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Wilson NA, Ahmed R, Piguet O, Irish M. Disrupted social perception in frontotemporal dementia and Alzheimer's disease - Associated cognitive processes and clinical implications. J Neurol Sci 2024; 458:122902. [PMID: 38325063 DOI: 10.1016/j.jns.2024.122902] [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: 09/28/2023] [Revised: 01/21/2024] [Accepted: 01/22/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Social perception refers to the ability to adapt and update one's behaviour in accordance with the current context and provides the foundation for many complex social and emotional interactions. Alterations in social cognition are a hallmark of the behavioural variant of frontotemporal dementia (bvFTD), yet the capacity for social perception in this syndrome remains unclear. METHODS We examined social perception in 18 bvFTD and 13 Alzheimer's disease (AD) patients, in comparison with 17 healthy older controls, using a social perception task derived from the Dewey Story Test. Participants also completed a comprehensive neuropsychological battery and carers provided ratings of behavioural and neuropsychiatric changes. RESULTS Overall, bvFTD and AD performance diverged significantly from control ratings on the social perception task, however, no significant difference was found between patient groups. Standardised values relative to the mean control rating revealed considerable variability within the patient groups in terms of the direction of deviation, i.e., over- or under-rating the vignettes relative to healthy controls (range z-scores = -1.79 to +1.63). Greater deviation from control ratings was associated with more pronounced memory (p = .007) and behavioural (p = .009) disturbances in bvFTD; whilst social perception performance correlated exclusively with verbal fluency in AD (p = .003). CONCLUSIONS Social perception is comparably disrupted in bvFTD and AD, yet likely reflects the differential breakdown of distinct cognitive processes in each dementia syndrome. Our findings have important clinical implications for the development of targeted interventions to manage disease-specific changes in social perception in dementia.
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Affiliation(s)
- Nikki-Anne Wilson
- The University of Sydney, Brain and Mind Centre, Sydney, NSW 2050, Australia; The University of Sydney, School of Psychology, Sydney, NSW 2006, Australia; The University of New South Wales, School of Psychology, Sydney, NSW 2052, Australia; Neuroscience Research Australia, Sydney, NSW 2031, Australia.
| | - Rebekah Ahmed
- The University of Sydney, Brain and Mind Centre, Sydney, NSW 2050, Australia; Memory and Cognition Clinic, Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
| | - Olivier Piguet
- The University of Sydney, Brain and Mind Centre, Sydney, NSW 2050, Australia; The University of Sydney, School of Psychology, Sydney, NSW 2006, Australia
| | - Muireann Irish
- The University of Sydney, Brain and Mind Centre, Sydney, NSW 2050, Australia; The University of Sydney, School of Psychology, Sydney, NSW 2006, Australia
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Dengler J, Deck BL, Stoll H, Fernandez-Nunez G, Kelkar AS, Rich RR, Erickson BA, Erani F, Faseyitan O, Hamilton RH, Medaglia JD. Enhancing cognitive control with transcranial magnetic stimulation in subject-specific frontoparietal networks. Cortex 2024; 172:141-158. [PMID: 38330778 DOI: 10.1016/j.cortex.2023.11.020] [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: 06/01/2023] [Revised: 10/26/2023] [Accepted: 11/28/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND Cognitive control processes, including those involving frontoparietal networks, are highly variable between individuals, posing challenges to basic and clinical sciences. While distinct frontoparietal networks have been associated with specific cognitive control functions such as switching, inhibition, and working memory updating functions, there have been few basic tests of the role of these networks at the individual level. METHODS To examine the role of cognitive control at the individual level, we conducted a within-subject excitatory transcranial magnetic stimulation (TMS) study in 19 healthy individuals that targeted intrinsic ("resting") frontoparietal networks. Person-specific intrinsic networks were identified with resting state functional magnetic resonance imaging scans to determine TMS targets. The participants performed three cognitive control tasks: an adapted Navon figure-ground task (requiring set switching), n-back (working memory), and Stroop color-word (inhibition). OBJECTIVE Hypothesis: We predicted that stimulating a network associated with externally oriented control [the "FPCN-B" (fronto-parietal control network)] would improve performance on the set switching and working memory task relative to a network associated with attention (the Dorsal Attention Network, DAN) and cranial vertex in a full within-subjects crossover design. RESULTS We found that set switching performance was enhanced by FPCN-B stimulation along with some evidence of enhancement in the higher-demand n-back conditions. CONCLUSION Higher task demands or proactive control might be a distinguishing role of the FPCN-B, and personalized intrinsic network targeting is feasible in TMS designs.
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Affiliation(s)
- Julia Dengler
- School of Biomedical Engineering Science and Health Systems, Drexel University, Philadelphia, PA, USA
| | - Benjamin L Deck
- Department of Psychological & Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Harrison Stoll
- Department of Psychological & Brain Sciences, Drexel University, Philadelphia, PA, USA
| | | | - Apoorva S Kelkar
- Department of Psychological & Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Ryan R Rich
- Department of Psychological & Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Brian A Erickson
- Department of Psychological & Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Fareshte Erani
- Department of Psychological & Brain Sciences, Drexel University, Philadelphia, PA, USA
| | | | - Roy H Hamilton
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - John D Medaglia
- Department of Psychological & Brain Sciences, Drexel University, Philadelphia, PA, USA; Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
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3
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Burke T, Holleran L, Mothersill D, Lyons J, O'Rourke N, Gleeson C, Cannon DM, McKernan DP, Morris DW, Kelly JP, Hallahan B, McDonald C, Donohoe G. Bilateral anterior corona radiata microstructure organisation relates to impaired social cognition in schizophrenia. Schizophr Res 2023; 262:87-94. [PMID: 37931564 DOI: 10.1016/j.schres.2023.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 09/25/2023] [Accepted: 10/28/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVE The Corona Radiata (CR) is a large white matter tract in the brain comprising of the anterior CR (aCR), superior CR (sCR), and posterior CR (pCR), which have associations with cognition, self-regulation, and, in schizophrenia, positive symptom severity. This study tested the hypothesis that the microstructural organisation of the aCR, as measured by Fractional Anisotropy (FA) using Diffusion Tensor Imaging (DTI), would relate to poorer social cognitive outcomes and higher positive symptom severity for people with schizophrenia, when compared to healthy participants. We further hypothesised that increased positive symptoms would relate to poorer social cognitive outcomes. METHODS Data were derived from n = 178 healthy participants (41 % females; 36.11 ± 12.36 years) and 58 people with schizophrenia (30 % females; 42.4 ± 11.1 years). The Positive and Negative Symptom Severity Scale measured clinical symptom severity. Social Cognition was measured using the Reading the Mind in the Eyes Test (RMET) Total Score, as well as the Positive, Neutral, and Negative stimuli valence. The ENIGMA-DTI protocol tract-based spatial statistics (TBSS) was used. RESULTS There was a significant difference in FA for the CR, in individuals with schizophrenia compared to healthy participants. On stratification, both the aCR and pCR were significantly different between groups, with patients showing reduced white matter tract microstructural organisation. Significant negative correlations were observed between positive symptomatology and reduced microstructural organisation of the aCR. Performance for RMET negative valence items was significantly correlated bilaterally with the aCR, but not the sCR or pCR, and no relationship to positive symptoms was observed. CONCLUSIONS These data highlight specific and significant microstructural white-matter differences for people with schizophrenia, which relates to positive clinical symptomology and poorer performance on social cognition stimuli. While reduced FA is associated with higher positive symptomatology in schizophrenia, this study shows the specific associated with anterior frontal white matter tracts and reduced social cognitive performance. The aCR may have a specific role to play in frontal-disconnection syndromes, psychosis, and social cognitive profile within schizophrenia, though further research requires more sensitive, specific, and detailed consideration of social cognition outcomes.
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Affiliation(s)
- Tom Burke
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - Laurena Holleran
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - David Mothersill
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland; Psychology Department, School of Business, National College of, Ireland
| | - James Lyons
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - Nathan O'Rourke
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - Christina Gleeson
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - Dara M Cannon
- Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland; Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland
| | - Declan P McKernan
- Pharmacology & Therapeutics and Galway Neuroscience Centre, National University of Ireland Galway, H91 W5P7 Galway, Ireland
| | - Derek W Morris
- Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - John P Kelly
- Pharmacology & Therapeutics and Galway Neuroscience Centre, National University of Ireland Galway, H91 W5P7 Galway, Ireland
| | - Brian Hallahan
- Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland; Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, H91 TK33 Galway, Ireland
| | - Colm McDonald
- Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland; Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, H91 TK33 Galway, Ireland
| | - Gary Donohoe
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland.
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de Lucena AT, Dos Santos TTBA, Santos PFA, Dourado MCN. Affective theory of mind in people with mild and moderate Alzheimer's disease. Int J Geriatr Psychiatry 2023; 38:e6032. [PMID: 38038609 DOI: 10.1002/gps.6032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 11/12/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE This study compared the affective theory of mind (ToM) of people with mild and moderate Alzheimer's disease (AD) and healthy older adults and also investigated the relationship between affective ToM and cognitive and clinical functioning in AD people. METHODS This cross-sectional study included 156 older adults with AD and 40 healthy older adults. We used an experimental task involving reasoning processes in different contextual situations. RESULTS The affective ToM was impaired in AD groups compared with healthy group, with moderate AD group showing lower performance than mild AD group. The affective ToM task of mild AD group was significantly correlated with the Mini-Mental State Examination (MMSE) and education years. Linear regression showed only education years as a predictor of ToM task performance. The neuropsychiatric symptoms and functionality were not correlated with the affective ToM. CONCLUSIONS Our findings demonstrated that people with mild and moderate AD presented impairments in affective ToM that can be explained by the difficulties to infer emotion from reasoning processes. In addition, the education years variable proved to be an affective ToM performance's predictor for the mild AD group, but not for the moderate AD group, indicating that ToM abilities are affected differently in different stages of AD. Neuropsychiatric symptoms and functionality seem to have no influence on affective ToM impairments in people with AD.
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Affiliation(s)
- Aline Tavares de Lucena
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Paulo Fernando Alves Santos
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Márcia Cristina Nascimento Dourado
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Legaz A, Prado P, Moguilner S, Báez S, Santamaría-García H, Birba A, Barttfeld P, García AM, Fittipaldi S, Ibañez A. Social and non-social working memory in neurodegeneration. Neurobiol Dis 2023; 183:106171. [PMID: 37257663 PMCID: PMC11177282 DOI: 10.1016/j.nbd.2023.106171] [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: 04/05/2023] [Revised: 05/08/2023] [Accepted: 05/24/2023] [Indexed: 06/02/2023] Open
Abstract
Although social functioning relies on working memory, whether a social-specific mechanism exists remains unclear. This undermines the characterization of neurodegenerative conditions with both working memory and social deficits. We assessed working memory domain-specificity across behavioral, electrophysiological, and neuroimaging dimensions in 245 participants. A novel working memory task involving social and non-social stimuli with three load levels was assessed across controls and different neurodegenerative conditions with recognized impairments in: working memory and social cognition (behavioral-variant frontotemporal dementia); general cognition (Alzheimer's disease); and unspecific patterns (Parkinson's disease). We also examined resting-state theta oscillations and functional connectivity correlates of working memory domain-specificity. Results in controls and all groups together evidenced increased working memory demands for social stimuli associated with frontocinguloparietal theta oscillations and salience network connectivity. Canonical frontal theta oscillations and executive-default mode network anticorrelation indexed non-social stimuli. Behavioral-variant frontotemporal dementia presented generalized working memory deficits related to posterior theta oscillations, with social stimuli linked to salience network connectivity. In Alzheimer's disease, generalized working memory impairments were related to temporoparietal theta oscillations, with non-social stimuli linked to the executive network. Parkinson's disease showed spared working memory performance and canonical brain correlates. Findings support a social-specific working memory and related disease-selective pathophysiological mechanisms.
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Affiliation(s)
- Agustina Legaz
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Universidad Nacional de Córdoba, Facultad de Psicología, Córdoba, Argentina
| | - Pavel Prado
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile; Escuela de Fonoaudiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Chile
| | - Sebastián Moguilner
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires, Argentina; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile; Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, United States; Trinity College Dublin (TCD), Dublin, Ireland
| | | | - Hernando Santamaría-García
- Pontificia Universidad Javeriana, Medical School, Physiology and Psychiatry Departments, Memory and Cognition Center Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Agustina Birba
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires, Argentina; Facultad de Psicología, Universidad de La Laguna, Tenerife, Spain; Instituto Universitario de Neurociencia, Universidad de La Laguna, Tenerife, Spain
| | - Pablo Barttfeld
- Cognitive Science Group. Instituto de Investigaciones Psicológicas (IIPsi), CONICET UNC, Facultad de Psicología, Universidad Nacional de Córdoba, Boulevard de la Reforma esquina Enfermera Gordillo, CP 5000. Córdoba, Argentina
| | - Adolfo M García
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires, Argentina; Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, United States; Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile; Trinity College Dublin (TCD), Dublin, Ireland
| | - Sol Fittipaldi
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires, Argentina; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile; Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, United States; Trinity College Dublin (TCD), Dublin, Ireland.
| | - Agustín Ibañez
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile; Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, United States; Trinity College Dublin (TCD), Dublin, Ireland.
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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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7
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Episodic memory in progressive supranuclear palsy: a neuropsychological and neuroimaging study. Neurol Sci 2022; 43:5363-5368. [DOI: 10.1007/s10072-022-06160-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 05/18/2022] [Indexed: 10/18/2022]
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8
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El Haj M, Allain P, Boutoleau Bretonnière C, Chapelet G, Antoine P, Gallouj K. Empathy of individuals with Alzheimer’s disease (AD) toward other AD patients. J Clin Exp Neuropsychol 2022; 44:293-301. [DOI: 10.1080/13803395.2022.2110573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Mohamad El Haj
- Nantes Université, Univ Angers, Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), Nantes, France
- CHU Nantes, Clinical Gerontology Department, Nantes, France
- Institut Universitaire de France, Paris, France
| | - Philippe Allain
- Laboratoire de Psychologie des Pays de la Loire, LPPL EA 4638 SFR Confluences, UNIV Angers, Nantes Université, Maison de la recherche Germaine Tillion, Angers Cedex 01, France
- Département de Neurologie, CHU Angers, Angers, France
| | | | - Guillaume Chapelet
- CHU Nantes, Clinical Gerontology Department, Nantes, France
- Université de Nantes, Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, Nantes, France
| | - Pascal Antoine
- Univ. Lille, CNRS, CHU Lille, UMR 9193 SCALab - Sciences Cognitives Et Sciences Affectives, Lille, France
| | - Karim Gallouj
- Unité de Gériatrie, Centre Hospitalier de Tourcoing, Tourcoing, France
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Leroi I, Karanja W, Adrion ER, Alladi S, Custodio N, Goswami SP, Guerchet M, Gubner J, Ibanez A, Ilinica S, Jafri H, Lawlor B, Mohamed AA, Ogunniyi A, Robertson I, Robinson L, Spector A, Varghese M, Weidner W, Caramelli P. Equity and balance in applied dementia research: A charter of conduct and checklist for global collaborations. Int J Geriatr Psychiatry 2022; 37. [PMID: 35703570 DOI: 10.1002/gps.5762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/04/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Iracema Leroi
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Wambui Karanja
- Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Emily R Adrion
- Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,School of Social and Political Science at the University of Edinburgh, Edinburgh, Scotland
| | - Suvarna Alladi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Nilton Custodio
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Perú
| | - S P Goswami
- All India Institute of Speech & Hearing, Mysuru, India
| | - Maëlenn Guerchet
- Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA
| | - Jennie Gubner
- Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA
| | - Agustin Ibanez
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA.,Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago de Chile, Santiago, Chile.,Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, Buenos Aires, Argentina
| | - Stefania Ilinica
- Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Hussain Jafri
- Fatima Jinnah Medical University Lahore, Lahore, Pakistan
| | - Brian Lawlor
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Aya Ashour Mohamed
- Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Department of Neurology, Ain Shams University, Cairo, Egypt
| | - Adesola Ogunniyi
- Department of Neurology, University College Hospital, Ibadan, Nigeria
| | - Ian Robertson
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Louise Robinson
- Population Heath Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Aimee Spector
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Setién-Suero E, Murillo-García N, Sevilla-Ramos M, Abreu-Fernández G, Pozueta A, Ayesa-Arriola R. Exploring the Relationship Between Deficits in Social Cognition and Neurodegenerative Dementia: A Systematic Review. Front Aging Neurosci 2022; 14:778093. [PMID: 35572150 PMCID: PMC9093607 DOI: 10.3389/fnagi.2022.778093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundNeurodegenerative diseases might affect social cognition in various ways depending on their components (theory of mind, emotional processing, attribution bias, and social perception) and the subtype of dementia they cause. This review aims to explore this difference in cognitive function among individuals with different aetiologies of dementia.MethodsThe following databases were explored: MEDLINE via PubMed, Cochrane Library, Lilacs, Web of Science, and PsycINFO. We selected studies examining social cognition in individuals with neurodegenerative diseases in which dementia was the primary symptom that was studied. The neurodegenerative diseases included Alzheimer's disease, Lewy body disease and frontotemporal lobar degeneration. The search yielded 2,803 articles.ResultsOne hundred twenty-two articles were included in the present review. The summarised results indicate that people with neurodegenerative diseases indeed have deficits in social cognitive performance. Both in populations with Alzheimer's disease and in populations with frontotemporal dementia, we found that emotional processing was strongly affected. However, although theory of mind impairment could also be observed in the initial stages of frontotemporal dementia, in Alzheimer's disease it was only appreciated when performing highly complex task or in advanced stages of the disease.ConclusionsEach type of dementia has a differential profile of social cognition deterioration. This review could provide a useful reference for clinicians to improve detection and diagnosis, which would undoubtedly guarantee better interventions.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020152562, PROSPERO, identifier: CRD42020152562.
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Affiliation(s)
- Esther Setién-Suero
- Department of Psychiatry, School of Medicine, University of Cantabria, University Hospital Marqués de Valdecilla, Santander, Spain
- IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
- *Correspondence: Esther Setién-Suero ; orcid.org/0000-0002-8027-6546
| | - Nancy Murillo-García
- Department of Psychiatry, School of Medicine, University of Cantabria, University Hospital Marqués de Valdecilla, Santander, Spain
- IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain
| | | | - Georgelina Abreu-Fernández
- Department of Psychiatry, School of Medicine, University of Cantabria, University Hospital Marqués de Valdecilla, Santander, Spain
- IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain
| | - Ana Pozueta
- Department of Psychiatry, School of Medicine, University of Cantabria, University Hospital Marqués de Valdecilla, Santander, Spain
- IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain
- Neurology Service and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, School of Medicine, University of Cantabria, University Hospital Marqués de Valdecilla, Santander, Spain
- IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain
- CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
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Polet K, Hesse S, Morisot A, Kullmann B, Louchart de la Chapelle S, Pesce A, Iakimova G. Eye-gaze Strategies During Facial Emotion Recognition in Neurodegenerative Diseases and Links With Neuropsychiatric Disorders. Cogn Behav Neurol 2022; 35:14-31. [PMID: 35239596 DOI: 10.1097/wnn.0000000000000288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/31/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Facial emotion recognition (FER) is primarily and severely impaired in individuals with the behavioral variant of frontotemporal dementia (bvFTD) and is often mildy impaired in individuals with Alzheimer disease (AD) or Parkinson disease (PD). Such impairment is associated with inappropriate social behaviors. OBJECTIVE To determine whether FER impairment is linked to the use of inappropriate eye-gaze strategies to decode facial emotions, leading to misinterpretation of others' intentions and then to behavioral disorders. METHOD We assessed FER in 9 individuals with bvFTD, 23 with AD, and 20 with PD, as well as 22 healthy controls (HC), using the Reading the Mind in the Eyes (RME) Test and the Ekman Faces Test. Eye movements (number and duration of fixations) were recorded with an eye-tracking device. Behavior was assessed using the Neuropsychiatric Inventory. RESULTS FER was mildly impaired in the AD and PD groups and severely impaired in the bvFTD group. FER impairment was accompanied by an increase in the number of fixations and a more attracted gaze toward the lower part of one's face. FER impairment and an increase in the number of fixations were positively correlated with behavioral disorders. CONCLUSION Our study demonstrated a link between FER impairment, modification of eye-gaze strategies during the observation of emotional faces, and behavioral disorders in individuals with bvFTD and those with AD or PD. These results suggest that an eye-gaze strategy rehabilitation program could have beneficial effects on emotion recognition and behavioral disorders in individuals with these diseases.
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Affiliation(s)
- Kévin Polet
- Clinical Research Unit-Memory Clinic Princess Grace Hospital, Monaco
| | - Solange Hesse
- Clinical Research Unit-Memory Clinic Princess Grace Hospital, Monaco
| | - Adeline Morisot
- Clinical Research Unit-Memory Clinic Princess Grace Hospital, Monaco
- Public Health Department, Nice Côte d'Azur University, University Hospital Center of Nice, Nice, France
| | - Benoît Kullmann
- Clinical Research Unit-Memory Clinic Princess Grace Hospital, Monaco
- Bibliographic Research Association for Neurosciences, Nice, France
| | | | - Alain Pesce
- Clinical Research Unit-Memory Clinic Princess Grace Hospital, Monaco
| | - Galina Iakimova
- Laboratory of Clinical, Cognitive, and Social Anthropology and Psychology, Nice Côte d'Azur University, Nice, France
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12
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Valera-Bermejo JM, De Marco M, Mitolo M, Cerami C, Dodich A, Venneri A. Large-Scale Functional Networks, Cognition and Brain Structures Supporting Social Cognition and Theory of Mind Performance in Prodromal to Mild Alzheimer's Disease. Front Aging Neurosci 2021; 13:766703. [PMID: 34867292 PMCID: PMC8636093 DOI: 10.3389/fnagi.2021.766703] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 10/19/2021] [Indexed: 12/19/2022] Open
Abstract
Impairment of social cognition (SC) skills such as recognition and attribution of intentions and affective states of others (Theory of Mind, ToM) has been evidenced in Alzheimer’s Disease (AD). This study investigated the neuropsychological, neuroanatomical and brain-functional underpinnings of SC processing to obtain an understanding of the social neurophenotype in early probable AD. Forty-six patients with mild cognitive impairment and mild probable AD underwent SC assessment including emotion recognition (Ekman-60-faces task) and cognitive and affective ToM (Reading-the-Mind-in-the-Eyes test and Story-based Empathy task). Linear models tested the association between SC scores and neuropsychological measures, grey matter maps and large-scale functional networks activity. The executive domain had the most predominant association with SC scores in the cognitive profile. Grey matter volume of the anterior cingulate, orbitofrontal, temporoparietal junction (TPJ), superior temporal, and cerebellar cortices were associated with ToM. Social cognition scores were associated with lower connectivity of the default-mode network with the prefrontal cortex. The right fronto-parietal network displayed higher inter-network connectivity in the right TPJ and insula while the salience network showed lower inter-network connectivity with the left TPJ and insula. Connectivity coupling alterations of executive-attentional networks may support default mode social-cognitive-associated decline through the recruitment of frontal executive mechanisms.
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Affiliation(s)
| | - Matteo De Marco
- Department of Life Sciences, Brunel University London, London, United Kingdom
| | - Micaela Mitolo
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Chiara Cerami
- IUSS Cognitive Neuroscience (ICoN) Center, University School for Advanced Studies IUSS-Pavia, Pavia, Italy.,Cognitive Computational Neuroscience Research Unit, Mondino Foundation IRCCS, Pavia, Italy
| | - Alessandra Dodich
- Center for Mind/Brain Sciences (CIMeC), Università degli Studi di Trento, Rovereto, Italy
| | - Annalena Venneri
- Department of Neuroscience, University of Sheffield, Sheffield, United Kingdom.,Department of Life Sciences, Brunel University London, London, United Kingdom
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13
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Geraudie A, Díaz Rivera M, Montembeault M, García AM. Language in Behavioral Variant Frontotemporal Dementia: Another Stone to Be Turned in Latin America. Front Neurol 2021; 12:702770. [PMID: 34447348 PMCID: PMC8383282 DOI: 10.3389/fneur.2021.702770] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/12/2021] [Indexed: 12/03/2022] Open
Abstract
Beyond canonical deficits in social cognition and interpersonal conduct, behavioral variant frontotemporal dementia (bvFTD) involves language difficulties in a substantial proportion of cases. However, since most evidence comes from high-income countries, the scope and relevance of language deficits in Latin American bvFTD samples remain poorly understood. As a first step toward reversing this scenario, we review studies reporting language measures in Latin American bvFTD cohorts relative to other groups. We identified 24 papers meeting systematic criteria, mainly targeting phonemic and semantic fluency, naming, semantic processing, and comprehension skills. The evidence shows widespread impairments in these domains, often related to overall cognitive disturbances. Some of these deficits may be as severe as in other diseases where they are more widely acknowledged, such as Alzheimer's disease. Considering the prevalence and informativeness of language deficits in bvFTD patients from other world regions, the need arises for more systematic research in Latin America, ideally spanning multiple domains, in diverse languages and dialects, with validated batteries. We outline key challenges and pathways of progress in this direction, laying the ground for a new regional research agenda on the disorder.
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Affiliation(s)
- Amandine Geraudie
- Neurology Department, Toulouse University Hospital, Toulouse, France
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Mariano Díaz Rivera
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- Agencia Nacional de Promoción Científica y Tecnológica, Buenos Aires, Argentina
| | - Maxime Montembeault
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Adolfo M. García
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Faculty of Education, National University of Cuyo, Mendoza, Argentina
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
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14
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Rijpma MG, Shdo SM, Shany-Ur T, Toller G, Kramer JH, Miller BL, Rankin KP. Salience driven attention is pivotal to understanding others' intentions. Cogn Neuropsychol 2021; 38:88-106. [PMID: 33522407 DOI: 10.1080/02643294.2020.1868984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Interpreting others' beliefs, desires and intentions is known as "theory of mind" (ToM), and is often evaluated using simplified measurement tools, which may not correctly reflect the brain circuits that are required for real-life ToM functioning. We aimed to identify the brain structures necessary to correctly infer intentions from realistic scenarios by administering The Awareness of Social Inference Test, Enriched subtest to 47 patients with behavioural variant frontotemporal dementia, 24 patients with progressive supranuclear palsy syndrome, 31 patients with Alzheimer's syndrome, and 77 older healthy controls. Neuroimaging data was analyzed using voxel based morphometry, and participants' understanding of intentions was correlated with voxel-wise and region-of interest data. We found that structural integrity of the cinguloinsular cortex in the salience network (SN) was more pivotal for accurate ToM than previously described, emphasizing the importance of the SN for selectively recognizing and attending to social cues during ToM inferences.
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Affiliation(s)
- Myrthe G Rijpma
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Suzanne M Shdo
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Tal Shany-Ur
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Gianina Toller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Katherine P Rankin
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
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15
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Moura MVB, Mariano LI, Teixeira AL, Caramelli P, de Souza LC. Social Cognition Tests Can Discriminate Behavioral Variant Frontotemporal Dementia From Alzheimer's Disease Independently of Executive Functioning. Arch Clin Neuropsychol 2021; 36:831-837. [PMID: 33034347 DOI: 10.1093/arclin/acaa084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/15/2020] [Accepted: 09/11/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate the accuracy of the Social and Emotional Assessment-short version (Mini-SEA) to differentiate subgroups of behavioral variant of frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) defined according to executive performance. METHODS bvFTD (n = 21), AD (n = 20), and healthy controls (HC, n = 23) underwent the Mini-SEA, comprising the Facial Emotion Recognition Test (FERT) and the faux-pas test. AD and bvFTD patients were classified according to their performance in the Frontal Assessment Battery into dysexecutive and nondysexecutive subgroups. RESULTS The area under the curve (AUC) values for the faux-pas test were 0.87 (dysexecutive-bvFTD vs. dysexecutive-AD) and 0.96 (non-dysexecutive-bvFTD vs. nondysexecutive-AD). The AUC values for FERT were 0.99 (dysexecutive-bvFTD vs. dysexecutive-AD) and 0.65 (nondysexecutive-bvFTD vs. nondysexecutive-AD); the AUC values for the Mini-SEA (total-score) were 0.95 (dysexecutive-bvFTD vs. dysexecutive-AD) and 0.88 (nondysexecutive-bvFTD vs. nondysexecutive-AD). DISCUSSION Social Cognition tests accurately distinguish bvFTD from AD regardless of the executive profile.
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Affiliation(s)
- Millena Vieira Brandão Moura
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Luciano Inácio Mariano
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Antônio Lúcio Teixeira
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Santa Casa BH Ensino e Pesquisa, Belo Horizonte, MG, Brazil
| | - Paulo Caramelli
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Leonardo Cruz de Souza
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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16
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Meconi F, Linde-Domingo J, S Ferreira C, Michelmann S, Staresina B, Apperly IA, Hanslmayr S. EEG and fMRI evidence for autobiographical memory reactivation in empathy. Hum Brain Mapp 2021; 42:4448-4464. [PMID: 34121270 PMCID: PMC8410563 DOI: 10.1002/hbm.25557] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/26/2021] [Accepted: 05/31/2021] [Indexed: 01/16/2023] Open
Abstract
Empathy relies on the ability to mirror and to explicitly infer others' inner states. Theoretical accounts suggest that memories play a role in empathy, but direct evidence of reactivation of autobiographical memories (AM) in empathy is yet to be shown. We addressed this question in two experiments. In Experiment 1, electrophysiological activity (EEG) was recorded from 28 participants. Participants performed an empathy task in which targets for empathy were depicted in contexts for which participants either did or did not have an AM, followed by a task that explicitly required memory retrieval of the AM and non‐AM contexts. The retrieval task was implemented to extract the neural fingerprints of AM and non‐AM contexts, which were then used to probe data from the empathy task. An EEG pattern classifier was trained and tested across tasks and showed evidence for AM reactivation when participants were preparing their judgement in the empathy task. Participants self‐reported higher empathy for people depicted in situations they had experienced themselves as compared to situations they had not experienced. A second independent fMRI experiment replicated this behavioural finding and showed increased activation for AM compared to non‐AM in the brain networks underlying empathy: precuneus, posterior parietal cortex, superior and inferior parietal lobule, and superior frontal gyrus. Together, our study reports behavioural, electrophysiological, and fMRI evidence that robustly supports AM reactivation in empathy.
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Affiliation(s)
| | - Juan Linde-Domingo
- School of Psychology, University of Birmingham, Birmingham.,Max Plank Institute Berlin for Human Development, Berlin, Germany
| | | | - Sebastian Michelmann
- School of Psychology, University of Birmingham, Birmingham.,Princeton Neuroscience Institute, Princeton, New Jersey, USA
| | - Bernhard Staresina
- School of Psychology, University of Birmingham, Birmingham.,Center for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Ian A Apperly
- School of Psychology, University of Birmingham, Birmingham
| | - Simon Hanslmayr
- School of Psychology, University of Birmingham, Birmingham.,Center for Human Brain Health, University of Birmingham, Birmingham, UK.,Institute for Neuroscience and Psychology, University of Glasgow, Glasgow, Scotland
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17
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Musa G, Slachevsky A, Muñoz-Neira C, Méndez-Orellana C, Villagra R, González-Billault C, Ibáñez A, Hornberger M, Lillo P. Alzheimer's Disease or Behavioral Variant Frontotemporal Dementia? Review of Key Points Toward an Accurate Clinical and Neuropsychological Diagnosis. J Alzheimers Dis 2021; 73:833-848. [PMID: 31884475 DOI: 10.3233/jad-190924] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Alzheimer's disease (AD) and frontotemporal dementia (FTD) are the most common neurodegenerative early-onset dementias. Despite the fact that both conditions have a very distinctive clinical pattern, they present with an overlap in their cognitive and behavioral features that may lead to misdiagnosis or delay in diagnosis. The current review intends to summarize briefly the main differences at the clinical, neuropsychological, and behavioral levels, in an attempt to suggest which aspects would facilitate an adequate diagnosis in a clinical setting, especially in Latin American and low- and middle-income countries, where the resources needed for a differential diagnosis (such as MRI or biomarkers) are not always available. A timely diagnosis of AD and FTD have significant implications for the medical management and quality of life of patients and careers.
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Affiliation(s)
- Gada Musa
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Department of Physiopathology, ICBM, Department of Neurosciences, Department of East Neuroscience, Faculty of Medicine, University of Chile, Providencia, Santiago, Chile.,Universidad de los Andes, Santiago, Chile.,Capredena, Health and Rehabilitation Center, Santiago, Chile
| | - Andrea Slachevsky
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Department of Physiopathology, ICBM, Department of Neurosciences, Department of East Neuroscience, Faculty of Medicine, University of Chile, Providencia, Santiago, Chile.,Gerosciences Center for Brain Health and Metabolism (GERO), Providencia, Santiago, Chile.,Memory and Neuropsychiatric Clinic (CMYN) Neurology Department- Hospital del Salvador and University of Chile, Providencia, Santiago, Chile.,Departamento de Medicina, Servicio de Neurología, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Carlos Muñoz-Neira
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department- Hospital del Salvador and University of Chile, Providencia, Santiago, Chile.,Research into Memory, Brain Sciences and Dementia Group (ReMemBr Group), Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Carolina Méndez-Orellana
- Carrera de Fonoaudiología, Departamento Ciencias de la Salud, Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile
| | - Roque Villagra
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Department of Physiopathology, ICBM, Department of Neurosciences, Department of East Neuroscience, Faculty of Medicine, University of Chile, Providencia, Santiago, Chile.,Gerosciences Center for Brain Health and Metabolism (GERO), Providencia, Santiago, Chile
| | - Christian González-Billault
- Gerosciences Center for Brain Health and Metabolism (GERO), Providencia, Santiago, Chile.,Department of Biology, Faculty of Sciences, Universidad de Chile, Santiago, Chile.,The Buck Institute for Research on Aging, Novato, CA, USA
| | - Agustín Ibáñez
- 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, Chile.,Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR), Sydney, Australia
| | | | - Patricia Lillo
- Gerosciences Center for Brain Health and Metabolism (GERO), Providencia, Santiago, Chile.,Department of Neurology South, Faculty of Medicine, Universidad de Chile, Santiago, Chile
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18
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Mariano LI, Caramelli P, Guimarães HC, Gambogi LB, Moura MVB, Yassuda MS, Teixeira AL, de Souza LC. Can Social Cognition Measurements Differentiate Behavioral Variant Frontotemporal Dementia from Alzheimer's Disease Regardless of Apathy? J Alzheimers Dis 2021; 74:817-827. [PMID: 32116247 DOI: 10.3233/jad-190861] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) share cognitive and behavioral symptoms, such as apathy. Social cognition measurements are useful in distinguishing bvFTD from AD, but their accuracies may be affected by apathy. OBJECTIVE To investigate whether social cognition measurements can distinguish bvFTD from either apathetic or non-apathetic AD patients. METHODS Three groups of participants were enrolled in the present study: bvFTD (n = 22), AD (n = 20), and healthy controls (HC, n = 23). The AD group was divided into apathetic (n = 10) and non-apathetic (n = 10). All subjects underwent comprehensive neuropsychological examination, including the short version of the Social and Emotional Assessment (Mini-SEA), which comprises the facial emotion recognition test and the faux-pas recognition test (Faux-Pas Test). Apathy was assessed according to the Starkstein's Apathy (SA) Scale. RESULTS The bvFTD and AD groups did not differ on global cognitive efficiency and on executive functions. In comparison to the whole AD group, bvFTD displayed lower Faux-Pas Test and Mini-SEA scores. Both AD subgroups, apathetic or non-apathetic, exhibited similar performance on all social cognition measurements. In comparison to either apathetic AD or non-apathetic AD, bvFTD patients underperformed on the Faux-Pas Test and on the Mini-SEA. The area under the curve values for the Mini-SEA total score were 0.87 (bvFTD versus AD), 0.90 (bvFTD versus apathetic AD), and 0.83 (bvFTD versus non-apathetic AD). CONCLUSION Social cognition tests provide accurate distinction between bvFTD against either apathetic AD or non-apathetic AD. Social cognition measurements did not correlate with apathy severity.
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Affiliation(s)
- Luciano Inácio Mariano
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Instituto de Ciências Biológicas, Pampulha, Belo Horizonte, Minas Gerais (MG), Brazil.,Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, UFMG, Belo Horizonte, MG, Brazil
| | - Paulo Caramelli
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Instituto de Ciências Biológicas, Pampulha, Belo Horizonte, Minas Gerais (MG), Brazil.,Departamento de Clínica Médica, Faculdade de Medicina, UFMG, Belo Horizonte, MG, Brazil
| | - Henrique Cerqueira Guimarães
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Instituto de Ciências Biológicas, Pampulha, Belo Horizonte, Minas Gerais (MG), Brazil
| | - Leandro Boson Gambogi
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Instituto de Ciências Biológicas, Pampulha, Belo Horizonte, Minas Gerais (MG), Brazil
| | | | - Mônica Sanches Yassuda
- Grupo de Neurologia Cognitiva e do Comportamento (GNCC), Departamento de Neurologia, Faculdade de Medicina, Universidade de São Paulo, Cerqueira César, São Paulo, SP, Brazil.,Programa de Pós-Graduação em Gerontologia, Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Antônio Lúcio Teixeira
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Santa Casa BH Ensino e Pesquisa, Santa Efigênia, Belo Horizonte, MG, Brazil
| | - Leonardo Cruz de Souza
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Instituto de Ciências Biológicas, Pampulha, Belo Horizonte, Minas Gerais (MG), Brazil.,Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, UFMG, Belo Horizonte, MG, Brazil.,Departamento de Clínica Médica, Faculdade de Medicina, UFMG, Belo Horizonte, MG, Brazil
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19
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Attentional control both helps and harms empathy. Cognition 2021; 206:104505. [DOI: 10.1016/j.cognition.2020.104505] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/15/2020] [Accepted: 10/26/2020] [Indexed: 01/10/2023]
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20
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Ramanan S, Roquet D, Goldberg ZL, Hodges JR, Piguet O, Irish M, Lambon Ralph MA. Establishing two principal dimensions of cognitive variation in logopenic progressive aphasia. Brain Commun 2020; 2:fcaa125. [PMID: 33376980 PMCID: PMC7750924 DOI: 10.1093/braincomms/fcaa125] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/25/2020] [Accepted: 07/13/2020] [Indexed: 12/28/2022] Open
Abstract
Logopenic progressive aphasia is a neurodegenerative syndrome characterized by sentence repetition and naming difficulties arising from left-lateralized temporoparietal atrophy. Clinical descriptions of logopenic progressive aphasia largely concentrate on profiling language deficits, however, accumulating evidence points to the presence of cognitive deficits even on tasks with minimal language demands. Although non-linguistic cognitive deficits in logopenic progressive aphasia are thought to scale with disease severity, patients at discrete stages of language dysfunction display overlapping cognitive profiles, suggesting individual-level variation in cognitive performance, independent of primary language dysfunction. To address this issue, we used principal component analysis to decompose the individual-level variation in cognitive performance in 43 well-characterized logopenic progressive aphasia patients who underwent multi-domain neuropsychological assessments and structural neuroimaging. The principal component analysis solution revealed the presence of two, statistically independent factors, providing stable and clinically intuitive explanations for the majority of variance in cognitive performance in the syndrome. Factor 1 reflected 'speech production and verbal memory' deficits which typify logopenic progressive aphasia. Systematic variations were also confirmed on a second, orthogonal factor mainly comprising visuospatial and executive processes. Adopting a case-comparison approach, we further demonstrate that pairs of patients with comparable Factor 1 scores, regardless of their severity, diverge considerably on visuo-executive test performance, underscoring the inter-individual variability in cognitive profiles in comparably 'logopenic' patients. Whole-brain voxel-based morphometry analyses revealed that speech production and verbal memory factor scores correlated with left middle frontal gyrus, while visuospatial and executive factor scores were associated with grey matter intensity of right-lateralized temporoparietal, middle frontal regions and their underlying white matter connectivity. Importantly, logopenic progressive aphasia patients with poorer visuospatial and executive factor scores demonstrated greater right-lateralized temporoparietal and frontal atrophy. Our findings demonstrate the inherent variation in cognitive performance at an individual- and group-level in logopenic progressive aphasia, suggesting the presence of a genuine co-occurring cognitive impairment that is statistically independent of language function and disease severity.
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Affiliation(s)
- Siddharth Ramanan
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia
- The University of Sydney, School of Psychology, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Daniel Roquet
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia
- The University of Sydney, School of Psychology, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Zoë-Lee Goldberg
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia
| | - John R Hodges
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
- The University of Sydney, School of Medical Sciences, Sydney, NSW, Australia
| | - Olivier Piguet
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia
- The University of Sydney, School of Psychology, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Muireann Irish
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia
- The University of Sydney, School of Psychology, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
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Wilson NA, Ahmed RM, Hodges JR, Piguet O, Irish M. Constructing the social world: Impaired capacity for social simulation in dementia. Cognition 2020; 202:104321. [DOI: 10.1016/j.cognition.2020.104321] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 11/28/2022]
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Orso B, Mattei C, Arnaldi D, Massa F, Serafini G, Plantone D, Doglione E, Grafman J, Nobili F, Pardini M. Clinical and MRI Predictors of Conversion From Mild Behavioural Impairment to Dementia. Am J Geriatr Psychiatry 2020; 28:755-763. [PMID: 31928846 DOI: 10.1016/j.jagp.2019.12.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/13/2019] [Accepted: 12/13/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVE As an analogy with mild cognitive impairment (MCI), the mild behavioral impairment (MBI) construct has been proposed as a diagnostic label for those presenting late-onset behavioral symptoms. To date, however, the clinical, cognitive, and structural imaging features associated with an increased risk of conversion from MBI to dementia are poorly understood. METHODS We retrospectively analyzed the cognitive performance and structural brain MRI of 113 subjects, with a clinical follow-up of at least 4 years available. Subjects were randomly assigned to a Group A (56 subjects; age: 65.4 ± 7.9 years, 15 females, MMSE score: 28.4 ± 2.3)) or to a Group B (57 subjects, age: 66.6 ± 6.4, 17 females, MMSE score: 28.0 ± 1.4). In the Group A, cognitive and structural variables were compared between converters (at 4 years) and nonconverters and then verified in the Group B group. RESULTS In the Group A, 14 patients converted to behavioral-variant of frontotemporal dementia (bv-FTD) and 4 to Alzheimer's Disease (AD). Converters presented at baseline lower executive function scores and total Theory of Mind (ToM scores), as well as more severe focal frontal atrophy. In the Group B, 13 subjects converted to bv-FTD and none to AD. The combination of the variables identified in the Group A significantly (p <0.001) discriminated between converters and nonconverters in the Group B with a sensitivity of 0.615 and a specificity of 1 (total accuracy 91.22%). CONCLUSION The combined presence of executive deficit, impaired ToM, and presence of isolated frontal atrophy was associated with risk of progression from MBI to a clinically evident neurodegenerative condition, mainly bv-FTD, over a 4-year period.
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Affiliation(s)
- B Orso
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa (Beatrice Orso, Dario Arnaldi, Federico Massa, Gianluca Serafini, Elisa Doglione, Flavio Nobili, Matteo Pardini), Italy
| | - C Mattei
- Bozen Civic Hospital (Chiara Mattei), Bozen, Italy
| | - D Arnaldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa (Beatrice Orso, Dario Arnaldi, Federico Massa, Gianluca Serafini, Elisa Doglione, Flavio Nobili, Matteo Pardini), Italy; Policlinico S. Martino IRCCS (Dario Arnaldi, Gianluca Serafini, Flavio Nobili, Matteo Pardini), Genova, Italy
| | - F Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa (Beatrice Orso, Dario Arnaldi, Federico Massa, Gianluca Serafini, Elisa Doglione, Flavio Nobili, Matteo Pardini), Italy
| | - G Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa (Beatrice Orso, Dario Arnaldi, Federico Massa, Gianluca Serafini, Elisa Doglione, Flavio Nobili, Matteo Pardini), Italy; Policlinico S. Martino IRCCS (Dario Arnaldi, Gianluca Serafini, Flavio Nobili, Matteo Pardini), Genova, Italy
| | - D Plantone
- Neurology Unit, Di Venere Hospital (Domenico Plantone), Bari, Italy
| | - E Doglione
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa (Beatrice Orso, Dario Arnaldi, Federico Massa, Gianluca Serafini, Elisa Doglione, Flavio Nobili, Matteo Pardini), Italy
| | - J Grafman
- Cognitive Neuroscience Laboratory, Shirley Ryan Ability Lab (Jordan Grafman), Chicago, IL
| | - F Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa (Beatrice Orso, Dario Arnaldi, Federico Massa, Gianluca Serafini, Elisa Doglione, Flavio Nobili, Matteo Pardini), Italy; Policlinico S. Martino IRCCS (Dario Arnaldi, Gianluca Serafini, Flavio Nobili, Matteo Pardini), Genova, Italy
| | - M Pardini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa (Beatrice Orso, Dario Arnaldi, Federico Massa, Gianluca Serafini, Elisa Doglione, Flavio Nobili, Matteo Pardini), Italy; Policlinico S. Martino IRCCS (Dario Arnaldi, Gianluca Serafini, Flavio Nobili, Matteo Pardini), Genova, Italy.
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Vollmer Dahlke D, Ory MG. Emerging Issues of Intelligent Assistive Technology Use Among People With Dementia and Their Caregivers: A U.S. Perspective. Front Public Health 2020; 8:191. [PMID: 32528920 PMCID: PMC7254691 DOI: 10.3389/fpubh.2020.00191] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 04/27/2020] [Indexed: 11/13/2022] Open
Abstract
The increasing number of older adults with cognitive deficits, including dementia, poses a major challenge for public health in the United States. At the same time, the limited number of informal and professional caregivers available to support this rapidly growing population is of mounting concern. Not only does population aging limit the number of potential caregivers, but extant caregivers often lack skills to provide quality care. The integration of intelligent assistive technologies (IAT), including devices, robotics and sensors in many forms, into eldercare, may offer opportunities to reduce caregiver burden and enhance healthcare services while improving the quality of life among older adults with mild to severe cognitive deficits. However, many caregivers and their care recipients lack access to these technologies. The reasons for this reduced access are multifactorial, including the digital divide, sociocultural factors, and technological literacy. This mini review investigates the emerging use of IAT available to caregivers and older adults with cognitive deficits and explores the challenges in socioeconomic status and technological literacy as well as ethical and legal implications that should be considered in the design and development of IAT for older adults with cognitive deficits. Drawing from existing literature, it will suggest frameworks for design and adoption aimed at increased and equitable access for this vulnerable population.
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Affiliation(s)
- Deborah Vollmer Dahlke
- DVD Associates LLC, Austin, TX, United States.,TX A&M Center for Population Health and Aging, College Station, TX, United States
| | - Marcia G Ory
- TX A&M Center for Population Health and Aging, College Station, TX, United States
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Yildirim E, Soncu Buyukiscan E, Demirtas‐Tatlidede A, Bilgiç B, Gurvit H. An investigation of affective theory of mind ability and its relation to neuropsychological functions in Alzheimer's disease. J Neuropsychol 2020; 14:399-415. [DOI: 10.1111/jnp.12207] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 02/21/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Elif Yildirim
- Department of Psychology Faculty of Arts and Sciences Isik University Istanbul Turkey
| | - Ezgi Soncu Buyukiscan
- Department of Psychology Faculty of Arts and Sciences Yeditepe University Istanbul Turkey
| | - Aslı Demirtas‐Tatlidede
- Behavioral Neurology and Movement Disorders Unit Department of Neurology Istanbul Faculty of Medicine Istanbul University Turkey
- Department of Neurology Faculty of Medicine Bahcesehir University Istanbul Turkey
| | - Başar Bilgiç
- Behavioral Neurology and Movement Disorders Unit Department of Neurology Istanbul Faculty of Medicine Istanbul University Turkey
| | - Hakan Gurvit
- Behavioral Neurology and Movement Disorders Unit Department of Neurology Istanbul Faculty of Medicine Istanbul University Turkey
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Chainay H, Gaubert F. Affective and cognitive theory of mind in Alzheimer’s disease: The role of executive functions. J Clin Exp Neuropsychol 2020; 42:371-386. [DOI: 10.1080/13803395.2020.1726293] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Hanna Chainay
- Laboratoire d’Etude des Mécanismes Cognitifs, Université Lyon 2, Bron, France
| | - Fanny Gaubert
- Laboratoire d’Etude des Mécanismes Cognitifs, Université Lyon 2, Bron, France
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Lucena ATD, Bhalla RK, Belfort Almeida Dos Santos TT, Dourado MCN. The relationship between theory of mind and cognition in Alzheimer’s disease: A systematic review. J Clin Exp Neuropsychol 2020; 42:223-239. [DOI: 10.1080/13803395.2019.1710112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Aline Tavares De Lucena
- Center for Alzheimer’s disease, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rishi K. Bhalla
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
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Martins AP, Prado LDGR, Lillo P, Mioshi E, Teixeira AL, de Souza LC. Deficits in Emotion Recognition as Markers of Frontal Behavioral Dysfunction in Amyotrophic Lateral Sclerosis. J Neuropsychiatry Clin Neurosci 2019; 31:165-169. [PMID: 30537912 DOI: 10.1176/appi.neuropsych.18040086] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease with prominent motor symptoms. Patients with ALS may also manifest frontal behavior symptoms and cognitive decline, including impairment in facial emotion recognition. The authors aimed to investigate whether deficits in emotion recognition were associated with frontal behavior symptoms in ALS. METHODS Participants were patients with probable or definite sporadic ALS (N=21; male:female ratio, 11:10; median age, 62 years; median disease duration, 3 years) and age-matched and education-matched healthy control subjects (N=25; male:female ratio, 14:11; median age, 61 years). The Facial Emotion Recognition Test (FERT) was administered to all participants. Patients with ALS were assessed using the Cambridge Behavior Inventory-Revised and were classified into two groups according to the presence of frontal behavioral symptoms: ALS with no behavioral symptom (ALSns; N=9) and ALS with at least one behavioral symptom (ALSbs; N=12). RESULTS Apathy and mood symptoms were the most frequent neuropsychiatric symptoms in the patient group. Patients with ALS performed worse than control subjects in the recognition of sadness (p<0.004). There were no differences between control subjects and patients in the ALSns group in all FERT scores, but the ALSbs group had lower performance than control subjects in sadness (p<0.003). CONCLUSIONS Emotion recognition deficit may be a marker of frontal behavior in ALS.
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Affiliation(s)
- Aldrin Pedroza Martins
- From the Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Martins, Prado, Teixeira, de Souza); Programa de Pós-Graduação em Neurociências, da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Prado, Teixeira, de Souza); the Departamento de Neurología Sur/Departamento de Neurociencia, Facultad de Medicina, Universidad de Chile, Santiago, Chile (Lillo); the Geroscience Center for Brain Health and Metabolism, Santiago, Chile (Lillo); the School of Health Sciences, University of East Anglia, Norwich, United Kingdom (Mioshi); and the Department of Internal Medicine, Faculdade de Medicina, da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Teixeira, de Souza)
| | - Laura de Godoy Rousseff Prado
- From the Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Martins, Prado, Teixeira, de Souza); Programa de Pós-Graduação em Neurociências, da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Prado, Teixeira, de Souza); the Departamento de Neurología Sur/Departamento de Neurociencia, Facultad de Medicina, Universidad de Chile, Santiago, Chile (Lillo); the Geroscience Center for Brain Health and Metabolism, Santiago, Chile (Lillo); the School of Health Sciences, University of East Anglia, Norwich, United Kingdom (Mioshi); and the Department of Internal Medicine, Faculdade de Medicina, da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Teixeira, de Souza)
| | - Patricia Lillo
- From the Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Martins, Prado, Teixeira, de Souza); Programa de Pós-Graduação em Neurociências, da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Prado, Teixeira, de Souza); the Departamento de Neurología Sur/Departamento de Neurociencia, Facultad de Medicina, Universidad de Chile, Santiago, Chile (Lillo); the Geroscience Center for Brain Health and Metabolism, Santiago, Chile (Lillo); the School of Health Sciences, University of East Anglia, Norwich, United Kingdom (Mioshi); and the Department of Internal Medicine, Faculdade de Medicina, da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Teixeira, de Souza)
| | - Eneida Mioshi
- From the Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Martins, Prado, Teixeira, de Souza); Programa de Pós-Graduação em Neurociências, da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Prado, Teixeira, de Souza); the Departamento de Neurología Sur/Departamento de Neurociencia, Facultad de Medicina, Universidad de Chile, Santiago, Chile (Lillo); the Geroscience Center for Brain Health and Metabolism, Santiago, Chile (Lillo); the School of Health Sciences, University of East Anglia, Norwich, United Kingdom (Mioshi); and the Department of Internal Medicine, Faculdade de Medicina, da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Teixeira, de Souza)
| | - Antônio Lúcio Teixeira
- From the Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Martins, Prado, Teixeira, de Souza); Programa de Pós-Graduação em Neurociências, da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Prado, Teixeira, de Souza); the Departamento de Neurología Sur/Departamento de Neurociencia, Facultad de Medicina, Universidad de Chile, Santiago, Chile (Lillo); the Geroscience Center for Brain Health and Metabolism, Santiago, Chile (Lillo); the School of Health Sciences, University of East Anglia, Norwich, United Kingdom (Mioshi); and the Department of Internal Medicine, Faculdade de Medicina, da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Teixeira, de Souza)
| | - Leonardo Cruz de Souza
- From the Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Martins, Prado, Teixeira, de Souza); Programa de Pós-Graduação em Neurociências, da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Prado, Teixeira, de Souza); the Departamento de Neurología Sur/Departamento de Neurociencia, Facultad de Medicina, Universidad de Chile, Santiago, Chile (Lillo); the Geroscience Center for Brain Health and Metabolism, Santiago, Chile (Lillo); the School of Health Sciences, University of East Anglia, Norwich, United Kingdom (Mioshi); and the Department of Internal Medicine, Faculdade de Medicina, da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Teixeira, de Souza)
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Fischer A, Landeira-Fernandez J, Sollero de Campos F, Mograbi DC. Empathy in Alzheimer’s Disease: Review of Findings and Proposed Model. J Alzheimers Dis 2019; 69:921-933. [DOI: 10.3233/jad-180730] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Anna Fischer
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brasil
| | - Jesus Landeira-Fernandez
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brasil
| | - Flavia Sollero de Campos
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brasil
| | - Daniel C. Mograbi
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brasil
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Johnen A, Bertoux M. Psychological and Cognitive Markers of Behavioral Variant Frontotemporal Dementia-A Clinical Neuropsychologist's View on Diagnostic Criteria and Beyond. Front Neurol 2019; 10:594. [PMID: 31231305 PMCID: PMC6568027 DOI: 10.3389/fneur.2019.00594] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 05/20/2019] [Indexed: 12/11/2022] Open
Abstract
Behavioral variant frontotemporal dementia (bvFTD) is the second leading cognitive disorder caused by neurodegeneration in patients under 65 years of age. Characterized by frontal, insular, and/or temporal brain atrophy, patients present with heterogeneous constellations of behavioral and psychological symptoms among which progressive changes in social conduct, lack of empathy, apathy, disinhibited behaviors, and cognitive impairments are frequently observed. Since the histopathology of the disease is heterogeneous and identified genetic mutations only account for ~30% of cases, there are no reliable biomarkers for the diagnosis of bvFTD available in clinical routine as yet. Early detection of bvFTD thus relies on correct application of clinical diagnostic criteria. Their evaluation however, requires expertise and in-depth assessments of cognitive functions, history taking, clinical observations as well as caregiver reports on behavioral and psychological symptoms and their respective changes. With this review, we aim for a critical appraisal of common methods to access the behavioral and psychological symptoms as well as the cognitive alterations presented in the diagnostic criteria for bvFTD. We highlight both, practical difficulties as well as current controversies regarding an overlap of symptoms and particularly cognitive impairments with other neurodegenerative and primary psychiatric diseases. We then review more recent developments and evidence on cognitive, behavioral and psychological symptoms of bvFTD beyond the diagnostic criteria which may prospectively enhance the early detection and differential diagnosis in clinical routine. In particular, evidence on specific impairments in social and emotional processing, praxis abilities as well as interoceptive processing in bvFTD is summarized and potential links with behavior and classic cognitive domains are discussed. We finally outline both, future opportunities and major challenges with regard to the role of clinical neuropsychology in detecting bvFTD and related neurocognitive disorders.
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Affiliation(s)
- Andreas Johnen
- Section for Neuropsychology, Department of Neurology, University Hospital Münster, Münster, Germany
| | - Maxime Bertoux
- Univ Lille, Inserm UMR 1171 Degenerative and Vascular Cognitive Disorders, CHU Lille, Lille, France
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Giovagnoli AR, Bell B, Erbetta A, Paterlini C, Bugiani O. Analyzing theory of mind impairment in patients with behavioral variant frontotemporal dementia. Neurol Sci 2019; 40:1893-1900. [DOI: 10.1007/s10072-019-03911-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 04/22/2019] [Indexed: 10/26/2022]
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Van den Stock J, De Winter FL, Stam D, Van de Vliet L, Huang YA, Dries E, Van Assche L, Emsell L, Bouckaert F, Vandenbulcke M. Reduced tendency to attribute mental states to abstract shapes in behavioral variant frontotemporal dementia links with cerebellar structural integrity. NEUROIMAGE-CLINICAL 2019; 22:101770. [PMID: 30884367 PMCID: PMC6424142 DOI: 10.1016/j.nicl.2019.101770] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/28/2019] [Accepted: 03/10/2019] [Indexed: 11/25/2022]
Abstract
Theory of mind (ToM) refers to the ability to attribute mental states to others. Behavioral variant frontotemporal dementia (bvFTD) is a neurodegenerative disorder characterized by profound deficits in social cognition, including ToM. We investigate whether bvFTD affects intention attribution tendency while viewing abstract animations and whether this might represent a primary deficit. A sample of 15 bvFTD patients and 19 matched controls were assessed on cognition and performed an implicit ToM task. They were instructed to describe what they observed in movement patterns displayed by geometrical shapes (triangles). These movement patterns either represented animacy, goal-directed actions or manipulation of mental state (ToM). The responses were scored for both accuracy and intentionality attribution. Using Voxel-Based Morphometry, we investigated the structural neuroanatomy associated with intention attribution tendency. The behavioral results revealed deficits in the bvFTD group on intentionality attribution that were specific for the ToM condition after controlling for global cognitive functioning (MMSE-score), visual attention (TMT B-score), fluid intelligence (RCPMT-score) and confrontation naming (BNT-score). In the bvFTD sample, the intention attribution tendency on the ToM-condition was associated with grey matter volume of a cluster in the cerebellum, spanning the right Crus I, Crus II, VIIIb, IX, left VIIb, IX and vermal IX and X. The results reveal a specific, primary, implicit domain-general ToM deficit in bvFTD that cannot be explained by cognitive dysfunction. Furthermore, the findings point to a contribution of the cerebellum in the social-cognitive phenotype of bvFTD. We show a reduction in intention attribution tendency to abstract shapes in bvFTD. Cognitive or subordinate processes did not explain the reduction. The reduction was associated with structural integrity of a cerebellar cluster.
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Affiliation(s)
- Jan Van den Stock
- Laboratory for Translational Neuropsychiatry, Department of Neurosciences, KU Leuven, Belgium; Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium; Brain and Emotion Laboratory, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.
| | - François-Laurent De Winter
- Laboratory for Translational Neuropsychiatry, Department of Neurosciences, KU Leuven, Belgium; Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Daphne Stam
- Laboratory for Translational Neuropsychiatry, Department of Neurosciences, KU Leuven, Belgium
| | - Laura Van de Vliet
- Laboratory for Translational Neuropsychiatry, Department of Neurosciences, KU Leuven, Belgium
| | - Yun-An Huang
- Laboratory for Translational Neuropsychiatry, Department of Neurosciences, KU Leuven, Belgium
| | - Eva Dries
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Lies Van Assche
- Laboratory for Translational Neuropsychiatry, Department of Neurosciences, KU Leuven, Belgium; Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Louise Emsell
- Laboratory for Translational Neuropsychiatry, Department of Neurosciences, KU Leuven, Belgium; Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium; Translational MRI, Department of Imaging and Pathology, KU Leuven, Belgium
| | - Filip Bouckaert
- Laboratory for Translational Neuropsychiatry, Department of Neurosciences, KU Leuven, Belgium; Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Mathieu Vandenbulcke
- Laboratory for Translational Neuropsychiatry, Department of Neurosciences, KU Leuven, Belgium; Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium
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Strikwerda-Brown C, Ramanan S, Irish M. Neurocognitive mechanisms of theory of mind impairment in neurodegeneration: a transdiagnostic approach. Neuropsychiatr Dis Treat 2019; 15:557-573. [PMID: 30863078 PMCID: PMC6388953 DOI: 10.2147/ndt.s158996] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Much of human interaction is predicated upon our innate capacity to infer the thoughts, beliefs, emotions, and perspectives of others, in short, to possess a "theory of mind" (ToM). While the term has evolved considerably since its inception, ToM encompasses our unique ability to apprehend the mental states of others, enabling us to anticipate and predict subsequent behavior. From a developmental perspective, ToM has been a topic of keen research interest, with numerous studies seeking to explicate the origins of this fundamental capacity and its disruption in developmental disorders such as autism. The study of ToM at the opposite end of the lifespan, however, is paradoxically new born, emerging as a topic of interest in its own right comparatively recently. Here, we consider the unique insights afforded by studying ToM capacity in neurodegenerative disorders. Arguing from a novel, transdiagnostic perspective, we consider how ToM vulnerability reflects the progressive degradation of neural circuits specialized for an array of higher-order cognitive processes. This mechanistic approach enables us to consider the common and unique neurocognitive mechanisms that underpin ToM dysfunction across neurodegenerative disorders and for the first time examine its relation to behavioral disturbances across social, intimate, legal, and criminal settings. As such, we aim to provide a comprehensive overview of ToM research in neurodegeneration, the resultant challenges for family members, clinicians, and the legal profession, and future directions worthy of exploration.
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Affiliation(s)
- Cherie Strikwerda-Brown
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia,
- The University of Sydney, School of Psychology, Sydney, NSW, Australia,
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia,
| | - Siddharth Ramanan
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia,
- The University of Sydney, School of Psychology, Sydney, NSW, Australia,
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia,
| | - Muireann Irish
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia,
- The University of Sydney, School of Psychology, Sydney, NSW, Australia,
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia,
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Synn A, Mothakunnel A, Kumfor F, Chen Y, Piguet O, Hodges JR, Irish M. Mental States in Moving Shapes: Distinct Cortical and Subcortical Contributions to Theory of Mind Impairments in Dementia. J Alzheimers Dis 2019; 61:521-535. [PMID: 29172002 DOI: 10.3233/jad-170809] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Impaired capacity for Theory of Mind (ToM) represents one of the hallmark features of the behavioral variant of frontotemporal dementia (bvFTD) and is suggested to underpin an array of socioemotional disturbances characteristic of this disorder. In contrast, while social processing typically remains intact in Alzheimer's disease (AD), the cognitive loading of socioemotional tasks may adversely impact mentalizing performance in AD. Here, we employed the Frith-Happé animations as a dynamic on-line assessment of mentalizing capacity with reduced incidental task demands in 18 bvFTD, 18 AD, and 25 age-matched Controls. Participants viewed silent animations in which geometric shapes interact in Random, Goal-Directed, and ToM conditions. An exclusive deficit in ToM classification was observed in bvFTD relative to Controls, while AD patients were impaired in the accurate classification of both Random and ToM trials. Correlation analyses revealed robust associations between ToM deficits and carer ratings of affective empathy disruption in bvFTD, and with episodic memory dysfunction in AD. Voxel-based morphometry analyses further identified dissociable neural correlates contingent on patient group. A distributed network of medial prefrontal, frontoinsular, striatal, lateral temporal, and parietal regions were implicated in the bvFTD group, whereas the right hippocampus correlated with task performance in AD. Notably, subregions of the cerebellum, including lobules I-IV and V, bilaterally were implicated in task performance irrespective of patient group. Our findings reveal new insights into the mechanisms potentially mediating ToM disruption in dementia syndromes, and suggest that the cerebellum may play a more prominent role in social cognition than previously appreciated.
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Affiliation(s)
- Artemis Synn
- School of Psychology, Macquarie University, Sydney, Australia
| | - Annu Mothakunnel
- Brain and Mind Centre, The University of Sydney, Australia.,School of Psychology, The University of Sydney, Australia
| | - Fiona Kumfor
- Brain and Mind Centre, The University of Sydney, Australia.,School of Psychology, The University of Sydney, Australia.,Australian Research Council Centre of Excellence in Cognition and its Disorders, Australia
| | - Yu Chen
- Brain and Mind Centre, The University of Sydney, Australia.,School of Psychology, The University of Sydney, Australia.,Australian Research Council Centre of Excellence in Cognition and its Disorders, Australia
| | - Olivier Piguet
- Brain and Mind Centre, The University of Sydney, Australia.,School of Psychology, The University of Sydney, Australia.,Australian Research Council Centre of Excellence in Cognition and its Disorders, Australia
| | - John R Hodges
- Brain and Mind Centre, The University of Sydney, Australia.,Australian Research Council Centre of Excellence in Cognition and its Disorders, Australia.,Sydney Medical School, The University of Sydney, Australia
| | - Muireann Irish
- Brain and Mind Centre, The University of Sydney, Australia.,School of Psychology, The University of Sydney, Australia.,Australian Research Council Centre of Excellence in Cognition and its Disorders, Australia
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Neuropsychological correlates of cognitive, emotional-affective and auto-activation apathy in Alzheimer's disease. Neuropsychologia 2018; 118:12-21. [DOI: 10.1016/j.neuropsychologia.2018.01.039] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 10/23/2017] [Accepted: 01/27/2018] [Indexed: 12/13/2022]
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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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Fortier J, Besnard J, Allain P. Theory of mind, empathy and emotion perception in cortical and subcortical neurodegenerative diseases. Rev Neurol (Paris) 2018; 174:237-246. [DOI: 10.1016/j.neurol.2017.07.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 06/15/2017] [Accepted: 07/04/2017] [Indexed: 12/13/2022]
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Takenoshita S, Terada S, Yokota O, Kutoku Y, Wakutani Y, Nakashima M, Maki Y, Hattori H, Yamada N. Sally-Anne Test in Patients with Alzheimer’s Disease Dementia. J Alzheimers Dis 2018; 61:1029-1036. [DOI: 10.3233/jad-170621] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Shintaro Takenoshita
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kita-ku, Okayama, Japan
| | - Seishi Terada
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kita-ku, Okayama, Japan
| | - Osamu Yokota
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kita-ku, Okayama, Japan
| | - Yumiko Kutoku
- Department of Neurology, Kawasaki Medical School, Kurashiki, Japan
| | - Yosuke Wakutani
- Department of Neurology, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Makoto Nakashima
- Department of Psychiatry, Okayama Red Cross Hospital, Okayama, Japan
| | - Yohko Maki
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hideyuki Hattori
- Department of Psychiatry, National Hospital for Geriatric Medicine, NCGG, Obu, Japan
| | - Norihito Yamada
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kita-ku, Okayama, Japan
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A data mining approach for modeling churn behavior via RFM model in specialized clinics Case study: A public sector hospital in Tehran. PROCEDIA COMPUTER SCIENCE 2017; 120:23-30. [PMID: 32288897 PMCID: PMC7128275 DOI: 10.1016/j.procs.2017.11.206] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Nowadays Health care industry has a significant growth in using data mining techniques to discover hidden information for effective decision making. Huge amount of healthcare data is suitable to mine hidden patterns and knowledge. In this paper we traced behavior of patients during the period of 3 years in three clinics of a big public sector hospital and tried to detect special groups and their tendencies by RFML model as a customer life time value (CLV). The main goal was to detect ‘potential for loyal’ customers for strengthen relationships and ‘potential to churn’ customers for recovery of the efficiency of customer retention campaigns and reduce the costs associated with churn. This strategy helps hospital administrators to increase profit and reduce costs of customers’ loss. At first, K-means clustering algorithm was applied for identification of target customers and groups and then, decision tree classifier as churn prediction was used. We compared performance of three clinics based on the number of loyal and churn customers. Our results showed that Pediatric Hematology clinic had a better performance than that of other clinics, because of more number of loyal customers.
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Chimagomedova AS, Lyashenko EA, Babkina OV, Iakovleva OV, Vasenina EE, Levin OS. Social cognitive function in neurodegenerative diseases. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:168-173. [DOI: 10.17116/jnevro2017117111168-173] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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