Emotional prosody recognition is impaired in Alzheimer’s disease

Distinctive autophagy/mitophagy biomarker profiles in frontotemporal lobar degeneration and Alzheimer's disease

Maintaining cellular homeostasis by removing damaged and senescent mitochondria, a process termed mitophagy, is crucial in preventing Alzheimer's disease (AD) and represents a promising therapeutic target. Our previous research revealed altered mitophagy biomarkers, such as increased CSF and serum PINK1 and serum BNIP3L and decreased serum TFEB levels, indicating impaired autophagy-lysosomal degradation in the AD continuum. However, the role of autophagy/mitophagy in frontotemporal lobar degeneration (FTLD) remains unclear. This study investigated the biomarkers of autophagy/mitophagy and lysosomal biogenesis (PINK1, ULK1, BNIP3L, and TFEB) in biofluids (CSF and serum) from 308 biomarker-defined individuals across the FTLD continuum (FTLD-dementia, n = 29; FTLD-MCI, n = 33) and compared them with those across the AD continuum (MCI-AD, n = 100; AD-dementia, n = 100) and cognitively unimpaired (CU) controls (n = 46) recruited from Czech Brain Aging Study. Additionally, we compared the mitophagy biomarkers across different FTLD clinical subtypes (frontal, semantic and nonfluent variant) with CU, and explored the association between mitophagy biomarkers and clinical phenotypes of FTLD (biomarkers of tau, biomarkers of neurodegeneration, cognition and ATN profile).Our findings indicated a significantly lower CSF PINK1 and ULK1 levels in FTLD compared to AD, with FTLD dementia showing particularly low CSF PINK1 levels compared to AD-dementia. Conversely, CSF ULK1 levels were higher in FTLD-MCI compared to AD-dementia. Serum analyses revealed lower PINK1 and higher TFEB levels in FTLD dementia compared to AD dementia. This study provides compelling evidence of distinct alterations in autophagy/mitophagy biomarkers between FTLD and AD, indicating that these neurodegenerative diseases may affect the cellular waste disposal system through different pathways. This is the first study to explore mitophagy biomarkers in human CSF and serum in FTLD, opening avenues for further research and potential clinical applications.

Understanding basic and social emotions in Alzheimer's disease and frontotemporal dementia

Introduction

Recent developments in the field of social cognition have led to a renewed interest in basic and social emotion recognition in early stages of Alzheimer's Disease (AD) and FrontoTemporal Dementia (FTD). Despite the growing attention to this issue, only few studies have attempted to investigate emotion recognition using both visual and vocal stimuli. In addition, recent studies have presented conflicting findings regarding the extent of impairment in patients in the early stages of these diseases. The present study aims to investigate emotion understanding (both basic and social emotions), using different tasks with visual and auditory stimuli, to identify supramodal deficits in AD and FTD to provide a reliable tool to better outline their behavioral and emotional profile and useful instruments for their management.

Methods

Eighteen patients with AD and 15 patients with FTD were included in the study. Healthy control (HCs) subjects were recruited to obtain normative data for basic emotion recognition tests and social emotion recognition tasks. To evaluate basic emotion recognition, the Facial Emotion Recognition Battery (FERB) and the Emotional Prosody Recognition Battery (EPRB) were administered. To evaluate social emotion recognition, the Faux Pas (FP), Reading the Mind in the Eyes (RME), and Reading the Mind in the Voice (RMV) tests were employed.

Results

FTD patients performed significantly worse than HCs in most of the subtests of the basic emotion recognition batteries, where, instead, AD patients were significantly impaired only when required to match emotional facial expression in different individuals (subtask of the FERB). Moreover, FTD patients scored significantly lower in RME and RMV tests compared both to AD patients and to HCs. In addition, ADs were selectively impaired in RMV as respect to HCs.

Discussion

FTD patients showed deficits in emotion recognition, affecting both basic and social emotions, whether conveyed through facial expressions or prosody. This result may explain the well-known social behavioral difficulties observed in FTD patients from the early stages of the disease. The fewer and specific deficits in AD patients with comparable MMSE scores may be attributed to the mild degree of impairment, as these deficits may appear later in the progression of AD.

Comprehension of acoustically degraded emotional prosody in Alzheimer's disease and primary progressive aphasia

Previous research suggests that emotional prosody perception is impaired in neurodegenerative diseases like Alzheimer's disease (AD) and primary progressive aphasia (PPA). However, no previous research has investigated emotional prosody perception in these diseases under non-ideal listening conditions. We recruited 18 patients with AD, and 31 with PPA (nine logopenic (lvPPA); 11 nonfluent/agrammatic (nfvPPA) and 11 semantic (svPPA)), together with 24 healthy age-matched individuals. Participants listened to speech stimuli conveying three emotions in clear and noise-vocoded forms and had to identify the emotion being conveyed. We then conducted correlation analyses between task performance and measures of socio-emotional functioning. All patient groups showed significant impairments in identifying clear emotional prosody compared to healthy individuals. These deficits were exacerbated under noise-vocoded conditions, with all patient groups performing significantly worse than healthy individuals and patients with lvPPA performing significantly worse than those with svPPA. Significant correlations with social cognition measures were observed more consistently for noise-vocoded than clear emotional prosody comprehension. These findings open a window on a dimension of real-world emotional communication that has often been overlooked in dementia, with particular relevance to social cognition, and begin to suggest a novel candidate paradigm for investigating and quantifying this systematically.

Category-Sensitive Age-Related Shifts Between Prosodic and Semantic Dominance in Emotion Perception Linked to Cognitive Capacities

PURPOSE

Prior research extensively documented challenges in recognizing verbal and nonverbal emotion among older individuals when compared with younger counterparts. However, the nature of these age-related changes remains unclear. The present study investigated how older and younger adults comprehend four basic emotions (i.e., anger, happiness, neutrality, and sadness) conveyed through verbal (semantic) and nonverbal (facial and prosodic) channels.

METHOD

A total of 73 older adults (43 women, Mage = 70.18 years) and 74 younger adults (37 women, Mage = 22.01 years) partook in a fixed-choice test for recognizing emotions presented visually via facial expressions or auditorily through prosody or semantics.

RESULTS

The results confirmed age-related decline in recognizing emotions across all channels except for identifying happy facial expressions. Furthermore, the two age groups demonstrated both commonalities and disparities in their inclinations toward specific channels. While both groups displayed a shared dominance of visual facial cues over auditory emotional signals, older adults indicated a preference for semantics, whereas younger adults displayed a preference for prosody in auditory emotion perception. Notably, the dominance effects observed in older adults for visual and semantic cues were less pronounced for sadness and anger compared to other emotions. These challenges in emotion recognition and the shifts in channel preferences among older adults were correlated with their general cognitive capabilities.

CONCLUSION

Together, the findings underscore that age-related obstacles in perceiving emotions and alterations in channel dominance, which vary by emotional category, are significantly intertwined with overall cognitive functioning.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.27307251.

Alterations of human CSF and serum-based mitophagy biomarkers in the continuum of Alzheimer disease

Defective mitophagy is consistently found in postmortem brain and iPSC-derived neurons from Alzheimer disease (AD) patients. However, there is a lack of extensive examination of mitophagy status in serum or cerebrospinal fluid (CSF), and the clinical potential of mitophagy biomarkers has not been tested. We quantified biomarkers of mitophagy/autophagy and lysosomal degradation (PINK1, BNIP3L and TFEB) in CSF and serum from 246 individuals, covering mild cognitive impairment due to AD (MCI-AD, n = 100), dementia due to AD (AD-dementia, n = 100), and cognitively unimpaired individuals (CU, n = 46), recruited from the Czech Brain Aging Study. Cognitive function and brain atrophy were also assessed. Our data show that serum and CSF PINK1 and serum BNIP3L were higher, and serum TFEB was lower in individuals with AD than in corresponding CU individuals. Additionally, the magnitude of mitophagy impairment correlated with the severity of clinical indicators in AD patients. Specifically, levels of PINK1 positively correlated with phosphorylated (p)-MAPT/tau (181), total (t)-MAPT/tau, NEFL (neurofilament light chain), and NRGN (neurogranin) levels in CSF and negatively with memory, executive function, and language domain. Serum TFEB levels negatively correlated with NEFL and positively with executive function and language. This study reveals mitophagy impairment reflected in biofluid biomarkers of individuals with AD and associated with more advanced AD pathology.Abbreviation: Aβ: amyloid beta; AD: Alzheimer disease; AVs: autophagic vacuoles; BNIP3L: BCL2 interacting protein 3 like; CU: cognitively unimpaired; CSF: cerebrospinal fluid; LAMP1: lysosomal-associated membrane protein 1; MAP1LC3/LC3: microtubule associated protein 1 light chain 3; MCI: mild cognitive impairment; NRGN: neurogranin; NEFL: neurofilament light chain; p-MAPT/tau: phosphorylated microtubule associated protein tau; PINK1: PTEN induced kinase 1; t-MAPT/tau: total microtubule associated protein tau; TFEB: transcription factor EB; TMT: Trail Making Test.

Social cognition in Idiopathic generalised epilepsies

Social cognition is a set of mental skills necessary to create satisfactory interpersonal relationships and feel a sense of belonging to a social group. Its deficits significantly reduce the quality of life in people with epilepsy. Studies on social cognition and its impairments focus predominantly on people with focal epilepsies. Idiopathic generalised epilepsies are a group of diseases that share similar clinical, prognostic and electrographic characteristics. Despite their typically normal intelligence, people with Idiopathic generalised epilepsies can suffer from learning disabilities and executive dysfunctions. Current studies also suggest social cognition impairments, but their results are inconsistent. This review offers the latest knowledge of social cognition in adults with Idiopathic generalised epilepsies. In addition, we provide an overview of the most frequently used assessment methods. We explain possible reasons for different outcomes and discuss future research perspectives.

Multidimensional assessment of social cognition using non-immersive virtual reality in dementia with Lewy bodies and Alzheimer's disease: an exploratory study

INTRODUCTION

Few studies have focused on social cognition in dementia with Lewy bodies (DLB), even though some brain structures being well known as underlying social cognitive processes are directly impacted in this disease. Furthermore, social cognition processes have been mostly studied independently using evaluations with poor ecological validity. We aimed at studying the ability of a new naturalistic and multidimensional social cognition task to reveal impairments in DLB patients. We chose to compare the profile of these patients with that of Alzheimer's disease (AD) patients, for which social cognition is better preserved.

METHOD

Fifteen patients (DLB: n = 7; AD: n = 8) and 28 healthy controls underwent the REALSoCog task. They encountered several social situations (e.g. control versus transgressions) in a non-immersive virtual city environment allowing the assessment of moral cognition, cognitive and affective theory of mind (ToM), emotional empathy and behavioral intentions.

RESULTS

The main results showed (i) a lower ability to detect transgressions in DLB patients, particularly conventional ones, whereas moral cognition seemed better preserved in AD patients; (ii) a cognitive ToM impairment in both DLB and AD patients, while affective ToM is impaired only in DLB patients; (iii) a decreased emotional empathy specifically observed in DLB patients; (iv) more inappropriate behavioral intentions, mainly in DLB patients, but also in some AD patients.

CONCLUSIONS

This study suggests the feasibility and potential interest of the REALSoCog task in revealing social cognition deficits, particularly for DLB patients by showing different social patterns as compared to AD patients. These results offer interesting clinical perspectives to develop more naturalistic tasks in such populations and for clinical differential diagnosis. Limitations and future perspectives are discussed.

Vocal expression of emotions discriminates dementia with Lewy bodies from Alzheimer's disease

Dementia with Lewy bodies (DLB) and Alzheimer's disease (AD), the two most common neurodegenerative dementias, both exhibit altered emotional processing. However, how vocal emotional expressions alter in and differ between DLB and AD remains uninvestigated. We collected voice data during story reading from 152 older adults comprising DLB, AD, and cognitively unimpaired (CU) groups and compared their emotional prosody in terms of valence and arousal dimensions. Compared with matched AD and CU participants, DLB patients showed reduced overall emotional expressiveness, as well as lower valence (more negative) and lower arousal (calmer), the extent of which was associated with cognitive impairment and insular atrophy. Classification models using vocal features discriminated DLB from AD and CU with an AUC of 0.83 and 0.78, respectively. Our findings may aid in discriminating DLB patients from AD and CU individuals, serving as a surrogate marker for clinical and neuropathological changes in DLB.

Highlights

DLB showed distinctive reduction in vocal expression of emotions.Cognitive impairment was associated with reduced vocal emotional expression in DLB.Insular atrophy was associated with reduced vocal emotional expression in DLB.Emotional expression measures successfully differentiated DLB from AD or controls.

Deep Learning of Speech Data for Early Detection of Alzheimer's Disease in the Elderly

BACKGROUND

Alzheimer's disease (AD) is the most common form of dementia, which makes the lives of patients and their families difficult for various reasons. Therefore, early detection of AD is crucial to alleviating the symptoms through medication and treatment.

OBJECTIVE

Given that AD strongly induces language disorders, this study aims to detect AD rapidly by analyzing the language characteristics.

MATERIALS AND METHODS

The mini-mental state examination for dementia screening (MMSE-DS), which is most commonly used in South Korean public health centers, is used to obtain negative answers based on the questionnaire. Among the acquired voices, significant questionnaires and answers are selected and converted into mel-frequency cepstral coefficient (MFCC)-based spectrogram images. After accumulating the significant answers, validated data augmentation was achieved using the Densenet121 model. Five deep learning models, Inception v3, VGG19, Xception, Resnet50, and Densenet121, were used to train and confirm the results.

RESULTS

Considering the amount of data, the results of the five-fold cross-validation are more significant than those of the hold-out method. Densenet121 exhibits a sensitivity of 0.9550, a specificity of 0.8333, and an accuracy of 0.9000 in a five-fold cross-validation to separate AD patients from the control group.

CONCLUSIONS

The potential for remote health care can be increased by simplifying the AD screening process. Furthermore, by facilitating remote health care, the proposed method can enhance the accessibility of AD screening and increase the rate of early AD detection.

Emotion recognition and processing in patients with mild cognitive impairment: A systematic review

The purpose of this study was to investigate emotion recognition and processing in patients with mild cognitive impairment (MCI) in order to update the state of current literature on this important but undervalued topic. We identified 15 papers published between 2012 and 2022 that meet the inclusion criteria. Paper search, selection, and extraction followed the PRISMA guidelines. We used a narrative synthesis approach in order to report a summary of the main findings taken from all papers. The results collected are still ambiguous: some studies did not find any differences between MCI and healthy controls (HC) groups in emotion recognition and processing, and other results reported emotion-specific deficits in emotion recognition regarding MCI patients (both regarding negative and neutral emotions). It is essential to underline that these findings could not be generalized to the whole MCI population due to the heterogeneous use of measures and composition of the sample. This does not allow us to make a comprehensive comparison between the results. Our suggestion for future research is to align the results using the same type of tests and emotion recognition assessment.

Emotion Recognition in a Health Continuum: Comparison of Healthy Adults of Advancing Age, Community Dwelling Adults Bearing Vascular Risk Factors and People Diagnosed with Mild Cognitive Impairment

The identification of basic emotions plays an important role in social relationships and behaviors linked to survival. In neurodegenerative conditions such as Alzheimer's disease (AD), the ability to recognize emotions may already be impaired at early stages of the disease, such as the stage of Mild Cognitive Impairment (MCI). However, as regards vascular pathologies related to cognitive impairment, very little is known about emotion recognition in people bearing vascular risk factors (VRF). Therefore, the aim of the present study was to examine emotion recognition ability in the health continuum "healthy advancing age-advancing age with VRF-MCI". The sample consisted of 106 adults divided in three diagnostic groups; 43 adults with MCI, 41 adults bearing one or more VRF, and 22 healthy controls of advancing age (HC). Since HC were more educated and younger than the other two groups, the age-group and level of educational were taken into account in the statistical analyses. A dynamic visual test was administered to examine recognition of basic emotions and emotionally neutral conditions. The results showed only a significant diagnostic group x educational level interaction as regards total emotion recognition ability, F (4, 28.910) = 4.117 p = 0.004 η2 = 0.166. High educational level seems to contribute to a high-level-emotion-recognition-performance both in healthy adults of advancing age and in adults bearing vascular risk factors. Medium educational level appears to play the same role only in healthy adults. Neither educational level can help MCI people to enhance their significantly lower emotion recognition ability.