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Rabini G, Meli C, Prodomi G, Speranza C, Anzini F, Funghi G, Pierotti E, Saviola F, Fumagalli GG, Di Giacopo R, Malaguti MC, Jovicich J, Dodich A, Papagno C, Turella L. Tango and physiotherapy interventions in Parkinson's disease: a pilot study on efficacy outcomes on motor and cognitive skills. Sci Rep 2024; 14:11855. [PMID: 38789492 PMCID: PMC11126665 DOI: 10.1038/s41598-024-62786-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Pharmacological treatments in Parkinson's disease (PD), albeit effective in alleviating many motor symptoms, have limited effects in non-motor signatures as cognitive impairment, as well as in other aspects included postural instability. Consequently, complementary interventions are nowadays a prerogative of clinical practice managing PD symptomatology. In this pilot longitudinal study, we recruited twenty-four PD patients participating in one of two interventions: adapted Argentine Tango or group-based physiotherapy. Participants underwent a motor and neuropsychological evaluation before and after four months of activities, carried out twice a week. We found a general stabilization of motor and cognitive abilities, with significant improvements in several motor skills, mainly pertaining to static and dynamic balance, similarly in both groups. At cognitive level, we measured a significant improvement in both groups in the Action Naming task. Interestingly, only PD patients in the Tango group improved their performance in the test measuring facial emotion recognition. These findings highlight the crucial role that physical activities have in the stabilization and slowdown of disease's progression in PD. They further highlight the beneficial effects of a group-based physical intervention, which, especially in the case of Tango, could lead to behavioral ameliorations in domains other than the motor, such as emotion recognition.
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Affiliation(s)
- Giuseppe Rabini
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy.
| | - Claudia Meli
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Giulia Prodomi
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Chiara Speranza
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Federica Anzini
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Giulia Funghi
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Enrica Pierotti
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Francesca Saviola
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Giorgio Giulio Fumagalli
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Raffaella Di Giacopo
- Neurology Unit, Rovereto Hospital, Azienda Provinciale per i Servizi Sanitari (APSS) di Trento, Trento, Italy
| | - Maria Chiara Malaguti
- Neurology Unit, Rovereto Hospital, Azienda Provinciale per i Servizi Sanitari (APSS) di Trento, Trento, Italy
| | - Jorge Jovicich
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Alessandra Dodich
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Costanza Papagno
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Luca Turella
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
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Maggi G, Giacobbe C, Vitale C, Amboni M, Obeso I, Santangelo G. Theory of mind in mild cognitive impairment and Parkinson's disease: The role of memory impairment. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2024; 24:156-170. [PMID: 38049608 PMCID: PMC10827829 DOI: 10.3758/s13415-023-01142-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Social cognition is impaired in Parkinson's disease (PD). Whether social cognitive impairment (iSC) is a by-product of the underlying cognitive deficits in PD or a process independent of cognitive status is unknown. To this end, the present study was designed to investigate the weight of specific cognitive deficits in social cognition, considering different mild cognitive impairment subtypes of PD (PD-MCI). METHODS Fifty-eight PD patients underwent a neuropsychological battery assessing executive functions, memory, language, and visuospatial domains, together with social cognitive tests focused on theory of mind (ToM). Patients were divided into subgroups according to their clinical cognitive status: amnestic PD-MCI (PD-aMCI, n = 18), non-amnestic PD-MCI (PD-naMCI, n = 16), and cognitively unimpaired (PD-CU, n = 24). Composite scores for cognitive and social domains were computed to perform mediation analyses. RESULTS Memory and language impairments mediated the effect of executive functioning in social cognitive deficits in PD patients. Dividing by MCI subgroups, iSC occurred more frequently in PD-aMCI (77.8%) than in PD-naMCI (18.8%) and PD-CU (8.3%). Moreover, PD-aMCI performed worse than PD-CU in all social cognitive measures, whereas PD-naMCI performed worse than PD-CU in only one subtype of the affective and cognitive ToM tests. CONCLUSIONS Our findings suggest that ToM impairment in PD can be explained by memory dysfunction that mediates executive control. ToM downsides in the amnesic forms of PD-MCI may suggest that subtle changes in social cognition could partly explain future transitions into dementia. Hence, the evaluation of social cognition in PD is critical to characterize a possible behavioral marker of cognitive decline.
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Affiliation(s)
- Gianpaolo Maggi
- Department of Psychology, University of Campania "Luigi Vanvitelli," Viale Ellittico, 31, 81100, Caserta, Italy.
| | - Chiara Giacobbe
- Department of Psychology, University of Campania "Luigi Vanvitelli," Viale Ellittico, 31, 81100, Caserta, Italy
| | - Carmine Vitale
- Institute of Diagnosis and Health, IDC-Hermitage Capodimonte, Naples, Italy
- Department of Motor Sciences and Wellness, University "Parthenope, Naples, Italy
| | - Marianna Amboni
- Institute of Diagnosis and Health, IDC-Hermitage Capodimonte, Naples, Italy
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Ignacio Obeso
- HM Hospitales - Centro Integral de Neurociencias AC HM CINAC, Hospital Universitario HM Puerta del Sur, HM Hospitales, Avda. Carlos V, 70. 28938, Móstoles, Madrid, Spain.
- Department of Psychobiology and Methods on Behavioural Sciences, Complutense University of Madrid, Madrid, Spain.
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli," Viale Ellittico, 31, 81100, Caserta, Italy.
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Maggio MG, Billeri L, Cardile D, Quartarone A, Calabrò RS. The Role of Innovation Technology in the Rehabilitation of Patients Affected by Huntington's Disease: A Scoping Review. Biomedicines 2023; 12:39. [PMID: 38255146 PMCID: PMC10813604 DOI: 10.3390/biomedicines12010039] [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: 11/22/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Huntington's disease is an autosomal dominant neurodegenerative disease caused by the repetition of cytosine, adenine, and guanine trinucleotides on the short arm of chromosome 4p16.3 within the Huntingtin gene. In this study, we aim to examine and map the existing evidence on the use of innovations in the rehabilitation of Huntington's disease. A scoping review was conducted on innovative rehabilitative treatments performed on patients with Huntington's disease. A search was performed on PubMed, Embase, Web of Science, and Cochrane databases to screen references of included studies and review articles for additional citations. Of an initial 1117 articles, only 20 met the search criteria. These findings showed that available evidence is still limited and that studies generally had small sample sizes and a high risk of bias. Regarding cognitive rehabilitation, it has emerged that VR- and PC-based methods as well as NIBS techniques are feasible and may have promising effects in individuals with Huntington's disease. On the other hand, scarce evidence was found for cognitive and motor training that might have a slight impact on overall cognitive function in individuals with Huntington's disease. Data show that further investigation is needed to explore the effects of innovative rehabilitation tools on cognition, especially considering that cognitive and psychiatric symptoms can precede the onset of motor symptoms by many years.
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Affiliation(s)
| | | | - Davide Cardile
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy; (M.G.M.); (L.B.)
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Mirzai N, Polet K, Morisot A, Hesse S, Pesce A, Louchart de la Chapelle S, Iakimova G. Can the Ability to Recognize Facial Emotions in Individuals With Neurodegenerative Disease be Improved? A Systematic Review and Meta-analysis. Cogn Behav Neurol 2023; 36:202-218. [PMID: 37410880 PMCID: PMC10683976 DOI: 10.1097/wnn.0000000000000348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 03/30/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Facial emotion recognition (FER) is commonly impaired in individuals with neurodegenerative disease (NDD). This impairment has been linked to an increase in behavioral disorders and caregiver burden. OBJECTIVE To identify interventions targeting the improvement of FER ability in individuals with NDD and investigate the magnitude of the efficacy of the interventions. We also wanted to explore the duration of the effects of the intervention and their possible impacts on behavioral and psychological symptoms of dementia and caregiver burden. METHOD We included 15 studies with 604 individuals who had been diagnosed with NDD. The identified interventions were categorized into three types of approach (cognitive, neurostimulation, and pharmacological) as well as a combined approach (neurostimulation with pharmacological). RESULTS The three types of approaches pooled together had a significant large effect size for FER ability improvement (standard mean difference: 1.21, 95% CI = 0.11, 2.31, z = 2.15, P = 0.03). The improvement lasted post intervention, in tandem with a decrease in behavioral disorders and caregiver burden. CONCLUSION A combination of different approaches for FER ability improvement may be beneficial for individuals with NDD and their caregivers.
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Affiliation(s)
- Naz Mirzai
- Clinical Research Unit–Memory Clinic, Princess Grace Hospital, Monaco
- Cote d’Azur University, Laboratory of Clinical, Cognitive and Social Anthropology and Psychology, Nice, France
| | - Kévin Polet
- Clinical Research Unit–Memory Clinic, Princess Grace Hospital, Monaco
| | - Adeline Morisot
- Clinical Research Unit–Memory Clinic, Princess Grace Hospital, Monaco
- Public Health Department, Cote d’Azur University, University Hospital Center of Nice, Nice, France
| | - Solange Hesse
- Clinical Research Unit–Memory Clinic, Princess Grace Hospital, Monaco
| | - Alain Pesce
- Bibliographic Research Association for Neurosciences, Nice, France
| | | | - Galina Iakimova
- Cote d’Azur University, Laboratory of Clinical, Cognitive and Social Anthropology and Psychology, Nice, France
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Wong D, Pike K, Stolwyk R, Allott K, Ponsford J, McKay A, Longley W, Bosboom P, Hodge A, Kinsella G, Mowszowski L. Delivery of Neuropsychological Interventions for Adult and Older Adult Clinical Populations: An Australian Expert Working Group Clinical Guidance Paper. Neuropsychol Rev 2023:10.1007/s11065-023-09624-0. [PMID: 38032472 DOI: 10.1007/s11065-023-09624-0] [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: 04/12/2022] [Accepted: 10/16/2023] [Indexed: 12/01/2023]
Abstract
Delivery of neuropsychological interventions addressing the cognitive, psychological, and behavioural consequences of brain conditions is increasingly recognised as an important, if not essential, skill set for clinical neuropsychologists. It has the potential to add substantial value and impact to our role across clinical settings. However, there are numerous approaches to neuropsychological intervention, requiring different sets of skills, and with varying levels of supporting evidence across different diagnostic groups. This clinical guidance paper provides an overview of considerations and recommendations to help guide selection, delivery, and implementation of neuropsychological interventions for adults and older adults. We aimed to provide a useful source of information and guidance for clinicians, health service managers, policy-makers, educators, and researchers regarding the value and impact of such interventions. Considerations and recommendations were developed by an expert working group of neuropsychologists in Australia, based on relevant evidence and consensus opinion in consultation with members of a national clinical neuropsychology body. While the considerations and recommendations sit within the Australian context, many have international relevance. We include (i) principles important for neuropsychological intervention delivery (e.g. being based on biopsychosocial case formulation and person-centred goals); (ii) a description of clinical competencies important for effective intervention delivery; (iii) a summary of relevant evidence in three key cohorts: acquired brain injury, psychiatric disorders, and older adults, focusing on interventions with sound evidence for improving activity and participation outcomes; (iv) an overview of considerations for sustainable implementation of neuropsychological interventions as 'core business'; and finally, (v) a call to action.
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Affiliation(s)
- Dana Wong
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Kerryn Pike
- School of Psychology and Public Health & John Richards Centre for Rural Ageing Research, La Trobe University, Melbourne, Australia
- School of Applied Psychology, Griffith University, Gold Coast, Australia
| | - Rene Stolwyk
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Kelly Allott
- , Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Jennie Ponsford
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Adam McKay
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- MERRC, Rehabilitation and Mental Health Division, Epworth HealthCare, Richmond, Australia
| | - Wendy Longley
- Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, Sydney, Australia
- The Uniting War Memorial Hospital, Waverley, Sydney, Australia
| | - Pascalle Bosboom
- MindLink Psychology, West Perth, Australia
- School of Psychological Science, University of Western Australia, Crawley, Australia
| | | | - Glynda Kinsella
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Loren Mowszowski
- Faculty of Science, School of Psychology & Brain and Mind Centre, The University of Sydney, Sydney, Australia
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Zhou H, Liu Z. Realization of Self-Adaptive Higher Teaching Management Based Upon Expression and Speech Multimodal Emotion Recognition. Front Psychol 2022; 13:857924. [PMID: 35418897 PMCID: PMC8997584 DOI: 10.3389/fpsyg.2022.857924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/09/2022] [Indexed: 11/29/2022] Open
Abstract
In the process of communication between people, everyone will have emotions, and different emotions will have different effects on communication. With the help of external performance information accompanied by emotional expression, such as emotional speech signals or facial expressions, people can easily communicate with each other and understand each other. Emotion recognition is an important network of affective computers and research centers for signal processing, pattern detection, artificial intelligence, and human-computer interaction. Emotions convey important information in human communication and communication. Since the end of the last century, people have started the research on emotion recognition, especially how to correctly judge the emotion type has invested a lot of time and energy. In this paper, multi-modal emotion recognition is introduced to recognize facial expressions and speech, and conduct research on adaptive higher education management. Language and expression are the most direct ways for people to express their emotions. After obtaining the framework of the dual-modal emotion recognition system, the BOW model is used to identify the characteristic movement of local areas or key points. The recognition rates of emotion recognition for 1,000 audios of anger, disgust, fear, happiness, sadness and surprise are: 97.3, 83.75, 64.87, 89.87, 84.12, and 86.68%, respectively.
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Affiliation(s)
- Huihui Zhou
- School of Education, University of Perpetual Help System DALTA, Las Piñas, Philippines
| | - Zheng Liu
- School of Hunanities and Communications, ZheJiang GongShang University, Hangzhou, China.,School of Journalism, Fudan University, Shanghai, China
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7
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Environmental stimulation in Huntington disease patients and animal models. Neurobiol Dis 2022; 171:105725. [DOI: 10.1016/j.nbd.2022.105725] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/03/2022] [Accepted: 04/08/2022] [Indexed: 01/07/2023] Open
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Lemercier P, Cleret de Langavant L, Hamet Bagnou J, Youssov K, Lemoine L, Audureau E, Massart R, Bachoud-Lévi AC. Self-Reported Social Relationship Capacities Predict Motor, Functional and Cognitive Decline in Huntington’s Disease. J Pers Med 2022; 12:jpm12020174. [PMID: 35207662 PMCID: PMC8879028 DOI: 10.3390/jpm12020174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 12/10/2022] Open
Abstract
Huntington’s Disease (HD) is an inherited neurodegenerative disease characterized by a combination of motor, cognitive, and behavioral disorders. The social and behavioral symptoms observed in HD patients impact their quality of life and probably explain their relational difficulties, conflicts, and social withdrawal. In this study, we described the development of the Social Relationship Self-Questionnaire (SRSQ), a self-reporting questionnaire that assesses how HD patients perceived their social relationships. The scale was proposed for 66 HD patients at an early stage of the disease, 32 PreHD patients (individuals carrying the mutant gene without motor symptoms), and 66 controls. The HD patients were included in a prospective longitudinal follow-up for an average of 1.07 years with motor, functional, cognitive, and behavioral assessments. Based on the HD patients’ answers at baseline, we identified two domains in the SRSQ. The first domain was related to social motivation and correlated with cognitive performance. The second domain was related to emotional insight and correlated with behavioral symptoms such as apathy, anxiety, and irritability. We discovered that both SRSQ domain scores at baseline predicted future motor, functional, and cognitive decline in HD.
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Affiliation(s)
- Pablo Lemercier
- Département d’Etudes Cognitives, Ecole Normale Supérieure, PSL University, 75005 Paris, France; (P.L.); (L.C.d.L.); (J.H.B.); (K.Y.); (L.L.); (R.M.)
- Equipe NeuroPsychologie Interventionnelle, Institut Mondor de Recherche Biomédicale, INSERM U955, University Paris Est Créteil, 94000 Créteil, France
- Centre National de Référence Maladie de Huntington, Service de Neurologie, Hôpital Henri Mondor-Albert Chenevier, AP-HP, 94000 Créteil, France
- NeurATRIS, 94000 Créteil, France
| | - Laurent Cleret de Langavant
- Département d’Etudes Cognitives, Ecole Normale Supérieure, PSL University, 75005 Paris, France; (P.L.); (L.C.d.L.); (J.H.B.); (K.Y.); (L.L.); (R.M.)
- Equipe NeuroPsychologie Interventionnelle, Institut Mondor de Recherche Biomédicale, INSERM U955, University Paris Est Créteil, 94000 Créteil, France
- Centre National de Référence Maladie de Huntington, Service de Neurologie, Hôpital Henri Mondor-Albert Chenevier, AP-HP, 94000 Créteil, France
- NeurATRIS, 94000 Créteil, France
| | - Jennifer Hamet Bagnou
- Département d’Etudes Cognitives, Ecole Normale Supérieure, PSL University, 75005 Paris, France; (P.L.); (L.C.d.L.); (J.H.B.); (K.Y.); (L.L.); (R.M.)
- Equipe NeuroPsychologie Interventionnelle, Institut Mondor de Recherche Biomédicale, INSERM U955, University Paris Est Créteil, 94000 Créteil, France
- Centre National de Référence Maladie de Huntington, Service de Neurologie, Hôpital Henri Mondor-Albert Chenevier, AP-HP, 94000 Créteil, France
- NeurATRIS, 94000 Créteil, France
| | - Katia Youssov
- Département d’Etudes Cognitives, Ecole Normale Supérieure, PSL University, 75005 Paris, France; (P.L.); (L.C.d.L.); (J.H.B.); (K.Y.); (L.L.); (R.M.)
- Centre National de Référence Maladie de Huntington, Service de Neurologie, Hôpital Henri Mondor-Albert Chenevier, AP-HP, 94000 Créteil, France
- NeurATRIS, 94000 Créteil, France
| | - Laurie Lemoine
- Département d’Etudes Cognitives, Ecole Normale Supérieure, PSL University, 75005 Paris, France; (P.L.); (L.C.d.L.); (J.H.B.); (K.Y.); (L.L.); (R.M.)
- Equipe NeuroPsychologie Interventionnelle, Institut Mondor de Recherche Biomédicale, INSERM U955, University Paris Est Créteil, 94000 Créteil, France
- Centre National de Référence Maladie de Huntington, Service de Neurologie, Hôpital Henri Mondor-Albert Chenevier, AP-HP, 94000 Créteil, France
- NeurATRIS, 94000 Créteil, France
| | - Etienne Audureau
- Clinical Epidemiology and Ageing, Service de Santé Publique, Henri Mondor Hospital, AP-HP, 94000 Créteil, France;
| | - Renaud Massart
- Département d’Etudes Cognitives, Ecole Normale Supérieure, PSL University, 75005 Paris, France; (P.L.); (L.C.d.L.); (J.H.B.); (K.Y.); (L.L.); (R.M.)
- Equipe NeuroPsychologie Interventionnelle, Institut Mondor de Recherche Biomédicale, INSERM U955, University Paris Est Créteil, 94000 Créteil, France
- Centre National de Référence Maladie de Huntington, Service de Neurologie, Hôpital Henri Mondor-Albert Chenevier, AP-HP, 94000 Créteil, France
- NeurATRIS, 94000 Créteil, France
| | - Anne-Catherine Bachoud-Lévi
- Département d’Etudes Cognitives, Ecole Normale Supérieure, PSL University, 75005 Paris, France; (P.L.); (L.C.d.L.); (J.H.B.); (K.Y.); (L.L.); (R.M.)
- Equipe NeuroPsychologie Interventionnelle, Institut Mondor de Recherche Biomédicale, INSERM U955, University Paris Est Créteil, 94000 Créteil, France
- Centre National de Référence Maladie de Huntington, Service de Neurologie, Hôpital Henri Mondor-Albert Chenevier, AP-HP, 94000 Créteil, France
- NeurATRIS, 94000 Créteil, France
- Correspondence:
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Pfalzer AC, Hale LM, Huitz E, Buchanan DA, Brown BK, Moroz S, Rouleau RM, Hay KR, Hoadley J, Laird A, Ciriegio AE, Watson KH, Jones MT, Lin YC, Kang H, Riordan H, Isaacs DA, McDonell KE, Compas BE, Claassen DO. Healthcare Delivery and Huntington's Disease During the Time of COVID-19. J Huntingtons Dis 2021; 10:313-322. [PMID: 33896846 DOI: 10.3233/jhd-200460] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Safer-at-home orders during the COVID-19 pandemic altered the structure of clinical care for Huntington's disease (HD) patients. This shift provided an opportunity to identify limitations in the current healthcare infrastructure and how these may impact the health and well-being of persons with HD. OBJECTIVE The study objectives were to assess the feasibility of remote healthcare delivery in HD patients, to identify socioeconomic factors which may explain differences in feasibility and to evaluate the impact of safer-at-home orders on HD patient stress levels. METHODS This observational study of a clinical HD population during the 'safer-at-home' orders asked patients or caregivers about their current access to healthcare resources and patient stress levels. A chart review allowed for an assessment of socioeconomic status and characterization of HD severity. RESULTS Two-hundred and twelve HD patients were contacted with 156 completing the survey. During safer-at-home orders, the majority of HD patients were able to obtain medications and see a physician; however, 25% of patients would not commit to regular telehealth visits, and less than 50% utilized an online healthcare platform. We found that 37% of participants were divorced/single, 39% had less than a high school diploma, and nearly 20% were uninsured or on low-income health insurance. Patient stress levels correlated with disease burden. CONCLUSION A significant portion of HD participants were not willing to participate in telehealth services. Potential explanations for these limitations may include socioeconomic barriers and caregiving structure. These observations illustrate areas for clinical care improvement to address healthcare disparities in the HD community.
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Affiliation(s)
- Anna C Pfalzer
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lisa M Hale
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Elizabeth Huitz
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Danielle A Buchanan
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brittany K Brown
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sarah Moroz
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Renee M Rouleau
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kaitlyn R Hay
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jennifer Hoadley
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amy Laird
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Abagail E Ciriegio
- Department of Psychology and Human Development, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kelly H Watson
- Department of Psychology and Human Development, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Maile T Jones
- Department of Psychology and Human Development, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ya-Chen Lin
- Vanderbilt University Medical Center, Vanderbilt University, Nashville, TN, USA
| | - Hakmook Kang
- Vanderbilt University Medical Center, Vanderbilt University, Nashville, TN, USA
| | - Heather Riordan
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - David A Isaacs
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Katherine E McDonell
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bruce E Compas
- Department of Psychology and Human Development, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
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Problems with Social Cognition and Decision-Making in Huntington's Disease: Why Is it Important? Brain Sci 2021; 11:brainsci11070838. [PMID: 34202701 PMCID: PMC8301991 DOI: 10.3390/brainsci11070838] [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: 05/12/2021] [Revised: 06/11/2021] [Accepted: 06/18/2021] [Indexed: 01/21/2023] Open
Abstract
Huntington’s disease starts slowly and progresses over a 15–20 year period. Motor changes begin subtly, often going unnoticed by patients although they are typically visible to those close to them. At this point, it is the early non-motor problems of HD that arguably cause the most functional impairment. Approximately 65% of gene carriers will experience a reduction in their occupational level, and just under half will feel unable to manage their finances independently before a clinical diagnosis is made. Understanding what drives this impairment in activities of daily living is the key to helping people with HD to live more independently for longer, especially in early disease. Early cognitive decline is likely to play a contributory factor although few studies have looked directly at this relationship. Recently, it has been shown that along with the well documented dysexecutive syndrome seen in HD, changes in social cognition and decision-making are more common than previously thought. Furthermore, some of the early neuropathological and neurochemical changes seen in HD disrupt networks known to be involved in social functioning. In this review, we explore how HD changes the way individuals interact in a social world. Specifically, we summarise the literature on both classical and social decision-making (value-based decision-making in a social context) along with studies of theory of mind, empathy, alexithymia, and emotion recognition in HD. The literature specific to HD is discussed and supported by evidence from similar neurodegenerative disorders and healthy individuals to propose future directions and potential therapeutic avenues to be explored.
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11
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Manuel AL, Roquet D, Landin-Romero R, Kumfor F, Ahmed RM, Hodges JR, Piguet O. Interactions between decision-making and emotion in behavioral-variant frontotemporal dementia and Alzheimer's disease. Soc Cogn Affect Neurosci 2020; 15:681-694. [PMID: 32613246 PMCID: PMC7393308 DOI: 10.1093/scan/nsaa085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/16/2020] [Accepted: 06/15/2020] [Indexed: 12/12/2022] Open
Abstract
Negative and positive emotions are known to shape decision-making toward more or less impulsive responses, respectively. Decision-making and emotion processing are underpinned by shared brain regions including the ventromedial prefrontal cortex (vmPFC) and the amygdala. How these processes interact at the behavioral and brain levels is still unclear. We used a lesion model to address this question. Study participants included individuals diagnosed with behavioral-variant frontotemporal dementia (bvFTD, n = 18), who typically present deficits in decision-making/emotion processing and atrophy of the vmPFC, individuals with Alzheimer’s disease (AD, n = 12) who present with atrophy in limbic structures and age-matched healthy controls (CTRL, n = 15). Prior to each choice on the delay discounting task participants were cued with a positive, negative or neutral picture and asked to vividly imagine witnessing the event. As hypothesized, our findings showed that bvFTD patients were more impulsive than AD patients and CTRL and did not show any emotion-related modulation of delay discounting rate. In contrast, AD patients showed increased impulsivity when primed by negative emotion. This increased impulsivity was associated with reduced integrity of bilateral amygdala in AD but not in bvFTD. Altogether, our results indicate that decision-making and emotion interact at the level of the amygdala supporting findings from animal studies.
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Affiliation(s)
- Aurélie L Manuel
- School of Psychology, The University of Sydney, Sydney, Australia.,Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia.,Laboratory for Research in Neuroimaging LREN, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Daniel Roquet
- School of Psychology, The University of Sydney, Sydney, Australia.,Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia
| | - Ramon Landin-Romero
- School of Psychology, The University of Sydney, Sydney, Australia.,Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia
| | - Fiona Kumfor
- School of Psychology, The University of Sydney, Sydney, Australia.,Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia
| | - Rebekah M Ahmed
- Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia.,Clinical Medical School, The University of Sydney, Sydney, Australia
| | - John R Hodges
- Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia.,Clinical Medical School, The University of Sydney, Sydney, Australia
| | - Olivier Piguet
- School of Psychology, The University of Sydney, Sydney, Australia.,Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia
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Zarotti N, Fletcher I, Simpson J. New Perspectives on Emotional Processing in People with Symptomatic Huntington's Disease: Impaired Emotion Regulation and Recognition of Emotional Body Language†. Arch Clin Neuropsychol 2020; 34:610-624. [PMID: 30395151 DOI: 10.1093/arclin/acy085] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Emotion regulation and emotional body language (EBL) recognition represent two fundamental components of emotional processing that have recently seen a considerable surge in research interest, in part due to the role they play in optimizing mental health. This appears to be particularly true for clinical conditions that can profoundly affect emotional functioning. Among these is Huntington's disease (HD), a neurodegenerative disorder that is associated with several psychological difficulties and cognitive impairments, including well-established deficits in facial emotion recognition. However, although the theoretical case for impairments is strong, the current evidence in HD on other components such as emotion regulation and EBL recognition is sparse. METHOD In this study, it was hypothesized that emotion regulation and recognition of EBL are impaired in people with symptomatic HD, and that these impairments significantly and positively correlate with each other. A between-subjects design was adopted to compare 13 people with symptomatic HD with 12 non-affected controls matched for age and education. RESULTS The results showed that emotion regulation and EBL recognition were significantly impaired in individuals with HD. Moreover, a significant positive correlation was observed between facial and EBL recognition impairments, whereas EBL performance was negatively related to the disease stage. However, emotion regulation and recognition performances were not significantly correlated. CONCLUSIONS This investigation represents the first evidence of a deficit of emotion regulation and EBL recognition in individuals with HD. The clinical implications of these findings are explored, and indications for future research are proposed.
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Affiliation(s)
- Nicolò Zarotti
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Ian Fletcher
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Jane Simpson
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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13
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Yin M, Tian L, Hua W, Zhang J, Liu D. The Establishment of Weak Ecological Microexpressions Recognition Test (WEMERT): An Extension on EMERT. Front Psychol 2019; 10:275. [PMID: 30890973 PMCID: PMC6411658 DOI: 10.3389/fpsyg.2019.00275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 01/28/2019] [Indexed: 12/01/2022] Open
Abstract
The JACBART (Japanese and Caucasian Brief Affect Recognition Test) microexpression recognition test only examines facial expressions under the neutral expression background and the ecological validity is not high. The EMERT (Ecological MicroExpressions Recognition Test) microexpression recognition test examined six microexpressions under seven backgrounds but does not detect the intensity of expressions. In the current study, a weak ecological microexpression recognition test was established to examine the recognition features of six weak microexpressions in all seven high intensity basic expressions. The results found: (1) the test had good retest reliability, criterion validity and ecological validity; and (2) the reliability and validity tests revealed a lot of characteristics of weak microexpression recognition. There were training effects in some weak microexpression recognition. Weak microexpression recognition was generally positively related to the microexpression recognition of JACBART but were generally negatively related to approximate common expressions. The backgrounds main effects in all weak microexpressions were significant and pairwise comparisons show there were a wide range of differences between weak microexpressions under different backgrounds. The standard deviations, of the accuracy of weak microexpressions in different backgrounds, were used to define the fluctuations of the weak microexpression recognition and we found that weak microexpression recognition had many fluctuations. (3) Personality openness and its subdimensions (O1, O2, O3, and O5) were generally positively related to some weak microexpression recognition, except O1, which was significantly negatively related to surprise under neutrality. O1 was positively related to the standard deviation of the weak anger microexpression recognition accuracies and O6 was negatively related to the standard deviation of the weak happiness microexpression recognition accuracies in the first measurement.
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Affiliation(s)
- Ming Yin
- Jiangsu Police Institute, Nanjing, China
| | | | - Wei Hua
- School of Education, Soochow University, Soochow, China
| | - Jianxin Zhang
- School of Humanities, Jiangnan University, Wuxi, China
| | - Dianzhi Liu
- School of Education, Soochow University, Soochow, China
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14
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Abstract
OBJECTIVES People with Huntington's disease (HD) experience poor social quality of life, relationship breakdown, and social withdrawal, which are mediated to some extent by socially debilitating neuropsychiatric symptoms, such as apathy and disinhibition. Social cognitive symptoms, such as impaired emotion recognition, also occur in HD, however, the extent of their association with these socially debilitating neuropsychiatric symptoms is unknown. Our study examined the relationship between emotion recognition and symptom ratings of apathy and disinhibition in HD. METHODS Thirty-two people with premanifest or symptomatic-HD completed Part 1 of The Awareness of Social Inference Test (TASIT), which is a facial emotion recognition task. In addition, we obtained severity ratings for apathy and disinhibition on the Frontal Systems Behavior Scale (FrSBe) from a close family member. Our analyses used motor symptom severity as a proxy for disease progression. RESULTS Emotion recognition performance was significantly associated with family-ratings of apathy, above and beyond their shared association with disease severity. We found a similar pattern for disinhibition ratings, which fell short of statistical significance. As expected, worse emotion recognition performance was correlated with higher severity in FrSBe symptom ratings. CONCLUSIONS Our findings suggest that emotion recognition abilities relate to key socially debilitating neuropsychiatric symptoms in HD. Our results help to understand the functional significance of emotion recognition impairments in HD, and may have implications for the development of remediation programs aimed at improving patients' social quality of life. (JINS, 2018, 24, 417-423).
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15
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Social Cognition Dysfunctions in Neurodegenerative Diseases: Neuroanatomical Correlates and Clinical Implications. Behav Neurol 2018; 2018:1849794. [PMID: 29854017 PMCID: PMC5944290 DOI: 10.1155/2018/1849794] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 04/03/2018] [Accepted: 04/11/2018] [Indexed: 02/07/2023] Open
Abstract
Social cognitive function, involved in the perception, processing, and interpretation of social information, has been shown to be crucial for successful communication and interpersonal relationships, thereby significantly impacting mental health, well-being, and quality of life. In this regard, assessment of social cognition, mainly focusing on four key domains, such as theory of mind (ToM), emotional empathy, and social perception and behavior, has been increasingly evaluated in clinical settings, given the potential implications of impairments of these skills for therapeutic decision-making. With regard to neurodegenerative diseases (NDs), most disorders, characterized by variable disease phenotypes and progression, although similar for the unfavorable prognosis, are associated to impairments of social cognitive function, with consequent negative effects on patients' management. Specifically, in some NDs these deficits may represent core diagnostic criteria, such as for behavioral variant frontotemporal dementia (bvFTD), or may emerge during the disease course as critical aspects, such as for Parkinson's and Alzheimer's diseases. On this background, we aimed to revise the most updated evidence on the neurobiological hypotheses derived from network-based approaches, clinical manifestations, and assessment tools of social cognitive dysfunctions in NDs, also prospecting potential benefits on patients' well-being, quality of life, and outcome derived from potential therapeutic perspectives of these deficits.
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16
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Marshall CR, Hardy CJD, Russell LL, Clark CN, Bond RL, Dick KM, Brotherhood EV, Mummery CJ, Schott JM, Rohrer JD, Kilner JM, Warren JD. Motor signatures of emotional reactivity in frontotemporal dementia. Sci Rep 2018; 8:1030. [PMID: 29348485 PMCID: PMC5773553 DOI: 10.1038/s41598-018-19528-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 01/04/2018] [Indexed: 11/18/2022] Open
Abstract
Automatic motor mimicry is essential to the normal processing of perceived emotion, and disrupted automatic imitation might underpin socio-emotional deficits in neurodegenerative diseases, particularly the frontotemporal dementias. However, the pathophysiology of emotional reactivity in these diseases has not been elucidated. We studied facial electromyographic responses during emotion identification on viewing videos of dynamic facial expressions in 37 patients representing canonical frontotemporal dementia syndromes versus 21 healthy older individuals. Neuroanatomical associations of emotional expression identification accuracy and facial muscle reactivity were assessed using voxel-based morphometry. Controls showed characteristic profiles of automatic imitation, and this response predicted correct emotion identification. Automatic imitation was reduced in the behavioural and right temporal variant groups, while the normal coupling between imitation and correct identification was lost in the right temporal and semantic variant groups. Grey matter correlates of emotion identification and imitation were delineated within a distributed network including primary visual and motor, prefrontal, insular, anterior temporal and temporo-occipital junctional areas, with common involvement of supplementary motor cortex across syndromes. Impaired emotional mimesis may be a core mechanism of disordered emotional signal understanding and reactivity in frontotemporal dementia, with implications for the development of novel physiological biomarkers of socio-emotional dysfunction in these diseases.
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Affiliation(s)
- Charles R Marshall
- Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK.
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK.
| | - Chris J D Hardy
- Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
| | - Lucy L Russell
- Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
| | - Camilla N Clark
- Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
| | - Rebecca L Bond
- Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
| | - Katrina M Dick
- Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
| | - Emilie V Brotherhood
- Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
| | - Cath J Mummery
- Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
| | - Jonathan M Schott
- Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
| | - James M Kilner
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
| | - Jason D Warren
- Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
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