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Boutoleau-Bretonnière C, Kapogiannis D, El Haj M. The guaranteed euros: Probabilistic discounting in behavioural-variant frontotemporal dementia. J Neuropsychol 2024; 18:239-250. [PMID: 38135907 DOI: 10.1111/jnp.12357] [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: 09/14/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
Financial decision-making requires trading off between guaranteed and probabilistic outcomes and between immediate and delayed ones. While research has demonstrated that patients with behavioural-variant frontotemporal dementia (bvFTD) prefer immediate rewards at the expense of future ones (i.e. temporal discounting), little is known about how patients choose between smaller, guaranteed and larger, but probabilistic, outcomes (i.e. probabilistic discounting). We thus investigated probabilistic discounting by inviting 18 patients with bvFTD and 20 control participants to choose between fixed smaller monetary amounts and a fixed larger monetary amount with a variated probability of occurrence (e.g. 'Would you rather have 40€ for sure or a 20% chance of winning 100€?'). Results demonstrated lower scores, indicating higher risk tolerance, on the probabilistic discounting task in patients with bvFTD (while impulsively choosing more immediate rewards on the temporal discounting task) compared to control participants. Probabilistic discounting was significantly correlated with a decline in general cognitive performance in patients with bvFTD. When dealing between smaller, guaranteed, and larger, but probabilistic, rewards, patients with bvFTD tend to prefer guaranteed rewards and discount the uncertain ones.
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Affiliation(s)
| | - Dimitrios Kapogiannis
- Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, Maryland, USA
| | - Mohamad El Haj
- Clinical Gerontology Department, CHU Nantes, Nantes, France
- Institut Universitaire de France, Paris, France
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2
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Haeger A, Muising J, Romanzetti S, Fimm B, Matz O, Schulz JB, Heim S, Reetz K. Communicative impairment and its neural correlates in Alzheimer's disease and frontotemporal dementia. Brain Behav 2024; 14:e3420. [PMID: 38494763 PMCID: PMC10945087 DOI: 10.1002/brb3.3420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 03/19/2024] Open
Abstract
OBJECTIVE Communication skills can deteriorate in neurodegenerative diseases such as Alzheimer's disease (AD) and frontotemporal dementia (FTD); however, their clinical assessment and treatment in patient care can be challenging. In the present study, we aimed to quantify the distinctive communication resources and barriers reported by patients and their relatives in AD and FTD and associated these communicative characteristics with clinical parameters, such as the degree of cognitive impairment and atrophy in language-associated brain areas. METHODS We assessed self-reported communication barriers and resources in 33 individuals with AD and FTD through an interview on daily-life communication, using the Aachener KOMPASS questionnaire. We correlated reported communication barriers and resources with atrophy from high-resolution 3T brain magnetic resonance imaging, neuropsychological assessment, and neurodegenerative markers from cerebrospinal fluid. RESULTS Communicative impairment was higher in FTD compared to AD. Increased reported communication barriers in our whole sample were associated with the atrophy rate in the left middle temporal lobe, a critical site within the neuronal language network, and with depressive symptoms as well as the semantic word fluency from neuropsychological assessment. The best model for prediction of communicative impairment included the diagnosis (AD or FTD), semantic word fluency, and depressive symptoms. CONCLUSIONS Our study demonstrates that communication barriers and resources can be successfully assessed via a structured interview based on self-report and report of patients' relatives in practice and are reflected in neuroimaging specific for AD and FTD as well as in further clinical parameters specific for these neurodegenerative diseases. This can potentially open new treatment options for clinical practice and patient care.
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Affiliation(s)
- Alexa Haeger
- Department of NeurologyRWTH Aachen UniversityAachenGermany
- JARA‐BRAIN Institute Molecular Neuroscience and NeuroimagingForschungszentrum Jülich GmbH and RWTH Aachen UniversityAachenGermany
| | - Janka Muising
- Department of NeurologyRWTH Aachen UniversityAachenGermany
| | - Sandro Romanzetti
- Department of NeurologyRWTH Aachen UniversityAachenGermany
- JARA‐BRAIN Institute Molecular Neuroscience and NeuroimagingForschungszentrum Jülich GmbH and RWTH Aachen UniversityAachenGermany
| | - Bruno Fimm
- Department of NeurologyRWTH Aachen UniversityAachenGermany
| | - Oliver Matz
- Department of NeurologyRWTH Aachen UniversityAachenGermany
| | - Jörg B. Schulz
- Department of NeurologyRWTH Aachen UniversityAachenGermany
- JARA‐BRAIN Institute Molecular Neuroscience and NeuroimagingForschungszentrum Jülich GmbH and RWTH Aachen UniversityAachenGermany
| | - Stefan Heim
- Department of NeurologyRWTH Aachen UniversityAachenGermany
- Institute of Neuroscience and Medicine (INM‐1)Research Centre JülichJülichGermany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical FacultyRWTH Aachen UniversityAachenGermany
| | - Kathrin Reetz
- Department of NeurologyRWTH Aachen UniversityAachenGermany
- JARA‐BRAIN Institute Molecular Neuroscience and NeuroimagingForschungszentrum Jülich GmbH and RWTH Aachen UniversityAachenGermany
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3
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Lenglin V, Wong S, O'Callaghan C, Erzinçlioğlu S, Hornberger M, Lebouvier T, Piguet O, Bourgeois-Gironde S, Bertoux M. Zero the hero: Evidence for involvement of the ventromedial prefrontal cortex in affective bias for free items. Cortex 2023; 160:24-42. [PMID: 36680922 DOI: 10.1016/j.cortex.2022.12.009] [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: 07/28/2022] [Revised: 10/31/2022] [Accepted: 12/06/2022] [Indexed: 12/30/2022]
Abstract
Recent evidence from psycho-economics shows that when the price of an item decreases to the extent that it becomes available for free, one can observe a remarkable increase of subjective utility toward this item. This phenomenon, which is not observed for any other price but zero, has been termed the zero-price effect (ZPE). The ZPE is attributed to an affective heuristic where the positive affect elicited by the free status of an item provides a mental shortcut biasing choice towards that item. Given that the ZPE relies on affective processing, a key role of the ventromedial prefrontal cortex (vmPFC) has been proposed, yet neuroscientific studies of the ZPE remain scarce. This study aimed to explore the role of the vmPFC in the ZPE using a novel, within-subject assessment in participants with either an acquired (lesion patients) or degenerative (behavioural-variant frontotemporal dementia patients) lesion of the vmPFC, and age-matched healthy controls. All participants were asked to make a series of choices between pairs of items that varied in price. One choice trial involved an equal decrease of both item prices, such that one of the items was priced zero. In contrast to controls, patients with both vmPFC-lesion and behavioural-variant frontotemporal dementia showed marked reductions in zero-related changes of preference in pairs of gift-cards, but not for pairs of food items. Our findings suggest that affective evaluations driving the ZPE are altered in patients with focal or degenerative damage to the vmPFC. This supports the notion of a key role of the vmPFC in the ZPE and, more generally, the importance of this region in value-based affective decision-making. Our findings also highlight the potential utility of affective heuristic tasks in future clinical assessments.
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Affiliation(s)
- V Lenglin
- Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, LiCEND & DistALZ, Lille, France; ETHICS EA7446, Lille Catholic University, Lille, France
| | - S Wong
- The University of Sydney, School of Psychology and Brain & Mind Centre, Sydney, Australia; Flinders University, College of Education, Psychology & Social Work, Adelaide, Australia
| | - C O'Callaghan
- The University of Sydney, Brain & Mind Centre and School of Medical Sciences, Faculty of Medicine and Health, Sydney, Australia
| | - S Erzinçlioğlu
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge UK
| | - M Hornberger
- Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK; Norwich Medical School, University of East Anglia, Norwich, UK
| | - T Lebouvier
- Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, LiCEND & DistALZ, Lille, France
| | - O Piguet
- The University of Sydney, School of Psychology and Brain & Mind Centre, Sydney, Australia
| | - S Bourgeois-Gironde
- Department of Economics, Université Paris 2 - Panthéon-Assas, Paris, France; Institut Jean-Nicod, Ecole Normale Supérieure, PSL Research University, Paris, France.
| | - M Bertoux
- Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, LiCEND & DistALZ, Lille, France; Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK.
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4
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Chokesuwattanaskul A, Jiang H, Bond RL, Jimenez DA, Russell LL, Sivasathiaseelan H, Johnson JCS, Benhamou E, Agustus JL, van Leeuwen JEP, Chokesuwattanaskul P, Hardy CJD, Marshall CR, Rohrer JD, Warren JD. The architecture of abnormal reward behaviour in dementia: multimodal hedonic phenotypes and brain substrate. Brain Commun 2023; 5:fcad027. [PMID: 36942157 PMCID: PMC10023829 DOI: 10.1093/braincomms/fcad027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/11/2022] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
Abnormal reward processing is a hallmark of neurodegenerative diseases, most strikingly in frontotemporal dementia. However, the phenotypic repertoire and neuroanatomical substrates of abnormal reward behaviour in these diseases remain incompletely characterized and poorly understood. Here we addressed these issues in a large, intensively phenotyped patient cohort representing all major syndromes of sporadic frontotemporal dementia and Alzheimer's disease. We studied 27 patients with behavioural variant frontotemporal dementia, 58 with primary progressive aphasia (22 semantic variant, 24 non-fluent/agrammatic variant and 12 logopenic) and 34 with typical amnestic Alzheimer's disease, in relation to 42 healthy older individuals. Changes in behavioural responsiveness were assessed for canonical primary rewards (appetite, sweet tooth, sexual activity) and non-primary rewards (music, religion, art, colours), using a semi-structured survey completed by patients' primary caregivers. Changes in more general socio-emotional behaviours were also recorded. We applied multiple correspondence analysis and k-means clustering to map relationships between hedonic domains and extract core factors defining aberrant hedonic phenotypes. Neuroanatomical associations were assessed using voxel-based morphometry of brain MRI images across the combined patient cohort. Altered (increased and/or decreased) reward responsiveness was exhibited by most patients in the behavioural and semantic variants of frontotemporal dementia and around two-thirds of patients in other dementia groups, significantly (P < 0.05) more frequently than in healthy controls. While food-directed changes were most prevalent across the patient cohort, behavioural changes directed toward non-primary rewards occurred significantly more frequently (P < 0.05) in the behavioural and semantic variants of frontotemporal dementia than in other patient groups. Hedonic behavioural changes across the patient cohort were underpinned by two principal factors: a 'gating' factor determining the emergence of altered reward behaviour and a 'modulatory' factor determining how that behaviour is directed. These factors were expressed jointly in a set of four core, trans-diagnostic and multimodal hedonic phenotypes: 'reward-seeking', 'reward-restricted', 'eating-predominant' and 'control-like'-variably represented across the cohort and associated with more pervasive socio-emotional behavioural abnormalities. The principal gating factor was associated (P < 0.05 after correction for multiple voxel-wise comparisons over the whole brain) with a common profile of grey matter atrophy in anterior cingulate, bilateral temporal poles, right middle frontal and fusiform gyri: the cortical circuitry that mediates behavioural salience and semantic and affective appraisal of sensory stimuli. Our findings define a multi-domain phenotypic architecture for aberrant reward behaviours in major dementias, with novel implications for the neurobiological understanding and clinical management of these diseases.
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Affiliation(s)
- Anthipa Chokesuwattanaskul
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
- Division of Neurology, Department of Internal Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- Cognitive Clinical and Computational Neuroscience Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Harmony Jiang
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Rebecca L Bond
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Daniel A Jimenez
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
- Department of Neurological Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Lucy L Russell
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Harri Sivasathiaseelan
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jeremy C S Johnson
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Elia Benhamou
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jennifer L Agustus
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Janneke E P van Leeuwen
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | | | - Chris J D Hardy
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Charles R Marshall
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jason D Warren
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
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5
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Altered reward processing underpins emotional apathy in dementia. COGNITIVE, AFFECTIVE, & BEHAVIORAL NEUROSCIENCE 2022; 23:354-370. [PMID: 36417157 PMCID: PMC10049956 DOI: 10.3758/s13415-022-01048-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/24/2022]
Abstract
Abstract
Introduction
While apathy is broadly defined as a loss of motivation, it is increasingly recognised as a multidimensional syndrome spanning executive, emotional, and initiation domains. Emotional apathy is purportedly driven by deficits in using socioemotional rewards to guide behaviour, yet the link between these symptoms and reward processing, and their common neural correlates, has not been directly examined.
Methods
Sixty-four patients (33 behavioural-variant frontotemporal dementia, 14 Alzheimer’s disease, 8 semantic dementia, 6 progressive nonfluent aphasia, 3 logopenic progressive aphasia) were classified into high (HEA; n = 36) and low (LEA; n = 28) emotional apathy groups based on emotional apathy subscale scores on the Dimensional Apathy Scale. Patients and age-matched healthy controls (n = 27) performed an instrumental reward learning task where they learned to associate cues with either social or monetary outcomes.
Results
HEA patients showed impaired learning on both the social and monetary reward conditions, relative to LEA patients (p = 0.016) and controls (p = 0.005). Conversely, the LEA group did not differ from controls (p = 0.925). Importantly, multiple regression analyses indicated that social reward learning significantly predicted emotional apathy. Voxel-based morphometry analyses revealed that emotional apathy and social reward learning were both associated with orbitofrontal cortex, ventral striatum, and insula atrophy.
Discussion
Our results demonstrate a unique link between impaired social reward learning and emotional apathy in dementia and reveal a shared neurobiological basis. Greater understanding of these neurocognitive mechanisms of reward processing will help improve the identification of emotional apathy in dementia and inform the development of novel interventions to address these symptoms.
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6
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Sun W, Matsuoka T, Narumoto J. Decision-Making Support for People With Alzheimer's Disease: A Narrative Review. Front Psychol 2021; 12:750803. [PMID: 34867639 PMCID: PMC8633444 DOI: 10.3389/fpsyg.2021.750803] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 10/25/2021] [Indexed: 01/01/2023] Open
Abstract
The proportion of people with dementia has been increasing yearly, and the decision-making capacity of these people has become a major concern in fields such as the financial industry and in medical settings. In this narrative review, we discuss decision-making in people with Alzheimer’s disease (AD), and we propose the support for decision-making in people with AD, especially financial and medical decision-making. We summarize several hypotheses and theories on the decision-making capacity of people with AD. These include the frontal lobe hypothesis, physiological theory, dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, and the Person-Task-Fit (PTF) framework. Both internal and external factors can affect decision-making by people with AD. Internal factors are affected by changes in the brain and neurotransmitters, as well as alterations in cognitive ability and emotion. External factors include task characters, task contents, and situation influence. Since feedback has a significant effect on decision-making capacity, a series of suggestions may be helpful to improve this capacity, such as explicit advice, simple options, pleasant rewards, the Talking Mats approach, memory and organizational aid, support by caregivers, cognitive training and feedback. Thus, in providing decision-making support for people with AD, it is important to identify the internal and external factors that impair this process and to deal with these factors.
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Affiliation(s)
- Weiyi Sun
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Teruyuki Matsuoka
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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7
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Fernandes C, Macedo I, Barbosa F, Marques-Teixeira J. Economic decision-making in the continuum between healthy aging and Alzheimer's Disease: A systematic review of 20 years of research. Neurosci Biobehav Rev 2021; 131:1243-1263. [PMID: 34715151 DOI: 10.1016/j.neubiorev.2021.10.030] [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: 06/07/2021] [Revised: 09/23/2021] [Accepted: 10/23/2021] [Indexed: 01/21/2023]
Abstract
The effect of pathological aging on economic decision-making is a topic of major relevance as impairments in this domain place older adults at increased risk for financial abuse. This review aims to characterize decision-making across the continuum that goes from healthy aging to Alzheimer's Dementia. We included 42 studies comparing patients with Mild Cognitive Impairment (MCI) and healthy older adults, patients with Alzheimer's Disease (AD) and healthy older adults, and patients with MCI and patients with AD. Substantial evidence emerged suggesting that both MCI as AD affect economic decision-making. However, a non-negligible number of behavioural tasks failed to find significant differences between patients and controls, and no differences were reported between patients with MCI and AD. On the contrary, measures of financial capacity reached more robust findings, showing that healthy older adults had better performance than patients, while MCI patients showed better performance than AD patients. This review presents the main conclusions that may be drawn from significant findings, as well as the hypotheses and recommendations for future research.
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Affiliation(s)
- Carina Fernandes
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal.
| | - Inês Macedo
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal
| | - João Marques-Teixeira
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal
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8
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Legaz A, Abrevaya S, Dottori M, Campo CG, Birba A, Caro MM, Aguirre J, Slachevsky A, Aranguiz R, Serrano C, Gillan CM, Leroi I, García AM, Fittipaldi S, Ibañez A. Multimodal mechanisms of human socially reinforced learning across neurodegenerative diseases. Brain 2021; 145:1052-1068. [PMID: 34529034 PMCID: PMC9128375 DOI: 10.1093/brain/awab345] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/17/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Social feedback can selectively enhance learning in diverse domains. Relevant
neurocognitive mechanisms have been studied mainly in healthy persons, yielding
correlational findings. Neurodegenerative lesion models, coupled with multimodal
brain measures, can complement standard approaches by revealing direct
multidimensional correlates of the phenomenon. To this end, we assessed socially reinforced and non-socially reinforced learning
in 40 healthy participants as well as persons with behavioural variant
frontotemporal dementia (n = 21), Parkinson’s
disease (n = 31) and Alzheimer’s disease
(n = 20). These conditions are typified by
predominant deficits in social cognition, feedback-based learning and
associative learning, respectively, although all three domains may be partly
compromised in the other conditions. We combined a validated behavioural task
with ongoing EEG signatures of implicit learning (medial frontal negativity) and
offline MRI measures (voxel-based morphometry). In healthy participants, learning was facilitated by social feedback relative to
non-social feedback. In comparison with controls, this effect was specifically
impaired in behavioural variant frontotemporal dementia and Parkinson’s
disease, while unspecific learning deficits (across social and non-social
conditions) were observed in Alzheimer’s disease. EEG results showed
increased medial frontal negativity in healthy controls during social feedback
and learning. Such a modulation was selectively disrupted in behavioural variant
frontotemporal dementia. Neuroanatomical results revealed extended
temporo-parietal and fronto-limbic correlates of socially reinforced learning,
with specific temporo-parietal associations in behavioural variant
frontotemporal dementia and predominantly fronto-limbic regions in
Alzheimer’s disease. In contrast, non-socially reinforced learning was
consistently linked to medial temporal/hippocampal regions. No associations with
cortical volume were found in Parkinson’s disease. Results are consistent
with core social deficits in behavioural variant frontotemporal dementia, subtle
disruptions in ongoing feedback-mechanisms and social processes in
Parkinson’s disease and generalized learning alterations in
Alzheimer’s disease. This multimodal approach highlights the impact of
different neurodegenerative profiles on learning and social feedback. Our findings inform a promising theoretical and clinical agenda in the fields of
social learning, socially reinforced learning and neurodegeneration.
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Affiliation(s)
- Agustina Legaz
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, C1011ACC, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina.,Universidad Nacional de Córdoba. Facultad de Psicología, Córdoba, CU320, Argentina
| | - Sofía Abrevaya
- National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina.,Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, CONICET, Buenos Aires, C1021, Argentina
| | - Martín Dottori
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, C1011ACC, Argentina
| | - Cecilia González Campo
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, C1011ACC, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina
| | - Agustina Birba
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, C1011ACC, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina
| | - Miguel Martorell Caro
- National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina.,Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, CONICET, Buenos Aires, C1021, Argentina
| | - Julieta Aguirre
- Instituto de Investigaciones Psicológicas (IIPsi), CONICET, Universidad Nacional de Córdoba, Córdoba, CB5000, Argentina
| | - Andrea Slachevsky
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital delSalvador, SSMO & Faculty of Medicine, University of Chile, Santiago, Chile.,Gerosciences Center for Brain Health and Metabolism, Santiago, Chile.,Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, ICBM, Neurosciences Department, Faculty of Medicine, University of Chile, Chile.,Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Chile
| | | | - Cecilia Serrano
- Neurología Cognitiva, Hospital Cesar Milstein, Buenos Aires, C1221, Argentina
| | - Claire M Gillan
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA 94158, USA.,Department of Psychology, Trinity College Dublin, Dublin, Ireland.,Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Iracema Leroi
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA 94158, USA
| | - Adolfo M García
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, C1011ACC, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina.,Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA 94158, USA.,Global Brain Health Institute (GBHI), Trinity College Dublin (TCD), Dublin, Dublin 2, Ireland.,Faculty of Education, National University of Cuyo, Mendoza, M5502JMA, Argentina.,Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | - Sol Fittipaldi
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, C1011ACC, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina.,Universidad Nacional de Córdoba. Facultad de Psicología, Córdoba, CU320, Argentina
| | - Agustín Ibañez
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, C1011ACC, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina.,Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA 94158, USA.,Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
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9
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Aldridge-Waddon L, Vanova M, Munneke J, Puzzo I, Kumari V. Atypical social reward anticipation as a transdiagnostic characteristic of psychopathology: A meta-analytic review and critical evaluation of current evidence. Clin Psychol Rev 2020; 82:101942. [PMID: 33160160 DOI: 10.1016/j.cpr.2020.101942] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/17/2020] [Accepted: 10/20/2020] [Indexed: 10/23/2022]
Abstract
Several psychopathologies (e.g. schizophrenia spectrum conditions, autism spectrum disorders) are characterised by atypical interpersonal and social behaviour, and there is increasing evidence to suggest this atypical social behaviour is related to adjusted behavioural and neural anticipation of social rewards. This review brings together social reward anticipation research in psychopathology (k = 42) and examines the extent to which atypical social reward anticipation is a transdiagnostic characteristic. Meta-analyses of anticipatory reaction times revealed that, in comparison to healthy controls, attention-deficit/hyperactivity disorder, autism spectrum disorder, and schizophrenia spectrum conditions are associated with significantly reduced behavioural anticipation of social rewards. The pooled meta-analysis of anticipatory reaction times found that the full clinical sample demonstrated significant social reward hypoanticipation in comparison to the healthy control group with a medium effect size. A narrative synthesis of meta-analytically ineligible behavioural data, self-report data, and neuroimaging studies complemented the results of the meta-analysis, but also indicated that bipolar disorder, eating disorders, and sexual addiction disorders may be associated with social reward hyperanticipation. The evaluation of existing evidence suggests that future research should better account for factors that affect reward anticipation (e.g. gender, psychotropic medication) and highlights the importance of using stimuli other than happy faces as social rewards.
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Affiliation(s)
- Luke Aldridge-Waddon
- Division of Psychology, Department of Life Sciences & Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, UK.
| | - Martina Vanova
- Division of Psychology, Department of Life Sciences & Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, UK
| | - Jaap Munneke
- Division of Psychology, Department of Life Sciences & Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, UK
| | - Ignazio Puzzo
- Division of Psychology, Department of Life Sciences & Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, UK
| | - Veena Kumari
- Division of Psychology, Department of Life Sciences & Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, UK
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10
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Heim B, Peball M, Saft C, von Hein SM, Ellmerer P, Piater JM, Seppi K, Djamshidian A. Time will tell: Decision making in premanifest and manifest Huntington's disease. Brain Behav 2020; 10:e01843. [PMID: 32978893 PMCID: PMC7667290 DOI: 10.1002/brb3.1843] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/06/2020] [Accepted: 08/22/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To investigate cognitive flexibility in premanifest and manifest Huntington's disease (HD). BACKGROUND HD is an autosomal dominant neurodegenerative disease characterized by motor, cognitive, and behavioral abnormalities with typical motor symptoms. In this study, we wanted to assess decision making in premanifest (pre-HD) and manifest HD patients. METHODS A total of 77 non-demented subjects including 29 pre-HD, 22 manifest HD patients, and 26 healthy controls (HC) were included. We stratified the pre-HD group based on their estimated years to disease onset into a far (FAR, n = 13) and a near (NEAR, n = 16) group. Furthermore, participants performed the Montreal cognitive assessment battery (MoCA), the trail making task part A and B (TMT A, TMT B), the Symbol digit modalities test (SDMT), and the beads task. RESULTS In the beads task, HD patients gathered less information than all other groups (all p-values < .001). Furthermore, the NEAR group gathered less information than the FAR group (p < .001) and HC (p = .001). There was no difference between the HC and the FAR group (p = 1.0). In the TMT and the SDMT, HD patients were slower than all other groups (all p-values < .01) but there were no other significant differences. CONCLUSIONS Decision making with a higher degree of uncertainty may be an early neuropsychological sign to indicate the disease process prior to reaching criteria for motor diagnosis of HD.
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Affiliation(s)
- Beatrice Heim
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Marina Peball
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Carsten Saft
- Department of Neurology, Huntington - Center NRW, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Sarah Maria von Hein
- Department of Neurology, Huntington - Center NRW, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Philipp Ellmerer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Klaus Seppi
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Atbin Djamshidian
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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11
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Johnen A, Bertoux M. Psychological and Cognitive Markers of Behavioral Variant Frontotemporal Dementia-A Clinical Neuropsychologist's View on Diagnostic Criteria and Beyond. Front Neurol 2019; 10:594. [PMID: 31231305 PMCID: PMC6568027 DOI: 10.3389/fneur.2019.00594] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 05/20/2019] [Indexed: 12/11/2022] Open
Abstract
Behavioral variant frontotemporal dementia (bvFTD) is the second leading cognitive disorder caused by neurodegeneration in patients under 65 years of age. Characterized by frontal, insular, and/or temporal brain atrophy, patients present with heterogeneous constellations of behavioral and psychological symptoms among which progressive changes in social conduct, lack of empathy, apathy, disinhibited behaviors, and cognitive impairments are frequently observed. Since the histopathology of the disease is heterogeneous and identified genetic mutations only account for ~30% of cases, there are no reliable biomarkers for the diagnosis of bvFTD available in clinical routine as yet. Early detection of bvFTD thus relies on correct application of clinical diagnostic criteria. Their evaluation however, requires expertise and in-depth assessments of cognitive functions, history taking, clinical observations as well as caregiver reports on behavioral and psychological symptoms and their respective changes. With this review, we aim for a critical appraisal of common methods to access the behavioral and psychological symptoms as well as the cognitive alterations presented in the diagnostic criteria for bvFTD. We highlight both, practical difficulties as well as current controversies regarding an overlap of symptoms and particularly cognitive impairments with other neurodegenerative and primary psychiatric diseases. We then review more recent developments and evidence on cognitive, behavioral and psychological symptoms of bvFTD beyond the diagnostic criteria which may prospectively enhance the early detection and differential diagnosis in clinical routine. In particular, evidence on specific impairments in social and emotional processing, praxis abilities as well as interoceptive processing in bvFTD is summarized and potential links with behavior and classic cognitive domains are discussed. We finally outline both, future opportunities and major challenges with regard to the role of clinical neuropsychology in detecting bvFTD and related neurocognitive disorders.
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Affiliation(s)
- Andreas Johnen
- Section for Neuropsychology, Department of Neurology, University Hospital Münster, Münster, Germany
| | - Maxime Bertoux
- Univ Lille, Inserm UMR 1171 Degenerative and Vascular Cognitive Disorders, CHU Lille, Lille, France
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12
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Klatt BN, Ries JD, Dunlap PM, Whitney SL, Agrawal Y. Vestibular Physical Therapy in Individuals With Cognitive Impairment: A Theoretical Framework. J Neurol Phys Ther 2019; 43 Suppl 2:S14-S19. [PMID: 30883488 DOI: 10.1097/npt.0000000000000266] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Falls are a major health care concern in individuals with Alzheimer disease (AD) and their caregivers. Vestibular impairment is a known risk factor for falls, and individuals with AD have been shown to have an increased prevalence of vestibular loss compared with age-matched controls. Vestibular physical therapy (VPT) is effective in improving balance and reducing fall risk in cognitively-intact persons with vestibular impairment. However, the effectiveness of VPT in improving balance and reducing falls in individuals with AD who have vestibular loss has never been explored. SUMMARY OF KEY POINTS:: In this article, we apply prevailing ideas about rehabilitation and motor learning in individuals with cognitive impairment (IwCI) to VPT. RECOMMENDATIONS FOR CLINICAL PRACTICE:: We propose a modification of current evidence-based VPT protocols for IwCI using the strength-based theoretical framework that emphasizes the motor learning abilities of IwCI. In addition, we highlight the importance of establishing an excellent rapport with IwCI, and present key strategies for optimizing the therapeutic relationship. In ongoing work, we are assessing the efficacy of this modified VPT protocol in IwCI to improve balance and reduce falls.
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Affiliation(s)
- Brooke N Klatt
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland (B.N.K., Y.A.); Department of Physical Therapy, Marymount University, Arlington, Virginia (J.D.R.); and Department of Physical Therapy, University of Pittsburgh, Pennsylvania (P.M.D., S.L.W.)
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13
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Working definitions, subjective and objective assessments and experimental paradigms in a study exploring social withdrawal in schizophrenia and Alzheimer’s disease. Neurosci Biobehav Rev 2019; 97:38-46. [DOI: 10.1016/j.neubiorev.2018.06.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 04/10/2018] [Accepted: 06/21/2018] [Indexed: 11/24/2022]
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14
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Maki Y, Sakurai T, Okochi J, Yamaguchi H, Toba K. Rehabilitation to live better with dementia. Geriatr Gerontol Int 2018; 18:1529-1536. [PMID: 30318671 DOI: 10.1111/ggi.13517] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/20/2018] [Accepted: 07/30/2018] [Indexed: 11/26/2022]
Abstract
The goal of dementia treatment is to improve the quality of life for both people with dementia and their families. Rehabilitation as a non-pharmacological approach, coordinated with pharmacological treatment, aims to allow patients to live better by slowing the progression, and relieving the behavioral and psychological symptoms of dementia. In dementia, the manifestation of symptoms caused by neurological impairment is modified by various factors; thus, multidimensional assessment and approaches are effective based on the concept of the International Classification of Functioning, which emphasizes the healthy components of every person's functioning. Regarding the process of rehabilitation, every person with dementia should take initiative throughout the course of rehabilitation, and shared decision-making is a fundamental requirement at every phase of intervention. The needs of rehabilitation differ depending on the stage of dementia. In the early stages, cognitive rehabilitation is needed, and interventions are carried out using preserved functions and compensatory strategies. As the disease progresses, capacities of instrumental and then basic activities of daily living deteriorate, and interventions need to be tailor-made and carried out in the context of actual living situations. In the early-to-moderate stages, prevention and management of behavioral and psychological symptoms of dementia are required. In the interventions to alleviate behavioral and psychological symptoms of dementia, it is critical to consider the individual and the meaning behind his/her behaviors from a holistic perspective. Family carers also need support, and education to learn coping strategies can be beneficial for both people with dementia and their carers. Rehabilitation can empower people with dementia and their families to live better with dementia. Geriatr Gerontol Int 2018; 18: 1529-1536.
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Affiliation(s)
- Yohko Maki
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Takashi Sakurai
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Jiro Okochi
- Wakakoukai Health Care Corporation, Geriatric Health Services Facility Tatsumanosato, Osaka, Japan
| | | | - Kenji Toba
- National Center for Geriatrics and Gerontology, Aichi, Japan
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15
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Wong S, Balleine BW, Kumfor F. A new framework for conceptualizing symptoms in frontotemporal dementia: from animal models to the clinic. Brain 2018; 141:2245-2254. [DOI: 10.1093/brain/awy123] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/13/2018] [Indexed: 12/11/2022] Open
Affiliation(s)
- Stephanie Wong
- The University of Sydney, School of Psychology and Brain and Mind Centre, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Bernard W Balleine
- University of New South Wales, School of Psychology, Sydney, NSW, Australia
| | - Fiona Kumfor
- The University of Sydney, School of Psychology and Brain and Mind Centre, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
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16
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Wong S, Irish M, Savage G, Hodges JR, Piguet O, Hornberger M. Strategic value-directed learning and memory in Alzheimer's disease and behavioural-variant frontotemporal dementia. J Neuropsychol 2018; 13:328-353. [PMID: 29431279 DOI: 10.1111/jnp.12152] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 01/17/2018] [Indexed: 12/22/2022]
Abstract
In healthy adults, the ability to prioritize learning of highly valued information is supported by executive functions and enhances subsequent memory retrieval for this information. In Alzheimer's disease (AD) and behavioural-variant frontotemporal dementia (bvFTD), marked deficits are evident in learning and memory, presenting in the context of executive dysfunction. It is unclear whether these patients show a typical memory bias for higher valued stimuli. We administered a value-directed word-list learning task to AD (n = 10) and bvFTD (n = 21) patients and age-matched healthy controls (n = 22). Each word was assigned a low, medium or high point value, and participants were instructed to maximize the number of points earned across three learning trials. Participants' memory for the words was assessed on a delayed recall trial, followed by a recognition test for the words and corresponding point values. Relative to controls, both patient groups showed poorer overall learning, delayed recall and recognition. Despite these impairments, patients with AD preferentially recalled high-value words on learning trials and showed significant value-directed enhancement of recognition memory for the words and points. Conversely, bvFTD patients did not prioritize recall of high-value words during learning trials, and this reduced selectivity was related to inhibitory dysfunction. Nonetheless, bvFTD patients showed value-directed enhancement of recognition memory for the point values, suggesting a mismatch between memory of high-value information and the ability to apply this in a motivationally salient context. Our findings demonstrate that value-directed enhancement of memory may persist to some degree in patients with dementia, despite pronounced deficits in learning and memory.
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Affiliation(s)
- Stephanie Wong
- ARC Centre of Excellence in Cognition and Its Disorders, Sydney, New South Wales, Australia.,Department of Psychology, Macquarie University, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Sydney, New South Wales, Australia.,School of Psychology, The University of Sydney, New South Wales, Australia
| | - Muireann Irish
- ARC Centre of Excellence in Cognition and Its Disorders, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Sydney, New South Wales, Australia.,School of Psychology, The University of Sydney, New South Wales, Australia.,Brain & Mind Centre, The University of Sydney, New South Wales, Australia
| | - Greg Savage
- ARC Centre of Excellence in Cognition and Its Disorders, Sydney, New South Wales, Australia.,Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - John R Hodges
- ARC Centre of Excellence in Cognition and Its Disorders, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Sydney, New South Wales, Australia.,Brain & Mind Centre, The University of Sydney, New South Wales, Australia.,School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia.,Central Clinical School, Sydney Medical School, The University of Sydney, New South Wales, Australia
| | - Olivier Piguet
- ARC Centre of Excellence in Cognition and Its Disorders, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Sydney, New South Wales, Australia.,School of Psychology, The University of Sydney, New South Wales, Australia.,Brain & Mind Centre, The University of Sydney, New South Wales, Australia
| | - Michael Hornberger
- ARC Centre of Excellence in Cognition and Its Disorders, Sydney, New South Wales, Australia.,Norwich Medical School, University of East Anglia, Norwich, UK.,Dementia and Complexity in Later Life, NHS Norfolk and Suffolk Foundation Trust, UK
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17
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Clark CN, Golden HL, McCallion O, Nicholas JM, Cohen MH, Slattery CF, Paterson RW, Fletcher PD, Mummery CJ, Rohrer JD, Crutch SJ, Warren JD. Music models aberrant rule decoding and reward valuation in dementia. Soc Cogn Affect Neurosci 2018; 13:192-202. [PMID: 29186630 PMCID: PMC5827340 DOI: 10.1093/scan/nsx140] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 11/06/2017] [Accepted: 11/19/2017] [Indexed: 01/03/2023] Open
Abstract
Aberrant rule- and reward-based processes underpin abnormalities of socio-emotional behaviour in major dementias. However, these processes remain poorly characterized. Here we used music to probe rule decoding and reward valuation in patients with frontotemporal dementia (FTD) syndromes and Alzheimer's disease (AD) relative to healthy age-matched individuals. We created short melodies that were either harmonically resolved ('finished') or unresolved ('unfinished'); the task was to classify each melody as finished or unfinished (rule processing) and rate its subjective pleasantness (reward valuation). Results were adjusted for elementary pitch and executive processing; neuroanatomical correlates were assessed using voxel-based morphometry. Relative to healthy older controls, patients with behavioural variant FTD showed impairments of both musical rule decoding and reward valuation, while patients with semantic dementia showed impaired reward valuation but intact rule decoding, patients with AD showed impaired rule decoding but intact reward valuation and patients with progressive non-fluent aphasia performed comparably to healthy controls. Grey matter associations with task performance were identified in anterior temporal, medial and lateral orbitofrontal cortices, previously implicated in computing diverse biological and non-biological rules and rewards. The processing of musical rules and reward distils cognitive and neuroanatomical mechanisms relevant to complex socio-emotional dysfunction in major dementias.
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Affiliation(s)
- Camilla N Clark
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Hannah L Golden
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Oliver McCallion
- Oxford University Clinical Academic Graduate School, University of Oxford, Oxford, UK
| | - Jennifer M Nicholas
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
- London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Miriam H Cohen
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Catherine F Slattery
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Ross W Paterson
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Phillip D Fletcher
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Catherine J Mummery
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
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18
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Perry DC, Datta S, Sturm VE, Wood KA, Zakrzewski J, Seeley WW, Miller BL, Kramer JH, Rosen HJ. Reward deficits in behavioural variant frontotemporal dementia include insensitivity to negative stimuli. Brain 2017; 140:3346-3356. [PMID: 29053832 DOI: 10.1093/brain/awx259] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/17/2017] [Indexed: 12/11/2022] Open
Abstract
During reward processing individuals weigh positive and negative features of a stimulus to determine whether they will pursue or avoid it. Though patients with behavioural variant frontotemporal dementia display changes in their pursuit of rewards, such as food, alcohol, money, and sex, the basis for these shifts is not clearly established. In particular, it is unknown whether patients' behaviour results from excessive focus on rewards, insensitivity to punishment, or to dysfunction in a particular stage of reward processing, such as anticipation, consumption, or action selection. Our goal was to determine the nature of the reward deficit in behavioural variant frontotemporal dementia and its underlying anatomy. We devised a series of tasks involving pleasant, unpleasant, and neutral olfactory stimuli, designed to separate distinct phases of reward processing. In a group of 25 patients with behavioural variant frontotemporal dementia and 21 control subjects, diagnosis by valence interactions revealed that patients with behavioural variant frontotemporal dementia rated unpleasant odours as less aversive than did controls and displayed lower skin conductance responses when anticipating an upcoming aversive odour. Subjective pleasantness ratings and skin conductance responses did not differ between behavioural variant frontotemporal dementia and controls for pleasant or neutral smells. In a task designed to measure the effort subjects would expend to smell or avoid smelling a stimulus, patients with behavioural variant frontotemporal dementia were less motivated, and therefore less successful than control subjects, at avoiding what they preferred not to smell, but had equivalent success at obtaining stimuli they found rewarding. Voxel-based morphometry of patients with behavioural variant frontotemporal dementia revealed that the inability to subjectively differentiate the valence of pleasant and unpleasant odours correlated with atrophy in right ventral mid-insula and right amygdala. High pleasantness ratings of unpleasant stimuli correlated with left dorsal anterior insula and frontal pole atrophy. These findings indicate that insensitivity to negative information may be a key component of the reward-seeking behaviours in behavioural variant frontotemporal dementia, and may relate to degeneration of structures that are involved in representing the emotional salience of sensory information.
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Affiliation(s)
- David C Perry
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Samir Datta
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Virginia E Sturm
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Kristie A Wood
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Jessica Zakrzewski
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - William W Seeley
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Bruce L Miller
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Joel H Kramer
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Howard J Rosen
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
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19
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Sturm VE, Perry DC, Wood K, Hua AY, Alcantar O, Datta S, Rankin KP, Rosen HJ, Miller BL, Kramer JH. Prosocial deficits in behavioral variant frontotemporal dementia relate to reward network atrophy. Brain Behav 2017; 7:e00807. [PMID: 29075567 PMCID: PMC5651391 DOI: 10.1002/brb3.807] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/07/2017] [Accepted: 07/20/2017] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Empathy and shared feelings of reward motivate individuals to share resources with others when material gain is not at stake. Behavioral variant frontotemporal dementia (bvFTD) is a neurodegenerative disease that affects emotion- and reward-relevant neural systems. Although there is diminished empathy and altered reward processing in bvFTD, how the disease impacts prosocial behavior is less well understood. METHODS A total of 74 participants (20 bvFTD, 15 Alzheimer's disease [AD], and 39 healthy controls) participated in this study. Inspired by token-based paradigms from animal studies, we developed a novel task to measure prosocial giving (the "Giving Game"). On each trial of the Giving Game, participants decided how much money to offer to the experimenter, and prosocial giving was the total amount that participants gave to the experimenter when it cost them nothing to give. Voxel-based morphometry was then used to identify brain regions that were associated with prosocial giving. RESULTS Prosocial giving was lower in bvFTD than in healthy controls; prosocial giving in AD did not differ significantly from either of the other groups. Whereas lower prosocial giving was associated with atrophy in the right pulvinar nucleus of the thalamus, greater prosocial giving was associated with atrophy in the left ventral striatum. CONCLUSION These findings suggest that simple acts of generosity deteriorate in bvFTD due to lateralized atrophy in reward-relevant neural systems that promote shared feelings of positive affect.
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Affiliation(s)
- Virginia E Sturm
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - David C Perry
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Kristie Wood
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Alice Y Hua
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Oscar Alcantar
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Samir Datta
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Katherine P Rankin
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Howard J Rosen
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Bruce L Miller
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Joel H Kramer
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
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20
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Wong S, Irish M, O’Callaghan C, Kumfor F, Savage G, Hodges JR, Piguet O, Hornberger M. Should I trust you? Learning and memory of social interactions in dementia. Neuropsychologia 2017; 104:157-167. [DOI: 10.1016/j.neuropsychologia.2017.08.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 08/10/2017] [Accepted: 08/10/2017] [Indexed: 01/15/2023]
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21
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Berryessa CM. Behavioral and neural impairments of frontotemporal dementia: Potential implications for criminal responsibility and sentencing. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2016; 46:1-6. [PMID: 27039661 DOI: 10.1016/j.ijlp.2016.02.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Individuals in the early stages of the behavioral variant of frontotemporal dementia (bvFTD), a progressive neurodegenerative disorder marked by atrophy to the brain's frontal regions, exhibit severe disturbances to social and moral processing and decision-making after the onset of the disorder. These behavioral impairments, underlain by the neural deficits associated with the disorder, can often lead individuals with bvFTD to criminally offend. As such, behavioral and frontotemporal lobe abnormalities exhibited by offenders with bvFTD potentially represent several complex challenges for the legal system. This paper examines some of the ways in which the behavioral and neural impairments associated with bvFTD may influence issues surrounding the criminal responsibility, specifically legal insanity, and sentencing of offenders with bvFTD in the U.S. legal system. As there is very little literature in these areas concerning bvFTD, the existing academic dialogue on psychopathy, a disorder with similar behavioral symptoms and neural deficits, is used to frame the discussion on these issues.
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Affiliation(s)
- Colleen M Berryessa
- Department of Criminology, University of Pennsylvania, 483 McNeil Building, 3718 Locust Walk, Philadelphia, PA 19104, USA.
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22
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Cerami C, Dodich A, Iannaccone S, Marcone A, Lettieri G, Crespi C, Gianolli L, Cappa SF, Perani D. Right Limbic FDG-PET Hypometabolism Correlates with Emotion Recognition and Attribution in Probable Behavioral Variant of Frontotemporal Dementia Patients. PLoS One 2015; 10:e0141672. [PMID: 26513651 PMCID: PMC4626030 DOI: 10.1371/journal.pone.0141672] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 10/12/2015] [Indexed: 02/01/2023] Open
Abstract
The behavioural variant of frontotemporal dementia (bvFTD) is a rare disease mainly affecting the social brain. FDG-PET fronto-temporal hypometabolism is a supportive feature for the diagnosis. It may also provide specific functional metabolic signatures for altered socio-emotional processing. In this study, we evaluated the emotion recognition and attribution deficits and FDG-PET cerebral metabolic patterns at the group and individual levels in a sample of sporadic bvFTD patients, exploring the cognitive-functional correlations. Seventeen probable mild bvFTD patients (10 male and 7 female; age 67.8±9.9) were administered standardized and validated version of social cognition tasks assessing the recognition of basic emotions and the attribution of emotions and intentions (i.e., Ekman 60-Faces test-Ek60F and Story-based Empathy task-SET). FDG-PET was analysed using an optimized voxel-based SPM method at the single-subject and group levels. Severe deficits of emotion recognition and processing characterized the bvFTD condition. At the group level, metabolic dysfunction in the right amygdala, temporal pole, and middle cingulate cortex was highly correlated to the emotional recognition and attribution performances. At the single-subject level, however, heterogeneous impairments of social cognition tasks emerged, and different metabolic patterns, involving limbic structures and prefrontal cortices, were also observed. The derangement of a right limbic network is associated with altered socio-emotional processing in bvFTD patients, but different hypometabolic FDG-PET patterns and heterogeneous performances on social tasks at an individual level exist.
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Affiliation(s)
- Chiara Cerami
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
- Clinical Neuroscience Department, San Raffaele Hospital, Milan, Italy
- * E-mail:
| | - Alessandra Dodich
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Sandro Iannaccone
- Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
- Clinical Neuroscience Department, San Raffaele Hospital, Milan, Italy
| | - Alessandra Marcone
- Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
- Clinical Neuroscience Department, San Raffaele Hospital, Milan, Italy
| | | | - Chiara Crespi
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Luigi Gianolli
- Nuclear Medicine Department, San Raffaele Hospital, Milan, Italy
| | - Stefano F. Cappa
- Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
- NeTS Center, Istituto Universitario di Studi Superiori, Pavia, Italy
| | - Daniela Perani
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
- Nuclear Medicine Department, San Raffaele Hospital, Milan, Italy
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23
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O'Callaghan C, Bertoux M, Irish M, Shine JM, Wong S, Spiliopoulos L, Hodges JR, Hornberger M. Fair play: social norm compliance failures in behavioural variant frontotemporal dementia. Brain 2015; 139:204-16. [PMID: 26503957 DOI: 10.1093/brain/awv315] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 09/13/2015] [Indexed: 11/13/2022] Open
Abstract
Adherence to social norms is compromised in a variety of neuropsychiatric conditions. Functional neuroimaging studies have investigated social norm compliance in healthy individuals, leading to the identification of a network of fronto-subcortical regions that underpins this ability. However, there is a lack of corroborative evidence from human lesion models investigating the structural anatomy of norm compliance across this fronto-subcortical network. To address this, we developed a neuroeconomic task to investigate social norm compliance in a neurodegenerative lesion model: behavioural variant frontotemporal dementia, a condition characterized by gross social dysfunction. The task assessed norm compliance across three behaviours that are well-studied in the neuroeconomics literature: fairness, prosocial and punishing behaviours. We administered our novel version of the Ultimatum Game in 22 patients with behavioural variant frontotemporal dementia and 22 age-matched controls, to assess how decision-making behaviour was modulated in response to (i) fairness of monetary offers; and (ii) social context of monetary offers designed to produce either prosocial or punishing behaviours. Voxel-based morphometry was used to characterize patterns of grey matter atrophy associated with task performance. Acceptance rates between patients and controls were equivalent when only fairness was manipulated. However, patients were impaired in modulating their decisions in response to social contextual information. Patients' performance in the punishment condition was consistent with a reduced tendency to engage in punishment; this was associated with decreased grey matter volume in the anterior cingulate, orbitofrontal cortex, left dorsolateral prefrontal cortex and right inferior frontal gyrus. In the prosocial condition, patients' performance suggested a reduced expression of prosocial behaviour, associated with decreased grey matter in the anterior insula, lateral orbitofrontal cortex, anterior cingulate and dorsal striatum. Acceptance rates in the Ultimatum Game were also significantly related to impairments in the everyday expression of empathic concern. In conclusion, we demonstrate that compliance to basic social norms (fairness) can be maintained in behavioural variant frontotemporal dementia; however, more complex normative behaviours (prosociality, punishment) that require integration of social contextual information are disrupted in association with atrophy in key fronto-striatal regions. These results suggest that the integration of social contextual information to guide normative behaviour is uniquely impaired in behavioural variant frontotemporal dementia, and may explain other common features of the condition including gullibility and impaired empathy. Our findings also converge with previous functional neuroimaging investigations in healthy individuals and provide the first description of the structural anatomy of social norm compliance in a neurodegenerative lesion model.
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Affiliation(s)
- Claire O'Callaghan
- 1 Neuroscience Research Australia, Sydney, Australia 2 School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Maxime Bertoux
- 3 Department of Clinical Neurosciences, Cambridge University, Cambridge, UK
| | - Muireann Irish
- 1 Neuroscience Research Australia, Sydney, Australia 4 School of Psychology, University of New South Wales, Sydney, Australia 5 ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - James M Shine
- 1 Neuroscience Research Australia, Sydney, Australia 6 School of Psychology, Stanford University, Palo Alto, California, USA
| | - Stephanie Wong
- 1 Neuroscience Research Australia, Sydney, Australia 5 ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Leonidas Spiliopoulos
- 7 Max Planck Institute for Human Development, Centre for Adaptive Rationality, Berlin, Germany
| | - John R Hodges
- 1 Neuroscience Research Australia, Sydney, Australia 2 School of Medical Sciences, University of New South Wales, Sydney, Australia 5 ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Michael Hornberger
- 1 Neuroscience Research Australia, Sydney, Australia 2 School of Medical Sciences, University of New South Wales, Sydney, Australia 3 Department of Clinical Neurosciences, Cambridge University, Cambridge, UK 5 ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
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24
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Bott NT, Radke A, Stephens ML, Kramer JH. Frontotemporal dementia: diagnosis, deficits and management. Neurodegener Dis Manag 2015; 4:439-54. [PMID: 25531687 DOI: 10.2217/nmt.14.34] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Frontotemporal dementia (FTD) is a progressive neurologic syndrome with diverse clinical presentations and attendant underlying pathologies. Psychiatric prodrome, neuropsychiatric symptoms and language difficulties are common in FTD, but the diversity of presentation raises unique diagnostic challenges that can significantly impact patient care and counsel for caregivers regarding clinical status and prognosis. While neuropsychiatric symptom measures are helpful, more sensitive assessments delineating the specific behavioral and linguistic deficits accompanying FTD are needed. Comprehensive clinical assessment in combination with evaluation of language, socio-emotional functioning, cognition and neuroimaging aid in accurate and early diagnosis and treatment planning. In what follows, we review each of the FTD syndromes, highlight current research investigating the cognitive, behavioral and socio-emotional deficits observed with this disease, address common diagnostic challenges and summarize best practices associated with management of FTD.
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Affiliation(s)
- Nicholas T Bott
- Department of Neurology, Memory & Aging Center, University of California, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, USA
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25
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Fletcher PD, Downey LE, Golden HL, Clark CN, Slattery CF, Paterson RW, Schott JM, Rohrer JD, Rossor MN, Warren JD. Auditory hedonic phenotypes in dementia: A behavioural and neuroanatomical analysis. Cortex 2015; 67:95-105. [PMID: 25929717 PMCID: PMC4465962 DOI: 10.1016/j.cortex.2015.03.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 03/08/2015] [Accepted: 03/27/2015] [Indexed: 02/03/2023]
Abstract
Patients with dementia may exhibit abnormally altered liking for environmental sounds and music but such altered auditory hedonic responses have not been studied systematically. Here we addressed this issue in a cohort of 73 patients representing major canonical dementia syndromes (behavioural variant frontotemporal dementia (bvFTD), semantic dementia (SD), progressive nonfluent aphasia (PNFA) amnestic Alzheimer's disease (AD)) using a semi-structured caregiver behavioural questionnaire and voxel-based morphometry (VBM) of patients' brain MR images. Behavioural responses signalling abnormal aversion to environmental sounds, aversion to music or heightened pleasure in music (‘musicophilia’) occurred in around half of the cohort but showed clear syndromic and genetic segregation, occurring in most patients with bvFTD but infrequently in PNFA and more commonly in association with MAPT than C9orf72 mutations. Aversion to sounds was the exclusive auditory phenotype in AD whereas more complex phenotypes including musicophilia were common in bvFTD and SD. Auditory hedonic alterations correlated with grey matter loss in a common, distributed, right-lateralised network including antero-mesial temporal lobe, insula, anterior cingulate and nucleus accumbens. Our findings suggest that abnormalities of auditory hedonic processing are a significant issue in common dementias. Sounds may constitute a novel probe of brain mechanisms for emotional salience coding that are targeted by neurodegenerative disease.
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Affiliation(s)
- Phillip D Fletcher
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Laura E Downey
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Hannah L Golden
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Camilla N Clark
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Catherine F Slattery
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Ross W Paterson
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Jonathan M Schott
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Jonathan D Rohrer
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Martin N Rossor
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom.
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