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Lindberg O, Li TQ, Lind C, Vestberg S, Almkvist O, Stiernstedt M, Ericson A, Bogdanovic N, Hansson O, Harper L, Westman E, Graff C, Tsevis T, Mannfolk P, Fischer H, Nilsonne G, Petrovic P, Nyberg L, Wahlund LO, Santillo AF. Altered empathy processing in frontotemporal dementia A task-based fMRI study. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.21.586051. [PMID: 38585830 PMCID: PMC10996471 DOI: 10.1101/2024.03.21.586051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
A lack of empathy, and particularly its affective components, is a core symptom of behavioural variant frontotemporal dementia (bvFTD). Visual exposure to images of a needle pricking a hand (pain condition) and Q-tips touching a hand (control condition) is an established functional magnetic resonance imaging (fMRI) paradigm used to investigate empathy for pain (EFP; pain condition minus control condition). EFP has been associated with increased blood oxygen level dependent (BOLD) signal in regions known to become atrophic in the early stages in bvFTD, including the anterior insula and the anterior cingulate. We therefore hypothesized that patients with bvFTD would display altered empathy processing in the EFP paradigm. Here we examined empathy processing using the EFP paradigm in 28 patients with bvFTD and 28 sex and age matched controls. Participants underwent structural MRI, task-based and resting-state fMRI. The Interpersonal Reactivity Index (IRI) was used as a measure of different facets of empathic function outside the scanner. The EFP paradigm was analysed at a whole brain level and using two regions-of-interest approaches, one based on a metanalysis of affective perceptual empathy versus cognitive evaluative empathy and one based on the controĺs activation pattern. In controls, EFP was linked to an expected increase of BOLD signal that displayed an overlap with the pattern of atrophy in the bvFTD patients (insula and anterior cingulate). Additional regions with increased signal were the supramarginal gyrus and the occipital cortex. These latter regions were the only ones that displayed increased BOLD signal in bvFTD patients. BOLD signal increase under the affective perceptual empathy but not the cognitive evaluative empathy region of interest was significantly greater in controls than in bvFTD patients. The controĺs rating on their empathic concern subscale of the IRI was significantly correlated with the BOLD signal in the EFP paradigm, as were an informantś ratings of the patientś empathic concern subscale. This correlation was not observed on other subscales of the IRI or when using the patient's self-ratings. Finally, controls and patients showed different connectivity patterns in empathy related networks during resting-state fMRI, mainly in nodes overlapping the ventral attention network. Our results indicate that reduced neural activity in regions typically affected by pathology in bvFTD is associated with reduced empathy processing, and a predictor of patientś capacity to experience affective empathy.
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Affiliation(s)
- Olof Lindberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Division of Clinical Geriatrics, Centre for Alzheimer Research, Neo, 14183 Huddinge, Sweden
| | - Tie-Qiang Li
- Department of Clinical Science, Intervention, and Technology, Karolinska Institute, Sweden
- Department of Medical Radiation and Nuclear Medicine, Karolinska University Hospital, Sweden
| | - Cecilia Lind
- Department of community medicine and rehabilitation, geriatrics Umeå university, Umeå university, Sweden
| | | | - Ove Almkvist
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Division of Clinical Geriatrics, Centre for Alzheimer Research, Neo, 14183 Huddinge, Sweden
- Department of Psychology, Stockholm, Sweden
| | - Mikael Stiernstedt
- Umeå center for Functional Brain Imaging (UFBI), Umeå University, Sweden
| | - Anita Ericson
- Department of community medicine and rehabilitation, geriatrics Umeå university, Umeå university, Sweden
| | - Nenad Bogdanovic
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Division of Clinical Geriatrics, Centre for Alzheimer Research, Neo, 14183 Huddinge, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Lund, Sweden
| | - Luke Harper
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Eric Westman
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Division of Clinical Geriatrics, Centre for Alzheimer Research, Neo, 14183 Huddinge, Sweden
| | - Caroline Graff
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Division of Clinical Geriatrics, Centre for Alzheimer Research, Neo, 14183 Huddinge, Sweden
- Karolinska university hospital, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Center for Alzheimer Research, Karolinska Institutet, Solna, Sweden
| | - Theofanis Tsevis
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Division of Clinical Geriatrics, Centre for Alzheimer Research, Neo, 14183 Huddinge, Sweden
- Karolinska university hospital, Stockholm, Sweden
| | - Peter Mannfolk
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - Håkan Fischer
- Department of Psychology, Stockholm, Sweden
- Stockholm University Brain Imaging Centre (SUBIC), Stockholm, Sweden
- Aging Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Gustav Nilsonne
- Department of Psychology, Stockholm, Sweden
- Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institute, Sweden
| | - Predrag Petrovic
- Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institute, Sweden
- Center for Cognitive and Computational Psychiatry, Department of Clinical Neuroscience, Karolinska Institute, Sweden
| | - Lars Nyberg
- Umeå center for Functional Brain Imaging (UFBI), Umeå University, Sweden
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
- Department of Medical and Translational Biology, Umeå University, Umeå, Sweden
| | - Lars-Olof Wahlund
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Division of Clinical Geriatrics, Centre for Alzheimer Research, Neo, 14183 Huddinge, Sweden
| | - Alexander F Santillo
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
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Samtani S, Meka A, Siette J. Beyond memory: exploring the value of social cognition for older adults with neurocognitive disorders. Front Psychiatry 2023; 14:1209745. [PMID: 37840782 PMCID: PMC10575711 DOI: 10.3389/fpsyt.2023.1209745] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/05/2023] [Indexed: 10/17/2023] Open
Abstract
Neurocognitive disorders involves progressive decline in cognition, function, behavior and needs. Recent developments have identified the need to characterize social cognition in individuals with neurocognitive impairments to support uncertainty in clinical decision making, treatment plans and monitoring individual change. Routine social cognition assessments have thus been more recently used and adopted in persons with dementia or mild cognitive impairment. This work serves to summarize current assessments and provide a discourse on the practicality of available social cognition tools, its implication in clinical practice and key future directions. We highlight advantages in establishing validated, multicomponent measures of social cognition for people with neurocognitive disorders.
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Affiliation(s)
- Suraj Samtani
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Anjani Meka
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, Australia
| | - Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, Australia
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3
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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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Cerami C, Perini G, Panzavolta A, Cotta Ramusino M, Costa A. A Call for Drug Therapies for the Treatment of Social Behavior Disorders in Dementia: Systematic Review of Evidence and State of the Art. Int J Mol Sci 2022; 23:ijms231911550. [PMID: 36232852 PMCID: PMC9569533 DOI: 10.3390/ijms231911550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 11/14/2022] Open
Abstract
Growing evidence supports the presence of social cognition deficits and social behavior alterations in major and minor neurocognitive disorders (NCDs). Even though the ability to identify socio-emotional changes has significantly improved in recent years, there is still no specific treatment available. Thus, we explored evidence of drug therapies targeting social cognition alterations in NCDs. Papers were selected according to PRISMA guidelines by searching on the PubMed and Scopus databases. Only papers reporting information on pharmacological interventions for the treatment of social cognition and/or social behavioral changes in major and/or minor NCDs were included. Among the 171 articles entered in the paper selection, only 9 papers were eligible for the scope of the review. Trials testing pharmacological treatments for socio-emotional alterations in NCDs are poor and of low-medium quality. A few attempts with neuroprotective, psychoactive, or immunomodulating drugs have been made. Oxytocin is the only drug specifically targeting the social brain that has been tested with promising results in frontotemporal dementia. Its beneficial effects in long-term use have yet to be evaluated. No recommendation can currently be provided. There is a long way to go to identify and test effective targets to treat social cognition changes in NCDs for the ultimate benefit of patients and caregivers.
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Affiliation(s)
- Chiara Cerami
- IUSS Cognitive Neuroscience (ICoN) Center, University School for Advanced Studies IUSS, 27100 Pavia, Italy
- Cognitive Computational Neuroscience Research Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
- Correspondence:
| | - Giulia Perini
- Unit of Behavioral Neurology and Center for Cognitive Disorders and Dementias (CDCD), IRCCS Mondino Foundation, 27100 Pavia, Italy
- Dementia Research Center (DRC), IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Andrea Panzavolta
- IUSS Cognitive Neuroscience (ICoN) Center, University School for Advanced Studies IUSS, 27100 Pavia, Italy
| | - Matteo Cotta Ramusino
- Unit of Behavioral Neurology and Center for Cognitive Disorders and Dementias (CDCD), IRCCS Mondino Foundation, 27100 Pavia, Italy
- Dementia Research Center (DRC), IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Alfredo Costa
- Unit of Behavioral Neurology and Center for Cognitive Disorders and Dementias (CDCD), IRCCS Mondino Foundation, 27100 Pavia, Italy
- Dementia Research Center (DRC), IRCCS Mondino Foundation, 27100 Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
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Holtmann O, Schloßmacher I, Franz M, Moenig C, Tenberge JG, Preul C, Schwindt W, Bruchmann M, Melzer N, Miltner WHR, Straube T. Effects of emotional valence and intensity on cognitive and affective empathy after insula lesions. Cereb Cortex 2022; 33:4562-4573. [PMID: 36124830 DOI: 10.1093/cercor/bhac362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/11/2022] [Accepted: 08/22/2022] [Indexed: 01/10/2023] Open
Abstract
The insula plays a central role in empathy. However, the complex structure of cognitive (CE) and affective empathy (AE) deficits following insular damage is not fully understood. In the present study, patients with insular lesions (n = 20) and demographically matched healthy controls (n = 24) viewed ecologically valid videos that varied in terms of valence and emotional intensity. The videos showed a person (target) narrating a personal life event. In CE conditions, subjects continuously rated the affective state of the target, while in AE conditions, they continuously rated their own affect. Mean squared error (MSE) assessed deviations between subject and target ratings. Patients differed from controls only in negative, low-intensity AE, rating their own affective state less negative than the target. This deficit was not related to trait empathy, neuropsychological or clinical parameters, or laterality of lesion. Empathic functions may be widely spared after insular damage in a naturalistic, dynamic setting, potentially due to the intact interpretation of social context by residual networks outside the lesion. The particular role of the insula in AE for negative states may evolve specifically in situations that bear higher uncertainty pointing to a threshold role of the insula in online ratings of AE.
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Affiliation(s)
- Olga Holtmann
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Straße 52, Muenster 48149, Germany.,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Fliednerstraße 21, Muenster 48149, Germany
| | - Insa Schloßmacher
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Straße 52, Muenster 48149, Germany.,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Fliednerstraße 21, Muenster 48149, Germany
| | - Marcel Franz
- Department of Clinical Psychology, Friedrich Schiller University Jena, Am Steiger 3, Jena 07743, Germany
| | - Constanze Moenig
- Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Muenster 48149, Germany
| | - Jan-Gerd Tenberge
- Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Muenster 48149, Germany
| | - Christoph Preul
- Department of Neurology, University Hospital Jena, Am Klinikum 1, Jena 07747, Germany
| | - Wolfram Schwindt
- Institute of Clinical Radiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Muenster 48149, Germany
| | - Maximilian Bruchmann
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Straße 52, Muenster 48149, Germany.,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Fliednerstraße 21, Muenster 48149, Germany
| | - Nico Melzer
- Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Muenster 48149, Germany.,Department of Neurology, Heinrich-Heine University of Düsseldorf, Moorenstraße 5, Düsseldorf 40225, Germany
| | - Wolfgang H R Miltner
- Department of Clinical Psychology, Friedrich Schiller University Jena, Am Steiger 3, Jena 07743, Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Straße 52, Muenster 48149, Germany.,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Fliednerstraße 21, Muenster 48149, Germany
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6
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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: 6] [Impact Index Per Article: 3.0] [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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7
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Resting state functional brain networks associated with emotion processing in frontotemporal lobar degeneration. Mol Psychiatry 2022; 27:4809-4821. [PMID: 35595978 PMCID: PMC9734056 DOI: 10.1038/s41380-022-01612-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/21/2022] [Accepted: 05/04/2022] [Indexed: 12/14/2022]
Abstract
This study investigated the relationship between emotion processing and resting-state functional connectivity (rs-FC) of the brain networks in frontotemporal lobar degeneration (FTLD). Eighty FTLD patients (including cases with behavioral variant of frontotemporal dementia, primary progressive aphasia, progressive supranuclear palsy syndrome, motor neuron disease) and 65 healthy controls underwent rs-functional MRI. Emotion processing was tested using the Comprehensive Affect Testing System (CATS). In patients and controls, correlations were investigated between each emotion construct and rs-FC changes within critical networks. Mean rs-FC of the clusters significantly associated with CATS scoring were compared among FTLD groups. FTLD patients had pathological CATS scores compared with controls. In controls, increased rs-FC of the cerebellar and visuo-associative networks correlated with better scores in emotion-matching and discrimination tasks, respectively; while decreased rs-FC of the visuo-spatial network was related with better performance in the affect-matching and naming. In FTLD, the associations between rs-FC and CATS scores involved more brain regions, such as orbitofrontal and middle frontal gyri within anterior networks (i.e., salience and default-mode), parietal and somatosensory regions within visuo-spatial and sensorimotor networks, caudate and thalamus within basal-ganglia network. Rs-FC changes associated with CATS were similar among all FTLD groups. In FTLD compared to controls, the pattern of rs-FC associated with emotional processing involves a larger number of brain regions, likely due to functional specificity loss and compensatory attempts. These associations were similar across all FTLD groups, suggesting a common physiopathological mechanism of emotion processing breakdown, regardless the clinical presentation and pattern of atrophy.
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Geraudie A, Battista P, García AM, Allen IE, Miller ZA, Gorno-Tempini ML, Montembeault M. Speech and language impairments in behavioral variant frontotemporal dementia: A systematic review. Neurosci Biobehav Rev 2021; 131:1076-1095. [PMID: 34673112 DOI: 10.1016/j.neubiorev.2021.10.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 01/11/2023]
Abstract
Although behavioral variant frontotemporal dementia (bvFTD) is classically defined by behavioral and socio-emotional changes, impairments often extend to other cognitive functions. These include early speech and language deficits related to the disease's core neural disruptions. Yet, their scope and clinical relevance remains poorly understood. This systematic review characterizes such disturbances in bvFTD, considering clinically, neuroanatomically, genetically, and neuropathologically defined subgroups. We included 181 experimental studies, with at least 5 bvFTD patients diagnosed using accepted criteria, comparing speech and language outcomes between bvFTD patients and healthy controls or between bvFTD subgroups. Results reveal extensive and heterogeneous deficits across cohorts, with (a) consistent lexico-semantic, reading & writing, and prosodic impairments; (b) inconsistent deficits in motor speech and grammar; and (c) relative preservation of phonological skills. Also, preliminary findings suggest that the severity of speech and language deficits might be associated with global cognitive impairment, predominantly temporal or fronto-temporal atrophy and MAPT mutations (vs C9orf72). Although under-recognized, these impairments contribute to patient characterization and phenotyping, while potentially informing diagnosis and management.
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Affiliation(s)
- Amandine Geraudie
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA; Neurology Department, Toulouse University Hospital, Toulouse, France
| | - Petronilla Battista
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA; Global Brain Health Institute, University of California, San Francisco, USA; Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Via Generale Nicola Bellomo, Bari, Italy
| | - Adolfo M García
- Global Brain Health Institute, University of California, San Francisco, USA; Universidad De San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | - Isabel E Allen
- Global Brain Health Institute, University of California, San Francisco, USA; Department of Epidemiology & Biostatistics, University of California San Francisco, CA, USA
| | - Zachary A Miller
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA; Global Brain Health Institute, University of California, San Francisco, USA
| | - Maxime Montembeault
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA.
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9
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Measuring social cognition in frontotemporal lobar degeneration: a clinical approach. J Neurol 2021; 269:2227-2244. [PMID: 34797433 DOI: 10.1007/s00415-021-10889-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/14/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022]
Abstract
Alterations in social cognition, a broad term indicating our ability to understand others and adapt our behavior accordingly, have been the focus of growing attention in the past years. Some neurological conditions, such as those belonging to the frontotemporal lobar degeneration (FTLD) spectrum, are associated to varying degrees with social cognition deficits, encompassing problems with theory of mind (ToM), empathy, perception of social stimuli, and social behavior. In this review, we outline a clinical framework for the evaluation of social cognition and discuss its role in the assessment of patients affected by a range of FTLD conditions.
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10
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Magno MA, Canu E, Filippi M, Agosta F. Social cognition in the FTLD spectrum: evidence from MRI. J Neurol 2021; 269:2245-2258. [PMID: 34797434 DOI: 10.1007/s00415-021-10892-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/14/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022]
Abstract
Over the past few years, there has been great interest in social cognition, a wide term referring to the human ability of understanding others' emotions, thoughts, and intentions, to empathize with them and to behave accordingly. While there is no agreement on the classification of social cognitive processes, they can broadly be categorized as consisting of theory of mind, empathy, social perception, and social behavior. The study of social cognition and its relative deficits is increasingly assuming clinical relevance. However, the clinical and neuroanatomical correlates of social cognitive alterations in neurodegenerative conditions, such as those belonging to the frontotemporal lobar (FTLD) spectrum, are not fully established. In this review, we describe the current understanding of social cognition impairments in different FTLD conditions with respect to MRI.
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Affiliation(s)
- Maria Antonietta Magno
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Elisa Canu
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy. .,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. .,Vita-Salute San Raffaele University, Milan, Italy.
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11
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Abstract
INTRODUCTION The syndromes of mild cognitive impairment (MCI) or mild neurocognitive disorder (MiND), often prodromal to dementia (Major Neurocognitive Disorder), are characterized by acquired clinically significant changes in one or more cognitive domains despite preserved independence. Mild impairment has significant medicolegal consequences for an affected person and their care system. We review the more common etiologies of MiND and provide a systematic review of its medicolegal implications. METHODS We conducted a systematic review of the peer-reviewed English literature on medicolegal aspects of MCI or MiND using comprehensive search terms and expanding our review to include sources cited by these reports. RESULTS Impairment of memory, executive function, social cognition, judgment, insight or abstraction can alter an individual's abilities in a variety of areas that include decision making, informed consent, designation of a surrogate decision-maker such as a health care proxy, understanding and management of financial affairs, execution of a will, or safe driving. CONCLUSION Even mild cognitive impairment can have significant behavioral consequences. Clinicians can assist care partners and persons with MCI or MiND by alerting them to the medicolegal concerns that often accompany cognitive decline. Early recognition and discussion can help a care system manage medicolegal risk more effectively and promote thoughtful advance planning.
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Affiliation(s)
- Anca Bejenaru
- Department of Psychiatry and Behavioral Health, Christiana Care, Wilmington, DE, USA
| | - James M Ellison
- Department of Psychiatry and Behavioral Health, Christiana Care, Wilmington, DE, USA.,Department of Family and Community Medicine, Christiana Care, Wilmington, DE, USA.,Department of Psychiatry & Human Behavior, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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12
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Bi T, Xie Q, Gao J, Zhang T, Kou H. The Effect of Empathy on the Attentional Processing of Painful and Emotional Stimuli. Psychol Res Behav Manag 2021; 14:1223-1234. [PMID: 34408507 PMCID: PMC8364384 DOI: 10.2147/prbm.s318657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/29/2021] [Indexed: 11/24/2022] Open
Abstract
Background Empathy is shown to affect the attentional processing of painful stimuli and emotional stimuli. However, whether the attentional effects on emotional stimuli depend on emotional valence and the nature of the relationship between the attentional effects on different stimuli are still unknown. Methods In the present study, 25 high-empathy (HE) participants and 25 low-empathy (LE) participants were recruited to perform dot-probe tasks on painful stimuli and emotional stimuli. Results The results showed that HE individuals had weak attentional disengagement to painful pictures. More importantly, regarding emotional pictures, HE individuals showed attentional avoidance to negative emotion pictures, while LE individuals showed attentional bias to positive emotion pictures. Correlation analysis showed that the attentional bias score and attentional disengagement score were only associated with each other within the same category of stimuli (painful, positive or negative stimuli). Conclusion These results revealed that HE individuals mainly showed attentional avoidance to negative stimuli, while LE individuals mainly showed attentional bias to positive stimuli.
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Affiliation(s)
- Taiyong Bi
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, People's Republic of China
| | - Qinhong Xie
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, People's Republic of China.,School of Criminal Justice, China University of Political Science and Law, Beijing, People's Republic of China
| | - Jianhui Gao
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, People's Republic of China
| | - Tao Zhang
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, People's Republic of China
| | - Hui Kou
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, People's Republic of China
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13
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Wright JKX, Grainger SA, Coundouris SP, Henry JD. Affective empathy in neurodegenerative disorders: The importance of measurement type. Neurosci Biobehav Rev 2021; 127:808-819. [PMID: 34098183 DOI: 10.1016/j.neubiorev.2021.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/09/2021] [Accepted: 05/22/2021] [Indexed: 01/02/2023]
Abstract
In recent years, there has been increasing attention focused on affective empathy in neurodegenerative disorders (NDs). However, prior studies have identified discrepancies not only between, but sometimes within, specific NDs. These discrepancies may reflect methodological differences in how affective empathy has been operationalized, with three quite distinct approaches to assessment possible (self-report, informant-report and performance-based). Therefore, we conducted the first meta-analytic review of affective empathy in people with NDs, that considered the potential moderating role of measurement type. Across 27 studies that included 1456 people with NDs and 832 controls, the results showed that most NDs are associated with impaired affective empathy, but that the magnitude of these difficulties differs meaningfully across disorders. However, most importantly, the results indicated that measurement type is a critical consideration in this literature, with substantive differences emerging for self- versus informant-rated measures. These results are discussed in relation to their practical implications for clinical assessment, as well as how they help to inform current theoretical understanding of affective empathic processing.
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Affiliation(s)
- Janet K X Wright
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Sarah A Grainger
- School of Psychology, The University of Queensland, Brisbane, Australia
| | | | - Julie D Henry
- School of Psychology, The University of Queensland, Brisbane, Australia.
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14
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Mendez MF. Degenerative dementias: Alterations of emotions and mood disorders. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:261-281. [PMID: 34389121 DOI: 10.1016/b978-0-12-822290-4.00012-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Degenerative dementias such as Alzheimer's disease and frontotemporal dementia result in distinct alterations in emotional processing, emotional experiences, and mood. The neuropathology of these dementias extends to structures involved in emotional processing, including the basolateral limbic network (orbitofrontal cortex, anterior temporal lobe, amygdala, and thalamus), the insula, and ventromedial frontal lobe. Depression is the most common emotion and mood disorder affecting patients with Alzheimer's disease. The onset of depression can be a prodromal sign of this dementia. Anxiety can also be present early in the course of Alzheimer's disease and especially among patients with early-onset forms of the disease. In contrast, patients with behavioral variant frontotemporal dementia demonstrate hypoemotionality, deficits in the recognition of emotion, and decreased psychophysiological reactivity to emotional stimuli. They typically have a disproportionate impairment in emotional and cognitive empathy. One other unique feature of behavioral variant frontotemporal dementia is the frequent occurrence of bipolar disorder. The management strategies for these alterations of emotion and mood in degenerative dementias primarily involve the judicious use of the psychiatric armamentarium of medications.
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Affiliation(s)
- Mario F Mendez
- Behavioral Neurology Program, Department of Neurology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States; Neurology Service, Veteran Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States.
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15
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Visser M, Wong S, Simonetti S, Hazelton JL, Devenney E, Ahmed RM, van Langenhove T, Parker D, Burrell JR, Hodges JR, Kumfor F. Using a second-person approach to identify disease-specific profiles of social behavior in frontotemporal dementia and Alzheimer's disease. Cortex 2020; 133:236-246. [PMID: 33137538 DOI: 10.1016/j.cortex.2020.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 08/14/2020] [Accepted: 09/10/2020] [Indexed: 12/21/2022]
Abstract
Changes in social behavior are recognized as potential symptoms of behavioral-variant frontotemporal dementia (bvFTD) and semantic dementia (SD), yet objective ways to assess these behaviors in natural social situations are lacking. This study takes a truly social (or second-person) approach and examines changes in real-world social behavior in different dementia syndromes, by analyzing non-scripted social interactions in bvFTD patients (n = 20) and SD patients (n = 20), compared to patients with Alzheimer's disease (AD) (n = 20). Video recordings of 10-min conversations between patients and behavioral neurologists were analyzed for the presence of socially engaging (e.g., nodding, smiling, gesturing) and disengaging behavior (e.g., avoiding eye contact, self-grooming, interrupting). Results demonstrated disease-specific profiles, with bvFTD patients showing less nodding and more looking away than AD, and SD patients showing more gesturing than AD. A principal components analysis revealed the presence of four unobserved components, showing atypical disengaging patterns of behavior. Whole-brain voxel-based morphometry analyses revealed distinct neurobiological bases for each of these components, with the brain regions identified previously associated with behavior selection, abstract mentalization and processing of multi-sensory and socially-relevant information, in mediating socially engaging and disengaging behavior. This study demonstrates the utility of systematic behavioral observation of social interactions in the differential diagnosis of dementia.
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Affiliation(s)
- Mandy Visser
- Leiden University Medical Center, Department of Public Health and Primary Care, the Netherlands; University of Technology Sydney, Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation (IMPACCT), Australia
| | - Stephanie Wong
- University of Sydney, Brain and Mind Centre, Australia; University of Sydney, School of Psychology, Australia
| | - Simone Simonetti
- University of Technology Sydney, Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation (IMPACCT), Australia
| | - Jessica L Hazelton
- University of Sydney, Brain and Mind Centre, Australia; University of Sydney, School of Psychology, Australia
| | - Emma Devenney
- University of Sydney, Brain and Mind Centre, Australia; University of Sydney, Central Clinical School, Australia
| | - Rebekah M Ahmed
- University of Sydney, Brain and Mind Centre, Australia; University of Sydney, Central Clinical School, Australia
| | | | - Deborah Parker
- University of Technology Sydney, Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation (IMPACCT), Australia
| | | | - John R Hodges
- University of Sydney, Brain and Mind Centre, Australia; University of Sydney, Central Clinical School, Australia
| | - Fiona Kumfor
- University of Sydney, Brain and Mind Centre, Australia; University of Sydney, School of Psychology, Australia.
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16
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Oliver LD, Stewart C, Coleman K, Kryklywy JH, Bartha R, Mitchell DGV, Finger EC. Neural effects of oxytocin and mimicry in frontotemporal dementia: A randomized crossover study. Neurology 2020; 95:e2635-e2647. [PMID: 32963103 DOI: 10.1212/wnl.0000000000010933] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 07/14/2020] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To determine whether intranasal oxytocin, alone or in combination with instructed mimicry of facial expressions, would augment neural activity in patients with frontotemporal dementia (FTD) in brain regions associated with empathy, emotion processing, and the simulation network, as indexed by blood oxygen-level dependent (BOLD) signal during fMRI. METHODS In a placebo-controlled, randomized crossover design, 28 patients with FTD received 72 IU intranasal oxytocin or placebo and then completed an fMRI facial expression mimicry task. RESULTS Oxytocin alone and in combination with instructed mimicry increased activity in regions of the simulation network and in limbic regions associated with emotional expression processing. CONCLUSIONS The findings demonstrate latent capacity to augment neural activity in affected limbic and other frontal and temporal regions during social cognition in patients with FTD, and support the promise and need for further investigation of these interventions as therapeutics in FTD. CLINICALTRIALSGOV IDENTIFIER NCT01937013. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that a single dose of 72 IU intranasal oxytocin augments BOLD signal in patients with FTD during viewing of emotional facial expressions.
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Affiliation(s)
- Lindsay D Oliver
- From the Graduate Program in Neuroscience (L.D.O., C.S., J.H.K.) and Department of Clinical Neurological Sciences (E.C.F.), Schulich School of Medicine and Dentistry, Robarts Research Institute (R.B., E.C.F.), and Brain and Mind Institute (D.G.V.M.), Department of Psychiatry and Department of Anatomy and Cell Biology, Western University, London; Campbell Family Mental Health Research Institute (L.D.O.), Centre for Addiction and Mental Health, Toronto; Parkwood Institute Research (K.C., E.C.F.), London, Ontario; and Department of Psychology (J.H.K.), University of British Columbia, Vancouver, Canada
| | - Chloe Stewart
- From the Graduate Program in Neuroscience (L.D.O., C.S., J.H.K.) and Department of Clinical Neurological Sciences (E.C.F.), Schulich School of Medicine and Dentistry, Robarts Research Institute (R.B., E.C.F.), and Brain and Mind Institute (D.G.V.M.), Department of Psychiatry and Department of Anatomy and Cell Biology, Western University, London; Campbell Family Mental Health Research Institute (L.D.O.), Centre for Addiction and Mental Health, Toronto; Parkwood Institute Research (K.C., E.C.F.), London, Ontario; and Department of Psychology (J.H.K.), University of British Columbia, Vancouver, Canada
| | - Kristy Coleman
- From the Graduate Program in Neuroscience (L.D.O., C.S., J.H.K.) and Department of Clinical Neurological Sciences (E.C.F.), Schulich School of Medicine and Dentistry, Robarts Research Institute (R.B., E.C.F.), and Brain and Mind Institute (D.G.V.M.), Department of Psychiatry and Department of Anatomy and Cell Biology, Western University, London; Campbell Family Mental Health Research Institute (L.D.O.), Centre for Addiction and Mental Health, Toronto; Parkwood Institute Research (K.C., E.C.F.), London, Ontario; and Department of Psychology (J.H.K.), University of British Columbia, Vancouver, Canada
| | - James H Kryklywy
- From the Graduate Program in Neuroscience (L.D.O., C.S., J.H.K.) and Department of Clinical Neurological Sciences (E.C.F.), Schulich School of Medicine and Dentistry, Robarts Research Institute (R.B., E.C.F.), and Brain and Mind Institute (D.G.V.M.), Department of Psychiatry and Department of Anatomy and Cell Biology, Western University, London; Campbell Family Mental Health Research Institute (L.D.O.), Centre for Addiction and Mental Health, Toronto; Parkwood Institute Research (K.C., E.C.F.), London, Ontario; and Department of Psychology (J.H.K.), University of British Columbia, Vancouver, Canada
| | - Robert Bartha
- From the Graduate Program in Neuroscience (L.D.O., C.S., J.H.K.) and Department of Clinical Neurological Sciences (E.C.F.), Schulich School of Medicine and Dentistry, Robarts Research Institute (R.B., E.C.F.), and Brain and Mind Institute (D.G.V.M.), Department of Psychiatry and Department of Anatomy and Cell Biology, Western University, London; Campbell Family Mental Health Research Institute (L.D.O.), Centre for Addiction and Mental Health, Toronto; Parkwood Institute Research (K.C., E.C.F.), London, Ontario; and Department of Psychology (J.H.K.), University of British Columbia, Vancouver, Canada
| | - Derek G V Mitchell
- From the Graduate Program in Neuroscience (L.D.O., C.S., J.H.K.) and Department of Clinical Neurological Sciences (E.C.F.), Schulich School of Medicine and Dentistry, Robarts Research Institute (R.B., E.C.F.), and Brain and Mind Institute (D.G.V.M.), Department of Psychiatry and Department of Anatomy and Cell Biology, Western University, London; Campbell Family Mental Health Research Institute (L.D.O.), Centre for Addiction and Mental Health, Toronto; Parkwood Institute Research (K.C., E.C.F.), London, Ontario; and Department of Psychology (J.H.K.), University of British Columbia, Vancouver, Canada
| | - Elizabeth C Finger
- From the Graduate Program in Neuroscience (L.D.O., C.S., J.H.K.) and Department of Clinical Neurological Sciences (E.C.F.), Schulich School of Medicine and Dentistry, Robarts Research Institute (R.B., E.C.F.), and Brain and Mind Institute (D.G.V.M.), Department of Psychiatry and Department of Anatomy and Cell Biology, Western University, London; Campbell Family Mental Health Research Institute (L.D.O.), Centre for Addiction and Mental Health, Toronto; Parkwood Institute Research (K.C., E.C.F.), London, Ontario; and Department of Psychology (J.H.K.), University of British Columbia, Vancouver, Canada.
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17
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Brown CL, Hua AY, De Coster L, Sturm VE, Kramer JH, Rosen HJ, Miller BL, Levenson RW. Comparing two facets of emotion perception across multiple neurodegenerative diseases. Soc Cogn Affect Neurosci 2020; 15:511-522. [PMID: 32363385 PMCID: PMC7328026 DOI: 10.1093/scan/nsaa060] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/25/2020] [Accepted: 04/27/2020] [Indexed: 12/30/2022] Open
Abstract
Deficits in emotion perception (the ability to infer others' emotions accurately) can occur as a result of neurodegeneration. It remains unclear how different neurodegenerative diseases affect different forms of emotion perception. The present study compares performance on a dynamic tracking task of emotion perception (where participants track the changing valence of a film character's emotions) with performance on an emotion category labeling task (where participants label specific emotions portrayed by film characters) across seven diagnostic groups (N = 178) including Alzheimer's disease (AD), behavioral variant frontotemporal dementia (bvFTD), semantic variant primary progressive aphasia (svPPA), non-fluent variant primary progressive aphasia (nfvPPA), progressive supranuclear palsy (PSP), corticobasal syndrome and healthy controls. Consistent with hypotheses, compared to controls, the bvFTD group was impaired on both tasks. The svPPA group was impaired on the emotion labeling task, whereas the nfvPPA, PSP and AD groups were impaired on the dynamic tracking task. Smaller volumes in bilateral frontal and left insular regions were associated with worse labeling, whereas smaller volumes in bilateral medial frontal, temporal and right insular regions were associated with worse tracking. Findings suggest labeling and tracking facets of emotion perception are differentially affected across neurodegenerative diseases due to their unique neuroanatomical correlates.
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Affiliation(s)
- Casey L Brown
- Berkeley Psychophysiology Laboratory, Department of Psychology, University of California, Berkeley, CA 94720-1650, USA
- Department of Psychiatry, University of California, San Francisco, CA 94115, USA
| | - Alice Y Hua
- Berkeley Psychophysiology Laboratory, Department of Psychology, University of California, Berkeley, CA 94720-1650, USA
| | - Lize De Coster
- Department of Psychiatry, University of California, San Francisco, CA 94115, USA
| | - Virginia E Sturm
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94115, USA
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94115, USA
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94115, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94115, USA
| | - Robert W Levenson
- Berkeley Psychophysiology Laboratory, Department of Psychology, University of California, Berkeley, CA 94720-1650, USA
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18
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Marshall CR, Hardy CJD, Russell LL, Bond RL, Sivasathiaseelan H, Greaves C, Moore KM, Agustus JL, van Leeuwen JEP, Wastling SJ, Rohrer JD, Kilner JM, Warren JD. The functional neuroanatomy of emotion processing in frontotemporal dementias. Brain 2020; 142:2873-2887. [PMID: 31321407 PMCID: PMC7959336 DOI: 10.1093/brain/awz204] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 05/08/2019] [Accepted: 05/12/2019] [Indexed: 11/13/2022] Open
Abstract
Impaired processing of emotional signals is a core feature of frontotemporal dementia syndromes, but the underlying neural mechanisms have proved challenging to characterize and measure. Progress in this field may depend on detecting functional changes in the working brain, and disentangling components of emotion processing that include sensory decoding, emotion categorization and emotional contagion. We addressed this using functional MRI of naturalistic, dynamic facial emotion processing with concurrent indices of autonomic arousal, in a cohort of patients representing all major frontotemporal dementia syndromes relative to healthy age-matched individuals. Seventeen patients with behavioural variant frontotemporal dementia [four female; mean (standard deviation) age 64.8 (6.8) years], 12 with semantic variant primary progressive aphasia [four female; 66.9 (7.0) years], nine with non-fluent variant primary progressive aphasia [five female; 67.4 (8.1) years] and 22 healthy controls [12 female; 68.6 (6.8) years] passively viewed videos of universal facial expressions during functional MRI acquisition, with simultaneous heart rate and pupillometric recordings; emotion identification accuracy was assessed in a post-scan behavioural task. Relative to healthy controls, patient groups showed significant impairments (analysis of variance models, all P < 0.05) of facial emotion identification (all syndromes) and cardiac (all syndromes) and pupillary (non-fluent variant only) reactivity. Group-level functional neuroanatomical changes were assessed using statistical parametric mapping, thresholded at P < 0.05 after correction for multiple comparisons over the whole brain or within pre-specified regions of interest. In response to viewing facial expressions, all participant groups showed comparable activation of primary visual cortex while patient groups showed differential hypo-activation of fusiform and posterior temporo-occipital junctional cortices. Bi-hemispheric, syndrome-specific activations predicting facial emotion identification performance were identified (behavioural variant, anterior insula and caudate; semantic variant, anterior temporal cortex; non-fluent variant, frontal operculum). The semantic and non-fluent variant groups additionally showed complex profiles of central parasympathetic and sympathetic autonomic involvement that overlapped signatures of emotional visual and categorization processing and extended (in the non-fluent group) to brainstem effector pathways. These findings open a window on the functional cerebral mechanisms underpinning complex socio-emotional phenotypes of frontotemporal dementia, with implications for novel physiological biomarker development.
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Affiliation(s)
- Charles R Marshall
- Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.,Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.,Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
| | - Christopher J D Hardy
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Lucy L Russell
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Rebecca L Bond
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Harri Sivasathiaseelan
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Caroline Greaves
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Katrina M Moore
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Jennifer L Agustus
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Janneke E P van Leeuwen
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Stephen J Wastling
- Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - James M Kilner
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
| | - Jason D Warren
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
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19
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Understanding empathy and its disorders through a focus on the neural mechanism. Cortex 2020; 127:347-370. [PMID: 32278184 DOI: 10.1016/j.cortex.2020.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 12/28/2022]
Abstract
Empathy is a complex, multi-dimensional process. As such, it can be impaired at multiple stages, producing disorders of empathy with separable underlying causes. Studies often divide empathy into emotional and cognitive components to simplify the large space of empathic processes. This practice can be helpful, but also causes people to misunderstand their interdependence at the level of the mechanism and how they correspond to surveys and tasks. As a result, inferences made from experimental results are often incorrect and cannot be integrated across studies. We explain how emotional and cognitive empathy overlap through the proximate mechanism and clarify their operationalization in common surveys and tasks. A systematic review of three clinical disorders is used to highlight this issue and reinterpret and unite results according to the proximate framework--Borderline Personality Disorder (BPD), Narcissistic Personality Disorder (NPD), and Frontotemporal Dementia (FTD). Aligning constructs through the proximate mechanism allows us to understand both empathy and its disorders.
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20
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Mendez MF, Carr AR, Jimenez EE, Riedel BC, Thompson PM. Impaired Empathy Versus General Hypoemotionality in Frontotemporal Dementia. J Neuropsychiatry Clin Neurosci 2020; 31:378-385. [PMID: 31046591 DOI: 10.1176/appi.neuropsych.18090202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Impaired empathy is a diagnostic feature of behavioral variant frontotemporal dementia (bvFTD), but it is not clear whether it is caused by a primary impairment in empathy or by general emotional blunting. METHODS Patients with bvFTD who met criteria for loss of empathy (N=10) and patients with Alzheimer's disease (N=15) were assessed with a measure for empathy (Socioemotional Dysfunction Scale [SDS]) and a measure for general emotion (Scale for Emotional Blunting [SEB]). All patients underwent neuroimaging. Both patient groups and a healthy control group (N=18) were evaluated by using autonomic responses (skin conductance responses [SCR]) to pictures from the Internal Affective Picture System (IAPS) (presence or absence of empathy stimuli and high versus low emotion). RESULTS All participants reported understanding the content and others' perspectives on the empathy pictures; however, only patients with bvFTD showed impaired empathic behavior on the SDS, which persisted after adjusting for measures from the emotion scale (SEB). Patients with bvFTD had significantly lower SCR for all the IAPS stimuli, including for empathy pictures, which also persisted after adjusting for emotional content. On MRI analysis, SCR across groups significantly correlated with the volume of the dorsal anterior cingulate gyrus (dACC). CONCLUSIONS These results indicate that patients with bvFTD have decreased empathic behavior with or without emotional blunting, and they exhibit decreased psychophysiological responses to empathy stimuli, independent of general emotion. These preliminary findings suggest a specific impairment in emotional empathy, possibly related to impairment of the emotional appraisal role of the dACC.
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Affiliation(s)
- Mario F Mendez
- The Departments of Neurology, Psychiatry and Biobehavioral Sciences, and Medicine, Statistic Core, David Geffen School of Medicine, University of California at Los Angeles (Mendez, Jimenez); the VA Greater Los Angeles Healthcare System (Mendez, Carr, Jimenez); the Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles (Riedel, Thompson); and the Departments of Engineering, Neurology, Ophthalmology, Pediatrics, Psychiatry, and Radiology, University of Southern California, Los Angeles (Thompson)
| | - Andrew R Carr
- The Departments of Neurology, Psychiatry and Biobehavioral Sciences, and Medicine, Statistic Core, David Geffen School of Medicine, University of California at Los Angeles (Mendez, Jimenez); the VA Greater Los Angeles Healthcare System (Mendez, Carr, Jimenez); the Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles (Riedel, Thompson); and the Departments of Engineering, Neurology, Ophthalmology, Pediatrics, Psychiatry, and Radiology, University of Southern California, Los Angeles (Thompson)
| | - Elvira E Jimenez
- The Departments of Neurology, Psychiatry and Biobehavioral Sciences, and Medicine, Statistic Core, David Geffen School of Medicine, University of California at Los Angeles (Mendez, Jimenez); the VA Greater Los Angeles Healthcare System (Mendez, Carr, Jimenez); the Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles (Riedel, Thompson); and the Departments of Engineering, Neurology, Ophthalmology, Pediatrics, Psychiatry, and Radiology, University of Southern California, Los Angeles (Thompson)
| | - Brandalyn C Riedel
- The Departments of Neurology, Psychiatry and Biobehavioral Sciences, and Medicine, Statistic Core, David Geffen School of Medicine, University of California at Los Angeles (Mendez, Jimenez); the VA Greater Los Angeles Healthcare System (Mendez, Carr, Jimenez); the Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles (Riedel, Thompson); and the Departments of Engineering, Neurology, Ophthalmology, Pediatrics, Psychiatry, and Radiology, University of Southern California, Los Angeles (Thompson)
| | - Paul M Thompson
- The Departments of Neurology, Psychiatry and Biobehavioral Sciences, and Medicine, Statistic Core, David Geffen School of Medicine, University of California at Los Angeles (Mendez, Jimenez); the VA Greater Los Angeles Healthcare System (Mendez, Carr, Jimenez); the Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles (Riedel, Thompson); and the Departments of Engineering, Neurology, Ophthalmology, Pediatrics, Psychiatry, and Radiology, University of Southern California, Los Angeles (Thompson)
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21
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Eddy CM. What Do You Have in Mind? Measures to Assess Mental State Reasoning in Neuropsychiatric Populations. Front Psychiatry 2019; 10:425. [PMID: 31354534 PMCID: PMC6636467 DOI: 10.3389/fpsyt.2019.00425] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/29/2019] [Indexed: 12/12/2022] Open
Abstract
Social interaction is closely associated with both functional capacity and well-being. Previous research has not only revealed evidence of social dysfunction in individuals with a wide range of psychiatric and neurological disorders but also generated an abundance of potential measures for assessing social cognition. This review explores the most popular measures used within neuropsychiatric populations to investigate the ability to recognize or reason about the mental states of others. Measures are also critically analyzed in terms of strengths and limitations to aid task selection in future clinical studies. The most frequently applied assessment tools use verbal, visual or audiovisual forms of presentation and assess recognition of mental states from facial features, self-rated empathy, the understanding of other's cognitive mental states such as beliefs and intentions, or the ability to combine knowledge of other's thoughts and emotions in order to understand subtle communications or socially inappropriate behavior. Key weaknesses of previous research include limited investigation of relationships with clinical symptoms, and underutilization of measures of everyday social functioning that offer a useful counterpart to traditional "lab" tasks. Future studies should aim to carefully select measures not only based on the range of skills to be assessed but also taking into account potential difficulties with interpretation and the need to gain insight into the application of social cognitive skills as well as ability per se. Some of the best measures include those with well-matched control trials (e.g., Yoni Task) or those that restrict the influence of verbal deficits (e.g., intentions comic strip task), elicit spontaneous mentalizing (e.g., Animations Task), and possess greater ecological validity (e.g., Movie for the Assessment of Social Cognition). Social cognitive research within psychiatric populations will be further enhanced through the development of more closely matched control tasks, and the exploration of relationships between task performance, medication, strategy use, and broader emotional and motor functions.
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Affiliation(s)
- Clare M. Eddy
- Research and Innovation, BSMHFT National Centre for Mental Health, Birmingham, United Kingdom
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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22
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Teichmann M, Daigmorte C, Funkiewiez A, Sanches C, Camus M, Mauras T, Le Ber I, Dubois B, Levy R, Azuar C. Moral Emotions in Frontotemporal Dementia. J Alzheimers Dis 2019; 69:887-896. [PMID: 31127763 DOI: 10.3233/jad-180991] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Emotions, with or without moral valence, appear to be altered in the behavioral variant of frontotemporal dementia (bvFTD) but the relative degree of moral emotion breakdown, which could be a marker of bvFTD diagnosis, remains unexplored. OBJECTIVE To assess moral emotions in bvFTD, to differentiate bvFTD from typical Alzheimer's disease (AD) based on moral emotion processing, and to provide a sensitive and specific assessment tool contributing to bvFTD diagnosis. METHODS We investigated moral emotions in 22 bvFTD patients, 15 patients with typical AD having positive CSF AD biomarkers, and 45 healthy controls. The 'Moral Emotions Assessment' task consisted in 42 scenarios exploring positive and negative moral emotions. To control for moral-specificity, we contrasted the 42 moral scenarios with 18 extra-moral scenarios eliciting the emotions without involving any inter-human moral context. RESULTS bvFTD patients were more impaired in emotion processing than AD patients and healthy controls and had significantly poorer performance in the processing of moral emotions than of emotions without moral valence. ROC analyses of data on moral scenarios showed a high area under the curve (83%), and indicated a cut-off score (< 37/42) for differentiating bvFTD from AD with a sensitivity of 82% and specificity of 73%. CONCLUSION Our findings demonstrate that bvFTD patients have disorders in emotion processing which is mainly related to failure regarding moral emotions. They also show that this deficit is reliably detected by the 'Moral Emotions Assessment' which represents a sensitive and specific diagnostic tool detecting bvFTD and differentiating it from AD.
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Affiliation(s)
- Marc Teichmann
- Institut du Cerveau et de la Moelle épinière (ICM), FrontLab, Paris, France.,Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence National 'FTD', Hôpital Pitié Salpêtrière, AP-HP, Paris, France
| | - Chloé Daigmorte
- Institut du Cerveau et de la Moelle épinière (ICM), FrontLab, Paris, France
| | - Aurélie Funkiewiez
- Institut du Cerveau et de la Moelle épinière (ICM), FrontLab, Paris, France.,Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence National 'FTD', Hôpital Pitié Salpêtrière, AP-HP, Paris, France
| | - Clara Sanches
- Institut du Cerveau et de la Moelle épinière (ICM), FrontLab, Paris, France
| | - Maeva Camus
- Unité de Neuro-Psychiatrie Comportementale (IHU), Hôpital de la Pitié Salpêtrière, Paris, France
| | - Thomas Mauras
- Unité de Neuro-Psychiatrie Comportementale (IHU), Hôpital de la Pitié Salpêtrière, Paris, France.,Service de Psychiatrie, Hôpital Sainte-Anne, Paris, France
| | - Isabelle Le Ber
- Institut du Cerveau et de la Moelle épinière (ICM), FrontLab, Paris, France.,Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence National 'FTD', Hôpital Pitié Salpêtrière, AP-HP, Paris, France
| | - Bruno Dubois
- Institut du Cerveau et de la Moelle épinière (ICM), FrontLab, Paris, France.,Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence National 'FTD', Hôpital Pitié Salpêtrière, AP-HP, Paris, France
| | - Richard Levy
- Institut du Cerveau et de la Moelle épinière (ICM), FrontLab, Paris, France.,Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence National 'FTD', Hôpital Pitié Salpêtrière, AP-HP, Paris, France
| | - Carole Azuar
- Institut du Cerveau et de la Moelle épinière (ICM), FrontLab, Paris, France.,Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence National 'FTD', Hôpital Pitié Salpêtrière, AP-HP, Paris, France.,Unité de Neuro-Psychiatrie Comportementale (IHU), Hôpital de la Pitié Salpêtrière, Paris, France
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23
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Yeo D, Kim H, Her S, Choi JW, Cha KS, Kim KH. Spatiotemporal Analysis of Event-related Current Density Reveals Dissociable Effects of Arousal and Valence on Emotional Picture Processing. J Korean Med Sci 2019; 34:e146. [PMID: 31124325 PMCID: PMC6535406 DOI: 10.3346/jkms.2019.34.e146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/22/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The processing of emotional visual stimulation involves the processing of emotional and visuoperceptual information. It is not completely revealed how the valence and arousal affect these two aspects. The objective was to investigate the effects of valence and arousal on spatiotemporal characteristics of cortical information processing using distributed source imaging of event-related current density (ERCD). METHODS Electroencephalograms (64 channels) were recorded from 19 healthy men while presenting affective pictures. Distributed source localization analysis was adopted to obtain the spatiotemporal pattern of ERCD on cortical surface in response to emotional visual stimulation. A nonparametric cluster-based permutation test was used to find meaningful time and space without prior knowledge. RESULTS Significant changes of ERCD in 400-800 ms among positive, negative, and neutral emotional conditions were found in left posterior cingulate cortex (PCC) and right inferior temporal cortex (ITC). In the PCC, the stimuli with higher arousal levels showed more negative ERCD than neutral stimuli. In the ITC, the ERCD for negative stimuli was significantly more negative than those of positive and neutral ones. CONCLUSION Arousal and valence had strong influence on memory encoding and visual analysis at late period. The location and time showing significant change in neural activity according to arousal and valence would provide valuable information for understanding the changes of cortical function by neuropsychiatric disorders.
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Affiliation(s)
- Donghoon Yeo
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea
| | - Hyun Kim
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea
| | - Seongjin Her
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea
| | - Jeong Woo Choi
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Kwang Su Cha
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Hwan Kim
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea.
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24
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Cognitive and Emotional Empathy in Individuals with Spinal Cord Injury. Behav Neurol 2019; 2019:1312934. [PMID: 30881519 PMCID: PMC6387693 DOI: 10.1155/2019/1312934] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 12/03/2018] [Accepted: 12/23/2018] [Indexed: 11/17/2022] Open
Abstract
Background Empathy has been conceptualized as comprising a cognitive and an emotional component, the latter being further divided into direct and indirect aspects, which refer, respectively, to the explicit evaluation of the observer's feelings while attending someone in an emotional situation and to the physiological response of the observer. Empathy has been previously investigated in several neurological disorders. Objective This study is aimed at investigating empathy in patients with spinal cord injury (SCI). We hypothesize that, due to deafferentation following their injury, SCI patients will display difficulty in the processing of emotional stimuli and blunted empathic responses as compared to healthy controls. Materials and Methods 20 patients with spinal cord injury (SCI) (12 males and 8 females, mean age = 50.9, standard deviation (SD) = 16.1 years; mean education = 10.9, SD = 4.1 years) were included in the study and compared to 20 matched healthy subjects. Participants were investigated using the State-Trait Anxiety Inventory (Form Y) (STAI-Y), the Beck Depression Scale, and the Toronto Alexithymia Scale. Moreover, participants were further evaluated by means of the Interpersonal Reactivity Index (IRI), which explores both cognitive and emotional aspects of empathy, and through an experimental protocol based on the use of a modified version of the computerized Multifaceted Empathy Test (MET) to evaluate emotional (direct and indirect) empathy and the ability to judge the valence of complex emotional scenes. Results As compared to healthy controls, SCI patients reported higher scores on the Perspective-Taking subscale of the IRI, while, on the modified MET, they were less accurate in identifying the valence of neutral scenes, notwithstanding their spared direct and indirect emotional empathy ability. Furthermore, we found a significant negative correlation between the time interval since injury and the direct emotional empathy scores on the positive images, as well as a negative correlation with the indirect emotional empathy scores on both positive and neutral images, indicating a blunting of the empathic responses as time elapses. Conclusion Results suggest that SCI patients, when analyzing the meaning of emotional stimuli, tend to rely on a cognitive empathy strategy rather than on emotion simulation.
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25
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Pick E, Kleinbub JR, Mannarini S, Palmieri A. Empathy In Neurodegenerative Diseases: A Systematic Review. Neuropsychiatr Dis Treat 2019; 15:3287-3304. [PMID: 31819455 PMCID: PMC6878921 DOI: 10.2147/ndt.s225920] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 10/31/2019] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Empathy, in its affective and cognitive components, is a crucial interpersonal ability. It is broadly studied in the field of psychopathology, whereas its study in the neurodegenerative diseases is relatively recent. Existing literature, though, focused on a reduced subset of considered diseases, which often found a compromise in empathy abilities. Organized knowledge about a more comprehensive set of diseases is lacking. METHOD The present PRISMA systematic review was aimed at collecting the current available literature concerning empathic alterations in adult patients affected by neurodegenerative diseases. It considered the different empathy components, evaluated existing patterns, the impact on patients' lives, and treatment considerations. RESULTS Overall, the 32 retrieved studies describe a spread deterioration of empathic abilities in patients, with each disease displaying its own pattern of empathy functioning. Literature in this field is fragmented and of heterogeneous quality, and further studies are warranted to increase evidence of many preliminary results. DISCUSSION In conclusion, we highlight the crucial importance of acknowledging empathy deficits in these diseases, showing their repercussion on both patients' and caregivers' quality of life, the establishment of a functional doctor-patient relationship, and the development of efficacious psychological intervention. These clinical approaches can be enriched by the knowledge of the spared abilities of patients affected by neurodegenerative diseases.
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Affiliation(s)
- Emanuele Pick
- Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padova, Italy
| | - Johann R Kleinbub
- Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padova, Italy
| | - Stefania Mannarini
- Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padova, Italy.,Interdepartmental Center for Family Research, University of Padova, Padova, Italy
| | - Arianna Palmieri
- Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy
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26
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Beadle JN, de la Vega CE. Impact of Aging on Empathy: Review of Psychological and Neural Mechanisms. Front Psychiatry 2019; 10:331. [PMID: 31244684 PMCID: PMC6580149 DOI: 10.3389/fpsyt.2019.00331] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/29/2019] [Indexed: 12/30/2022] Open
Abstract
Empathy in aging is a key capacity because it affects the quality of older adults' relationships and reduced levels are associated with greater loneliness. Many older adults also find themselves in the role of a caregiver to a loved one, and thus empathy is critical for the success of the caregiver-patient relationship. Furthermore, older adults are motivated to make strong emotional connections with others, as highlighted in the socioemotional selectivity theory. Consequently, reductions in empathy could negatively impact their goals. However, there is growing evidence that older adults experience at least some changes in empathy, depending on the domain. Specifically, the state of the research is that older adults have lower cognitive empathy (i.e., the ability to understand others' thoughts and feelings) than younger adults, but similar and in some cases even higher levels of emotional empathy (i.e., the ability to feel emotions that are similar to others' or feel compassion for them). A small number of studies have examined the neural mechanisms for age-related differences in empathy and have found reduced activity in a key brain area associated with cognitive empathy. However, more research is needed to further characterize how brain changes impact empathy with age, especially in the emotional domain of empathy. In this review, we discuss the current state of the research on age-related differences in the psychological and neural bases of empathy, with a specific comparison of the cognitive versus emotional components. Finally, we highlight new directions for research in this area and examine the implications of age-related differences in empathy for older adults.
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Affiliation(s)
- Janelle N Beadle
- Department of Gerontology, University of Nebraska at Omaha, Omaha, NE, United States
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27
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Wu X, Xu F, Chen X, Wang L, Huang W, Wan K, Ji GJ, Xiao G, Xu S, Yu F, Zhu C, Xi C, Wang K. The Effect of High-Definition Transcranial Direct Current Stimulation of the Right Inferior Frontal Gyrus on Empathy in Healthy Individuals. Front Hum Neurosci 2018; 12:446. [PMID: 30483081 PMCID: PMC6240690 DOI: 10.3389/fnhum.2018.00446] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 10/17/2018] [Indexed: 01/09/2023] Open
Abstract
Empathy, including cognitive and emotional empathy, refers to the ability to infer the mental states of others and to the capacity to share emotions. The neural mechanisms involved in empathy are complex and not yet fully understood, and previous studies have shown that both cognitive and emotional empathy are closely associated with the inferior frontal gyrus (IFG). In this study, we examined whether empathy can be modulated by high-definition transcranial direct current stimulation (HD-tDCS) of the right IFG. Twenty-three healthy participants took part in all three experimental conditions (i.e., anodal, cathodal and sham stimulation) in a randomized order. Participants then completed the Chinese version of the Multifaceted Empathy Test (MET), which assesses both cognitive and emotional empathy. The results show that scores obtained for cognitive empathy following cathodal stimulation are significantly lower than those obtained following sham stimulation. In addition, scores obtained for cognitive empathy following anodal stimulation are higher than those obtained following sham stimulation, though the difference is only marginally significant. However, the results fail to show whether the stimulation of the right IFG via HD-tDCS plays a role in emotional empathy. Our results suggest that the right IFG plays a key role in cognitive empathy and indicate that HD-tDCS can regulate cognitive empathy by inducing excitability changes in the right IFG.
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Affiliation(s)
- Xiaoling Wu
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui, China
| | - Feifei Xu
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui, China
| | - Xingui Chen
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui, China.,Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lu Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wanling Huang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ke Wan
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Gong-Jun Ji
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui, China
| | - Guixian Xiao
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Sheng Xu
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China
| | - Fengqiong Yu
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui, China
| | - Chunyan Zhu
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui, China
| | - Chunhua Xi
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui, China.,Department of Neurology, The Third Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Kai Wang
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui, China.,Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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28
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Healey ML, Grossman M. Cognitive and Affective Perspective-Taking: Evidence for Shared and Dissociable Anatomical Substrates. Front Neurol 2018; 9:491. [PMID: 29988515 PMCID: PMC6026651 DOI: 10.3389/fneur.2018.00491] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 06/06/2018] [Indexed: 01/10/2023] Open
Abstract
Perspective-taking refers to the ability to recognize another person's point of view. Crucial to the development of interpersonal relationships and prosocial behavior, perspective-taking is closely linked to human empathy, and like empathy, perspective-taking is commonly subdivided into cognitive and affective components. While the two components of empathy have been frequently compared, the differences between cognitive and affective perspective-taking have been under-investigated in the cognitive neuroscience literature to date. Here, we define cognitive perspective-taking as the ability to infer an agent's thoughts or beliefs, and affective perspective-taking as the ability to infer an agent's feelings or emotions. In this paper, we review data from functional imaging studies in healthy adults as well as behavioral and structural imaging studies in patients with behavioral variant frontotemporal dementia in order to determine if there are distinct neural correlates for cognitive and affective perspective-taking. Data suggest that there are both shared and non-shared cognitive and anatomic substrates. For example, while both types of perspective-taking engage regions such as the temporoparietal junction, precuneus, and temporal poles, only affective perspective-taking engages regions within the limbic system and basal ganglia. Differences are also observed in prefrontal cortex: while affective perspective-taking engages ventromedial prefrontal cortex, cognitive perspective-taking engages dorsomedial prefrontal cortex and dorsolateral prefrontal cortex (DLPFC). To corroborate these findings, we also examine if cognitive and affective perspective-taking share the same relationship with executive functions. While it is clear that affective perspective-taking requires emotional substrates that are less prominent in cognitive perspective-taking, it remains unknown to what extent executive functions (including working memory, mental set switching, and inhibitory control) may contribute to each process. Overall results indicate that cognitive perspective-taking is dependent on executive functioning (particularly mental set switching), while affective perspective-taking is less so. We conclude with a critique of the current literature, with a focus on the different outcome measures used across studies and misconceptions due to imprecise terminology, as well as recommendations for future research.
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Affiliation(s)
- Meghan L Healey
- Penn Department of Neurology and Frontotemporal Degeneration Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.,Neuroscience Graduate Group, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Murray Grossman
- Penn Department of Neurology and Frontotemporal Degeneration Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.,Neuroscience Graduate Group, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
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29
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30
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Carr AR, Mendez MF. Affective Empathy in Behavioral Variant Frontotemporal Dementia: A Meta-Analysis. Front Neurol 2018; 9:417. [PMID: 29946291 PMCID: PMC6005854 DOI: 10.3389/fneur.2018.00417] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 05/22/2018] [Indexed: 01/10/2023] Open
Abstract
Background: Empathy deficits are a widely recognized symptom in the behavioral variant frontotemporal dementia (bvFTD), and although several reviews have examined cognitive empathy deficits, there are no meta-analytic studies on affective empathy deficits. Objective: Identify salience of affective empathy in bvFTD. Method: A thorough review of affective empathy found 139 possible studies, but only 10 studies included measures of affective empathy and met standardized criteria. Results: BvFTD patients demonstrated a modest impairment compared to controls across all tasks (d = 0.98). Empathic concern as measured by the interpersonal reactivity index was particularly effected (d = 1.12). Conclusions: This study provides evidence for an increased commitment to observing affective empathy in bvFTD and capturing its role in the disorder.
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Affiliation(s)
- Andrew R. Carr
- V.A. Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Mario F. Mendez
- V.A. Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States
- Departments of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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31
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Roberts S, Henry JD, Molenberghs P. Immoral behaviour following brain damage: A review. J Neuropsychol 2018; 13:564-588. [DOI: 10.1111/jnp.12155] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 02/21/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Stefanie Roberts
- School of Psychological Sciences Monash Institute of Cognitive and Clinical Neurosciences Monash University Clayton Victoria Australia
| | - Julie D. Henry
- School of Psychology University of Queensland St Lucia Queensland Australia
| | - Pascal Molenberghs
- School of Psychological Sciences The University of Melbourne Parkville Victoria Australia
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32
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dos Santos SB, Rocha GP, Fernandez LL, de Padua AC, Reppold CT. Association of Lower Spiritual Well-Being, Social Support, Self-Esteem, Subjective Well-Being, Optimism and Hope Scores With Mild Cognitive Impairment and Mild Dementia. Front Psychol 2018; 9:371. [PMID: 29666594 PMCID: PMC5891611 DOI: 10.3389/fpsyg.2018.00371] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/06/2018] [Indexed: 01/08/2023] Open
Abstract
Introduction: Positive psychology (PP) constructs contribute significantly to a better quality of life for people with various diseases. There are still few studies that have evaluated the evolution of these aspects during the progression of dementia. Objective: To compare the scores for self-esteem, life satisfaction, affect, spirituality, hope, optimism and perceived support network between elderly people with mild cognitive impairment (MCI), mild dementia and moderate dementia and control group. Methods: Cross-sectional study. The sample consisted of 66 healthy controls, 15 elderly people with MCI, 25 with mild dementia and 22 with moderate dementia matched by age, gender, and schooling. The instruments used were: Spirituality Self Rating Scale (SSRS), Rosenberg Self-Esteem Scale, Medical Outcomes Study's Social Support Scale, Life Satisfaction Scale (LSS), Positive and Negative Affect Schedule (PANAS), Revised Life Orientation Test (LOT-R), and Adult Dispositional Hope Scale (ADHS). Results: The scores for spiritual well-being, social support, self-esteem, life satisfaction, positive affect, optimism, negative affect, and hope differed significantly between the groups (p < 0.05). The individuals with MCI and mild dementia had lower spiritual well-being, social support, self-esteem, life satisfaction, positive affect, optimism and hope scores, and higher negative affect scores compared with the controls. The scores for PP constructs did not differ between the group of people with moderate dementia and the control group. Conclusion: Dementia was found to impact several PP constructs in the early stages of the disease. For individuals with greater cognitive impairment, anosognosia appears to suppress the disease's impact on these constructs.
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Affiliation(s)
- Sabrina B. dos Santos
- Postgraduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Gabrielli P. Rocha
- Department of Psychology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Liana L. Fernandez
- Department of Basic Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Analuiza C. de Padua
- Department of Medical Clinics, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Caroline T. Reppold
- Department of Psychology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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33
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Greening SG, Mitchell DG, Smith FW. Spatially generalizable representations of facial expressions: Decoding across partial face samples. Cortex 2018; 101:31-43. [DOI: 10.1016/j.cortex.2017.11.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 11/02/2017] [Accepted: 11/28/2017] [Indexed: 10/18/2022]
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Oliver LD, Vieira JB, Neufeld RWJ, Dziobek I, Mitchell DGV. Greater involvement of action simulation mechanisms in emotional vs cognitive empathy. Soc Cogn Affect Neurosci 2018; 13:367-380. [PMID: 29462481 PMCID: PMC5928409 DOI: 10.1093/scan/nsy013] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 01/10/2018] [Accepted: 02/12/2018] [Indexed: 12/30/2022] Open
Abstract
Empathy is crucial for successful interpersonal interactions, and it is impaired in many psychiatric and neurological disorders. Action-perception matching, or action simulation mechanisms, has been suggested to facilitate empathy by supporting the simulation of perceived experience in others. However, this remains unclear, and the involvement of the action simulation circuit in cognitive empathy (the ability to adopt another's perspective) vs emotional empathy (the capacity to share and react affectively to another's emotional experience) has not been quantitatively compared. Presently, healthy adults completed a classic cognitive empathy task (false belief), an emotional empathy task and an action simulation button-pressing task during functional magnetic resonance imaging. Conjunction analyses revealed common recruitment of the inferior frontal gyrus (IFG), thought to be critical for action-perception matching, during both action simulation and emotional, but not cognitive, empathy. Furthermore, activation was significantly greater in action simulation regions in the left IFG during emotional vs cognitive empathy, and activity in this region was positively correlated with mean feeling ratings during the emotional empathy task. These findings provide evidence for greater involvement of action simulation mechanisms in emotional than cognitive empathy. Thus, the action simulation circuit may be an important target for delineating the pathophysiology of disorders featuring emotional empathy impairments.
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Affiliation(s)
- Lindsay D Oliver
- Graduate Program in Neuroscience, Schulich School of Medicine and Dentistry.,The Brain and Mind Institute, University of Western Ontario, London, ON N6A 5B7, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada
| | - Joana B Vieira
- The Brain and Mind Institute, University of Western Ontario, London, ON N6A 5B7, Canada
| | - Richard W J Neufeld
- Graduate Program in Neuroscience, Schulich School of Medicine and Dentistry.,Department of Psychiatry.,Department of Psychology, University of Western Ontario, London, ON N6A 5B7, Canada
| | - Isabel Dziobek
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Derek G V Mitchell
- Graduate Program in Neuroscience, Schulich School of Medicine and Dentistry.,The Brain and Mind Institute, University of Western Ontario, London, ON N6A 5B7, Canada.,Department of Psychiatry.,Department of Psychology, University of Western Ontario, London, ON N6A 5B7, Canada.,Department of Anatomy and Cell Biology, University of Western Ontario, London, ON N6A 5B7, Canada
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35
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Kumfor F, Ibañez A, Hutchings R, Hazelton JL, Hodges JR, Piguet O. Beyond the face: how context modulates emotion processing in frontotemporal dementia subtypes. Brain 2018; 141:1172-1185. [DOI: 10.1093/brain/awy002] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 11/15/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Fiona Kumfor
- The University of Sydney, School of Psychology, Sydney, Australia
- The University of Sydney, Brain and Mind Centre, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Agustin Ibañez
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Universidad Autonoma del Caribe, Barranquilla, Colombia
- Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile
| | - Rosalind Hutchings
- The University of Sydney, School of Psychology, Sydney, Australia
- The University of Sydney, Brain and Mind Centre, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Jessica L Hazelton
- The University of Sydney, School of Psychology, Sydney, Australia
- The University of Sydney, Brain and Mind Centre, Sydney, Australia
| | - John R Hodges
- The University of Sydney, School of Psychology, Sydney, Australia
- The University of Sydney, Brain and Mind Centre, Sydney, Australia
- The University of Sydney, Clinical Medical School, Sydney, Australia
| | - Olivier Piguet
- The University of Sydney, School of Psychology, Sydney, Australia
- The University of Sydney, Brain and Mind Centre, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
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36
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Healey ML, Grossman M. Cognitive and Affective Perspective-Taking: Evidence for Shared and Dissociable Anatomical Substrates. Front Neurol 2018. [PMID: 29988515 DOI: 10.3389/fneur.2018.00491/bibtex] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Perspective-taking refers to the ability to recognize another person's point of view. Crucial to the development of interpersonal relationships and prosocial behavior, perspective-taking is closely linked to human empathy, and like empathy, perspective-taking is commonly subdivided into cognitive and affective components. While the two components of empathy have been frequently compared, the differences between cognitive and affective perspective-taking have been under-investigated in the cognitive neuroscience literature to date. Here, we define cognitive perspective-taking as the ability to infer an agent's thoughts or beliefs, and affective perspective-taking as the ability to infer an agent's feelings or emotions. In this paper, we review data from functional imaging studies in healthy adults as well as behavioral and structural imaging studies in patients with behavioral variant frontotemporal dementia in order to determine if there are distinct neural correlates for cognitive and affective perspective-taking. Data suggest that there are both shared and non-shared cognitive and anatomic substrates. For example, while both types of perspective-taking engage regions such as the temporoparietal junction, precuneus, and temporal poles, only affective perspective-taking engages regions within the limbic system and basal ganglia. Differences are also observed in prefrontal cortex: while affective perspective-taking engages ventromedial prefrontal cortex, cognitive perspective-taking engages dorsomedial prefrontal cortex and dorsolateral prefrontal cortex (DLPFC). To corroborate these findings, we also examine if cognitive and affective perspective-taking share the same relationship with executive functions. While it is clear that affective perspective-taking requires emotional substrates that are less prominent in cognitive perspective-taking, it remains unknown to what extent executive functions (including working memory, mental set switching, and inhibitory control) may contribute to each process. Overall results indicate that cognitive perspective-taking is dependent on executive functioning (particularly mental set switching), while affective perspective-taking is less so. We conclude with a critique of the current literature, with a focus on the different outcome measures used across studies and misconceptions due to imprecise terminology, as well as recommendations for future research.
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Affiliation(s)
- Meghan L Healey
- Penn Department of Neurology and Frontotemporal Degeneration Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
- Neuroscience Graduate Group, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Murray Grossman
- Penn Department of Neurology and Frontotemporal Degeneration Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
- Neuroscience Graduate Group, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
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37
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Hardt S, Heidler J, Albuquerque B, Valek L, Altmann C, Wilken-Schmitz A, Schäfer MK, Wittig I, Tegeder I. Loss of synaptic zinc transport in progranulin deficient mice may contribute to progranulin-associated psychopathology and chronic pain. Biochim Biophys Acta Mol Basis Dis 2017; 1863:2727-2745. [DOI: 10.1016/j.bbadis.2017.07.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/30/2017] [Accepted: 07/14/2017] [Indexed: 12/11/2022]
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Piguet O, Kumfor F, Hodges J. Diagnosing, monitoring and managing behavioural variant frontotemporal dementia. Med J Aust 2017; 207:303-308. [DOI: 10.5694/mja16.01458] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 06/30/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Olivier Piguet
- Brain and Mind Centre, University of Sydney, Sydney, NSW
- School of Psychology, University of Sydney, Sydney, NSW
| | - Fiona Kumfor
- Brain and Mind Centre, University of Sydney, Sydney, NSW
- School of Psychology, University of Sydney, Sydney, NSW
| | - John Hodges
- Brain and Mind Centre, University of Sydney, Sydney, NSW
- Sydney Medical School, University of Sydney, Sydney, NSW
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Grynberg D, Maurage P, Nandrino JL. Preserved Affective Sharing But Impaired Decoding of Contextual Complex Emotions in Alcohol Dependence. Alcohol Clin Exp Res 2017; 41:779-785. [PMID: 28092119 DOI: 10.1111/acer.13330] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 01/04/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Prior research has repeatedly shown that alcohol dependence is associated with a large range of impairments in psychological processes, which could lead to interpersonal deficits. Specifically, it has been suggested that these interpersonal difficulties are underpinned by reduced recognition and sharing of others' emotional states. However, this pattern of deficits remains to be clarified. This study thus aimed to investigate whether alcohol dependence is associated with impaired abilities in decoding contextual complex emotions and with altered sharing of others' emotions. METHODS Forty-one alcohol-dependent individuals (ADI) and 37 matched healthy individuals completed the Multifaceted Empathy Test, in which they were instructed to identify complex emotional states expressed by individuals in contextual scenes and to state to what extent they shared them. RESULTS Compared to healthy individuals, ADI were impaired in identifying negative (Cohen's d = 0.75) and positive (Cohen's d = 0.46) emotional states but, conversely, presented preserved abilities in sharing others' emotional states. CONCLUSIONS This study shows that alcohol dependence is characterized by an impaired ability to decode complex emotional states (both positive and negative), despite the presence of complementary contextual cues, but by preserved emotion-sharing. Therefore, these results extend earlier data describing an impaired ability to decode noncontextualized emotions toward contextualized and ecologically valid emotional states. They also indicate that some essential emotional competences such as emotion-sharing are preserved in alcohol dependence, thereby offering potential therapeutic levers.
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Affiliation(s)
- Delphine Grynberg
- Sciences Cognitives et Sciences Affectives, CNRS, CHU Lille, UMR 9193, Université de Lille, Lille, France
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Jean-Louis Nandrino
- Sciences Cognitives et Sciences Affectives, CNRS, CHU Lille, UMR 9193, Université de Lille, Lille, France
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40
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Arroyo-Anlló EM, Chamorro Sánchez J, Ortiz Oria VM, Gil R. Consciencia del otro en patologías neurodegenerativas. REVISTA LATINOAMERICANA DE PSICOLOGIA 2017. [DOI: 10.1016/j.rlp.2015.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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41
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Cognitive and Affective Empathy Disruption in Non-Fluent Primary Progressive Aphasia Syndromes. BRAIN IMPAIR 2016. [DOI: 10.1017/brimp.2016.21] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Empathy involves being able to understand and respond to others’ emotional experiences. Whilst deficits in empathy have been observed in frontotemporal dementia, the extent to which empathy is disrupted in dementia syndromes with predominant language impairment remains unclear. The current study investigated cognitive and affective empathy in the two non-fluent primary progressive aphasia syndromes: progressive non-fluent aphasia (PNFA) and logopenic progressive aphasia (LPA). Informants of 23 PNFA and 16 LPA patients completed the Interpersonal Reactivity Index (IRI), regarding patients’ capacity for empathy pre- and post-disease onset. Twenty-four healthy control participants completed the self-rated IRI for comparison of post-disease empathy capabilities. Within-group analyses revealed reduced cognitive empathy and increased personal distress in both patient groups. In addition, lowered affective empathy was reported in PNFA, with a similar trend observed in LPA. Interestingly, reduced affective empathy was associated with greater carer burden in LPA. Between-group analyses revealed reduced cognitive empathy in both patient groups relative to controls. The current study is the first to document empathy changes in PNFA and LPA, offering insight into the social cognitive deficits experienced in these syndromes. Future neuroimaging studies are needed to identify the underlying neural correlates and mechanisms driving empathy deficits in PNFA and LPA.
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42
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Oliver LD, Neufeld RW, Dziobek I, Mitchell DG. Distinguishing the relationship between different aspects of empathic responding as a function of psychopathic, autistic, and anxious traits. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.04.058] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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43
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Dermody N, Wong S, Ahmed R, Piguet O, Hodges JR, Irish M. Uncovering the Neural Bases of Cognitive and Affective Empathy Deficits in Alzheimer’s Disease and the Behavioral-Variant of Frontotemporal Dementia. J Alzheimers Dis 2016; 53:801-16. [DOI: 10.3233/jad-160175] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Nadene Dermody
- School of Psychology, The University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Randwick, Sydney, Australia
| | - Stephanie Wong
- Neuroscience Research Australia, Randwick, Sydney, Australia
- Australian Research Council Centre for Excellence in Cognition and its Disorders, Sydney, Australia
| | - Rebekah Ahmed
- Neuroscience Research Australia, Randwick, Sydney, Australia
- Prince of Wales Clinical School, Faculty of Medicine, The University of New South Wales, Sydney, Australia
| | - Olivier Piguet
- Neuroscience Research Australia, Randwick, Sydney, Australia
- School of Medical Science, The University of New South Wales, Sydney, Australia
- Australian Research Council Centre for Excellence in Cognition and its Disorders, Sydney, Australia
| | - John R. Hodges
- Neuroscience Research Australia, Randwick, Sydney, Australia
- School of Medical Science, The University of New South Wales, Sydney, Australia
- Australian Research Council Centre for Excellence in Cognition and its Disorders, Sydney, Australia
| | - Muireann Irish
- School of Psychology, The University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Randwick, Sydney, Australia
- Australian Research Council Centre for Excellence in Cognition and its Disorders, Sydney, Australia
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44
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Fong SS, Navarrete CD, Perfecto SE, Carr AR, Jimenez EE, Mendez MF. Behavioral and autonomic reactivity to moral dilemmas in frontotemporal dementia versus Alzheimer's disease. Soc Neurosci 2016; 12:409-418. [PMID: 27151065 DOI: 10.1080/17470919.2016.1186111] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The personal/impersonal distinction of moral decision-making postulates intuitive emotional responses from medial frontal activity and rational evaluation from lateral frontal activity. This model can be analyzed in behavioral variant frontotemporal dementia (bvFTD), a disorder characterized by impaired emotional intuitions, ventromedial prefrontal cortex (vmPFC) involvement, and relative sparing of lateral frontal regions. Moral dilemmas were presented to 10 bvFTD, 11 Alzheimer's disease (AD), and 9 healthy control (HC) participants while recording skin conductance responses, a measure of emotional arousal. We evaluated their personal versus impersonal conflict, subjective discomfort, and adherence to social norms. Replicating prior work, bvFTD participants were more willing to harm in the personal, but not the impersonal, dilemma compared to AD and HC groups. BvFTD participants had lower arousal and less of an increase in conflict on the personal versus the impersonal dilemma, in contrast to increased arousal and conflict for the AD and HC groups. Furthermore, bvFTD participants verbalized less discomfort, a correlate of low adherence to social norms. These findings support impaired emotional reactions to moral dilemmas in bvFTD and vmPFC lesions and the personal/impersonal model. It suggests a reversion to utilitarian-like considerations when emotional intuition is impaired in the brain.
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Affiliation(s)
- Sylvia S Fong
- a Department of Neurology, David Geffen School of Medicine , University of California at Los Angeles , Los Angeles , CA , USA.,b Section of Neurology , V.A. Greater Los Angeles Healthcare Center , Los Angeles , CA , USA
| | | | - Sean E Perfecto
- a Department of Neurology, David Geffen School of Medicine , University of California at Los Angeles , Los Angeles , CA , USA
| | - Andrew R Carr
- b Section of Neurology , V.A. Greater Los Angeles Healthcare Center , Los Angeles , CA , USA
| | - Elvira E Jimenez
- a Department of Neurology, David Geffen School of Medicine , University of California at Los Angeles , Los Angeles , CA , USA.,b Section of Neurology , V.A. Greater Los Angeles Healthcare Center , Los Angeles , CA , USA
| | - Mario F Mendez
- a Department of Neurology, David Geffen School of Medicine , University of California at Los Angeles , Los Angeles , CA , USA.,b Section of Neurology , V.A. Greater Los Angeles Healthcare Center , Los Angeles , CA , USA.,d Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine , University of California at Los Angeles , Los Angeles , CA , USA
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45
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Cohen MH, Carton AM, Hardy CJ, Golden HL, Clark CN, Fletcher PD, Jaisin K, Marshall CR, Henley SMD, Rohrer JD, Crutch SJ, Warren JD. Processing emotion from abstract art in frontotemporal lobar degeneration. Neuropsychologia 2016; 81:245-254. [PMID: 26748236 PMCID: PMC4749539 DOI: 10.1016/j.neuropsychologia.2015.12.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 12/19/2015] [Accepted: 12/30/2015] [Indexed: 01/25/2023]
Abstract
art may signal emotions independently of a biological or social carrier: it might therefore constitute a test case for defining brain mechanisms of generic emotion decoding and the impact of disease states on those mechanisms. This is potentially of particular relevance to diseases in the frontotemporal lobar degeneration (FTLD) spectrum. These diseases are often led by emotional impairment despite retained or enhanced artistic interest in at least some patients. However, the processing of emotion from art has not been studied systematically in FTLD. Here we addressed this issue using a novel emotional valence matching task on abstract paintings in patients representing major syndromes of FTLD (behavioural variant frontotemporal dementia, n=11; sematic variant primary progressive aphasia (svPPA), n=7; nonfluent variant primary progressive aphasia (nfvPPA), n=6) relative to healthy older individuals (n=39). Performance on art emotion valence matching was compared between groups taking account of perceptual matching performance and assessed in relation to facial emotion matching using customised control tasks. Neuroanatomical correlates of art emotion processing were assessed using voxel-based morphometry of patients' brain MR images. All patient groups had a deficit of art emotion processing relative to healthy controls; there were no significant interactions between syndromic group and emotion modality. Poorer art emotion valence matching performance was associated with reduced grey matter volume in right lateral occopitotemporal cortex in proximity to regions previously implicated in the processing of dynamic visual signals. Our findings suggest that abstract art may be a useful model system for investigating mechanisms of generic emotion decoding and aesthetic processing in neurodegenerative diseases.
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Affiliation(s)
- Miriam H Cohen
- Dementia Research Centre, UCL Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, United Kingdom
| | - Amelia M Carton
- Dementia Research Centre, UCL Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, United Kingdom
| | - Christopher J Hardy
- Dementia Research Centre, UCL Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, United Kingdom
| | - Hannah L Golden
- Dementia Research Centre, UCL Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, United Kingdom
| | - Camilla N Clark
- Dementia Research Centre, UCL Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, United Kingdom
| | - Phillip D Fletcher
- Dementia Research Centre, UCL Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, United Kingdom
| | - Kankamol Jaisin
- Dementia Research Centre, UCL Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, United Kingdom
| | - Charles R Marshall
- Dementia Research Centre, UCL Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, United Kingdom
| | - Susie M D Henley
- Dementia Research Centre, UCL Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, United Kingdom
| | - Jonathan D Rohrer
- Dementia Research Centre, UCL Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, United Kingdom
| | - Sebastian J Crutch
- Dementia Research Centre, UCL Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, United Kingdom
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, United Kingdom.
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