetic-sympathetic axis. The behavioral variant of frontotemporal dementia (bvFTD), featuring progressive and often asymmetric degeneration that includes the frontoinsular and cingulate cortices, provides a unique lesion model for elucidating brain structures that control autonomic tone. Here, we show that bvFTD is associated with reduced baseline cardiac vagal tone and that this reduction correlates with left-lateralized functional and structural frontoinsular and cingulate cortex deficits and with reduced agreeableness. Our results suggest that networked brain regions in the dominant hemisphere are critical for maintaining an adaptive level of baseline parasympathetic outflow.
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Emotional caricatures in frontotemporal dementia. Cortex 2016; 76:134-6. [PMID: 26303277 DOI: 10.1016/j.cortex.2015.07.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 07/06/2015] [Accepted: 07/15/2015] [Indexed: 11/22/2022]
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Digby R, Lee S, Williams A. Interviewing people with dementia in hospital: recommendations for researchers. J Clin Nurs 2016; 25:1156-65. [DOI: 10.1111/jocn.13141] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2015] [Indexed: 11/30/2022]
Affiliation(s)
| | - Susan Lee
- School of Nursing and Midwifery; Monash University; Frankston Vic. Australia
| | - Allison Williams
- Monash Nursing Academy; Monash University; Clayton Melbourne Vic. Australia
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Yokoyama JS, Bonham LW, Sturm VE, Adhimoolam B, Karydas A, Coppola G, Miller BL, Rankin KP. The 5-HTTLPR variant in the serotonin transporter gene modifies degeneration of brain regions important for emotion in behavioral variant frontotemporal dementia. NEUROIMAGE-CLINICAL 2015; 9:283-90. [PMID: 26509115 PMCID: PMC4576414 DOI: 10.1016/j.nicl.2015.07.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 07/30/2015] [Accepted: 07/31/2015] [Indexed: 11/28/2022]
Abstract
The serotonin transporter length polymorphism (5-HTTLPR) short allele (5-HTTLPR-s) has been associated with differential susceptibility for anxiety and depression in multiple psychiatric disorders. 5-HTTLPR-s modifies the serotonergic systems that support emotion and behavioral regulation by reducing gene expression, which slows the reuptake of serotonin, and is associated with distinct morphological and functional effects. Serotonergic systems are also shown to be dysfunctional in behavioral variant frontotemporal dementia (bvFTD), a disease characterized by marked socioemotional dysfunction. However, studies of 5-HTTLPR-s effects in bvFTD have been inconsistent. Our objective was to investigate the patterns of gray matter volume by 5-HTTLPR-s genotype in both healthy older controls and bvFTD patients. We performed voxel-based morphometry of 179 cognitively normal older adults and 24 bvFTD cases to determine brain changes associated with dose (0/1/2) of 5-HTTLPR-s allele. 5-HTTLPR-s frequency did not differ between controls and bvFTD. We found a significant interaction effect whereby carrying more 5-HTTLPR-s alleles in bvFTD was associated with smaller volume in left inferior frontal gyrus (T = 4.86, PFWE = 0.03) and larger volume in right temporal lobe (T = 5.01, PFWE = 0.01). These results suggest that the 5-HTTLPR-s allele differentially influences brain morphology in bvFTD. We propose that patients with bvFTD and 5-HTTLPR-s have altered volumes in regions that support socioemotional behavior, which may be a developmental or disease-related compensation for altered serotonergic activity. 5-HTTLPR-s correlates with greater right medial temporal lobe (R MTL) volume in FTD. 5-HTTLPR-s correlates with lower left inferior frontal gyrus (L IFG) volume in FTD. R MTL and L IFG volumes are associated with neuropsychiatric symptom severity. 5-HTTLPR-s effects on R MTL and L IFG volumes occur independently of disease severity.
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Affiliation(s)
- Jennifer S Yokoyama
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Luke W Bonham
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Virginia E Sturm
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Babu Adhimoolam
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Anna Karydas
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Giovanni Coppola
- Departments of Neurology and Psychiatry, Semel Institute for Neuroscience and Human Behavior, The David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Katherine P Rankin
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA 94158, USA
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