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Jarsch M, Semenkova A, Monsch AU, Kressig RW, Sollberger M. Eine Lücke, die es zu schließen gilt: Die Untersuchung sozial-kognitiver Fähigkeiten an deutschsprachigen Memory-Kliniken. ZEITSCHRIFT FÜR NEUROPSYCHOLOGIE 2022. [DOI: 10.1024/1016-264x/a000358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung: Die Untersuchung sozial-kognitiver Fähigkeiten kann zur Diagnostik kognitiver Störungen beitragen. In diesem Zusammenhang stellt sich die Frage, inwieweit sozial-kognitive Fähigkeiten in deutschsprachigen Memory-Kliniken (MK) untersucht werden. Wir führten dazu eine Befragung in 87 deutschsprachigen MK in Deutschland, österreich und der Schweiz durch. Es zeigte sich, dass die Untersuchung sozial-kognitiver Fähigkeiten mehrheitlich befürwortet wird, jedoch nur selten erfolgt. Die Mehrheit der MK könnte sich jedoch vorstellen, in Zukunft sozial-kognitive Diagnostik durchzuführen, vorausgesetzt, dass hierfür adäquate psychometrische Testverfahren vorliegen. Die Forderung der MK nach psychometrischen sozial-kognitiven Tests gewinnt an Bedeutung angesichts der Tatsache, dass die kürzlich publizierten ICD-11-Kriterien (International Statistical Classification of Diseases and Related Health Problems) die Untersuchung sozial-kognitiver Fähigkeiten bei der Abklärung einer kognitiven Störung empfehlen.
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Affiliation(s)
- Marianne Jarsch
- Memory Clinic, Universitäre Altersmedizin FELIX PLATTER und Universität Basel, Schweiz
- Fakultät für Psychologie, Universität Basel, Schweiz
| | - Anna Semenkova
- Memory Clinic, Universitäre Altersmedizin FELIX PLATTER und Universität Basel, Schweiz
- Fakultät für Psychologie, Universität Basel, Schweiz
| | - Andreas U. Monsch
- Memory Clinic, Universitäre Altersmedizin FELIX PLATTER und Universität Basel, Schweiz
- Fakultät für Psychologie, Universität Basel, Schweiz
| | - Reto W. Kressig
- Memory Clinic, Universitäre Altersmedizin FELIX PLATTER und Universität Basel, Schweiz
| | - Marc Sollberger
- Memory Clinic, Universitäre Altersmedizin FELIX PLATTER und Universität Basel, Schweiz
- Neurologische Klinik, Universitätsspital und Universität Basel, Schweiz
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Hengstschläger A, Sommerlad A, Huntley J. What Are the Neural Correlates of Impaired Awareness of Social Cognition and Function in Dementia? A Systematic Review. Brain Sci 2022; 12:1136. [PMID: 36138872 PMCID: PMC9496823 DOI: 10.3390/brainsci12091136] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/30/2022] Open
Abstract
Deficits in social cognition and function are characteristic of dementia, commonly accompanied by a loss of awareness of the presence or extent of these deficits. This lack of awareness can impair social relationships, increase patients' and carers' burden, and contribute to increased rates of institutionalization. Despite clinical importance, neural correlates of this complex phenomenon remain unclear. We conducted a systematic search of five electronic databases to identify functional and structural neuroimaging studies investigating the neural correlates of impaired awareness of social cognition and function in any dementia type. We rated study quality and conducted a narrative synthesis of the results of the eight studies that met the predefined eligibility criteria. Across these studies, deficits in awareness of impairments in social cognition and function were associated with structural or functional abnormalities in the frontal pole, orbitofrontal cortex, temporal pole, middle temporal gyrus, inferior temporal gyrus, fusiform gyrus, amygdala, hippocampus, parahippocampal gyrus, and insula. Several identified regions overlap with established neural correlates of social cognition. More research is needed to understand awareness of social cognition and function and how this becomes impaired in dementia to improve neuroscientific understanding, aid the identification of this problematic symptom, and target interventions to reduce burden and improve care.
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Affiliation(s)
| | - Andrew Sommerlad
- Division of Psychiatry, University College London, London W1T 7BN, UK
- Camden and Islington NHS Foundation Trust, London NW1 0PE, UK
| | - Jonathan Huntley
- Division of Psychiatry, University College London, London W1T 7BN, UK
- Camden and Islington NHS Foundation Trust, London NW1 0PE, UK
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Sommerlad A, Huntley J, Livingston G, Rankin KP, Fancourt D. Empathy and its associations with age and sociodemographic characteristics in a large UK population sample. PLoS One 2021; 16:e0257557. [PMID: 34543334 PMCID: PMC8452078 DOI: 10.1371/journal.pone.0257557] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/06/2021] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Empathy is fundamental to social cognition, driving prosocial behaviour and mental health but associations with aging and other socio-demographic characteristics are unclear. We therefore aimed to characterise associations of these characteristics with two main self-reported components of empathy, namely empathic-concern (feeling compassion) and perspective-taking (understanding others' perspective). METHODS We asked participants in an internet-based survey of UK-dwelling adults aged ≥18 years to complete the Interpersonal Reactivity Index subscales measuring empathic concern and perspective taking, and sociodemographic and personality questionnaires. We weighted the sample to be UK population representative and employed multivariable weighted linear regression models. RESULTS In 30,033 respondents, mean empathic concern score was 3.86 (95% confidence interval 3.85, 3.88) and perspective taking was 3.57 (3.56. 3.59); the correlation between these sub-scores was 0.45 (p < 0.001). Empathic concern and perspective taking followed an inverse-u shape trajectory in women with peak between 40 and 50 years whereas in men, perspective taking declines with age but empathic concern increases. In fully adjusted models, greater empathic concern was associated with female gender, non-white ethnicity, having more education, working in health, social-care, or childcare professions, and having higher neuroticism, extroversion, openness to experience and agreeableness traits. Perspective taking was associated with younger age, female gender, more education, employment in health or social-care, neuroticism, openness, and agreeableness. CONCLUSIONS Empathic compassion and understanding are distinct dimensions of empathy with differential demographic associations. Perspective taking may decline due to cognitive inflexibility with older age whereas empathic concern increases in older men suggesting it is socially-driven.
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Affiliation(s)
- Andrew Sommerlad
- Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Jonathan Huntley
- Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Gill Livingston
- Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Katherine P. Rankin
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California, United States of America
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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Parthimos TP, Karavasilis E, Rankin KP, Seimenis I, Leftherioti K, Papanicolaou AC, Miller B, Papageorgiou SG, Papatriantafyllou JD. The Neural Correlates of Impaired Self-Monitoring Among Individuals With Neurodegenerative Dementias. J Neuropsychiatry Clin Neurosci 2020; 31:201-209. [PMID: 30605361 DOI: 10.1176/appi.neuropsych.17120349] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Self-monitoring is a crucial component of human empathy and necessary for the formation and repair of social relations. Several studies have brought to light possible neuronal substrates associated with self-monitoring, but the information that they have provided is inconclusive. The authors, therefore, studied a large group of patients with dementia to assess what brain structures are necessary for the self-monitoring function.Methods: Seventy-seven patients with dementia of various types were screened using voxel-based morphometry to assess possible volume reduction in the brain structures of patients with self-monitoring problems, and the decrease of socioemotional expressiveness and modification of self-presentation was estimated using the Revised Self-Monitoring Scale. Regression analysis was employed to investigate the correlation between gray matter loss and deficient self-monitoring.Results: The socioemotional expressiveness scores were associated with decreased gray matter volume in the right olfactory cortex, inferior frontal gyrus, superior temporal pole, parahippocampal gyrus, insula, and medial temporal gyrus bilaterally. Self-presentation scores were associated with bilateral gray matter volume reduction in the olfactory cortex, insula, rectus gyrus and inferior frontal gyrus, right superior temporal pole, and parahippocampal gyrus, as well as the left medial temporal gyrus and anterior superior frontal gyrus.Conclusions: These results suggest that patients with dementia present decreased ability of self-monitoring, probably due to impaired insula and orbitofrontal cortex and their disconnection from structures of the salience network.
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Affiliation(s)
- Theodore P Parthimos
- The 3rd Age Day Care Center IASIS, Glyfada, Greece (Parthimos, Leftherioti, Papatriantafyllou); the Department of Medical Physics, Medical School, Democritus University of Thrace, Alexandroupolis, Greece (Karavasilis, Seimenis); the Second Department of Radiology, University General Hospital Attikon, National and Kapodistrian University of Athens, Greece (Karavasilis); the Department of Neurology, Memory and Aging Center, University of California San Francisco (Rankin, Miller); the Department of Pediatrics, Division of Clinical Neurosciences, University of Tennessee Health Science Center, Memphis; Neuroscience Institute, Le Bonheur Children's Hospital, Memphis; Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis (Papanicolaou); and the Second Department of Neurology, University General Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece (Papageorgiou)
| | - Efstratios Karavasilis
- The 3rd Age Day Care Center IASIS, Glyfada, Greece (Parthimos, Leftherioti, Papatriantafyllou); the Department of Medical Physics, Medical School, Democritus University of Thrace, Alexandroupolis, Greece (Karavasilis, Seimenis); the Second Department of Radiology, University General Hospital Attikon, National and Kapodistrian University of Athens, Greece (Karavasilis); the Department of Neurology, Memory and Aging Center, University of California San Francisco (Rankin, Miller); the Department of Pediatrics, Division of Clinical Neurosciences, University of Tennessee Health Science Center, Memphis; Neuroscience Institute, Le Bonheur Children's Hospital, Memphis; Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis (Papanicolaou); and the Second Department of Neurology, University General Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece (Papageorgiou)
| | - Katherine P Rankin
- The 3rd Age Day Care Center IASIS, Glyfada, Greece (Parthimos, Leftherioti, Papatriantafyllou); the Department of Medical Physics, Medical School, Democritus University of Thrace, Alexandroupolis, Greece (Karavasilis, Seimenis); the Second Department of Radiology, University General Hospital Attikon, National and Kapodistrian University of Athens, Greece (Karavasilis); the Department of Neurology, Memory and Aging Center, University of California San Francisco (Rankin, Miller); the Department of Pediatrics, Division of Clinical Neurosciences, University of Tennessee Health Science Center, Memphis; Neuroscience Institute, Le Bonheur Children's Hospital, Memphis; Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis (Papanicolaou); and the Second Department of Neurology, University General Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece (Papageorgiou)
| | - Ioannis Seimenis
- The 3rd Age Day Care Center IASIS, Glyfada, Greece (Parthimos, Leftherioti, Papatriantafyllou); the Department of Medical Physics, Medical School, Democritus University of Thrace, Alexandroupolis, Greece (Karavasilis, Seimenis); the Second Department of Radiology, University General Hospital Attikon, National and Kapodistrian University of Athens, Greece (Karavasilis); the Department of Neurology, Memory and Aging Center, University of California San Francisco (Rankin, Miller); the Department of Pediatrics, Division of Clinical Neurosciences, University of Tennessee Health Science Center, Memphis; Neuroscience Institute, Le Bonheur Children's Hospital, Memphis; Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis (Papanicolaou); and the Second Department of Neurology, University General Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece (Papageorgiou)
| | - Katerina Leftherioti
- The 3rd Age Day Care Center IASIS, Glyfada, Greece (Parthimos, Leftherioti, Papatriantafyllou); the Department of Medical Physics, Medical School, Democritus University of Thrace, Alexandroupolis, Greece (Karavasilis, Seimenis); the Second Department of Radiology, University General Hospital Attikon, National and Kapodistrian University of Athens, Greece (Karavasilis); the Department of Neurology, Memory and Aging Center, University of California San Francisco (Rankin, Miller); the Department of Pediatrics, Division of Clinical Neurosciences, University of Tennessee Health Science Center, Memphis; Neuroscience Institute, Le Bonheur Children's Hospital, Memphis; Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis (Papanicolaou); and the Second Department of Neurology, University General Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece (Papageorgiou)
| | - Andrew C Papanicolaou
- The 3rd Age Day Care Center IASIS, Glyfada, Greece (Parthimos, Leftherioti, Papatriantafyllou); the Department of Medical Physics, Medical School, Democritus University of Thrace, Alexandroupolis, Greece (Karavasilis, Seimenis); the Second Department of Radiology, University General Hospital Attikon, National and Kapodistrian University of Athens, Greece (Karavasilis); the Department of Neurology, Memory and Aging Center, University of California San Francisco (Rankin, Miller); the Department of Pediatrics, Division of Clinical Neurosciences, University of Tennessee Health Science Center, Memphis; Neuroscience Institute, Le Bonheur Children's Hospital, Memphis; Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis (Papanicolaou); and the Second Department of Neurology, University General Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece (Papageorgiou)
| | - Bruce Miller
- The 3rd Age Day Care Center IASIS, Glyfada, Greece (Parthimos, Leftherioti, Papatriantafyllou); the Department of Medical Physics, Medical School, Democritus University of Thrace, Alexandroupolis, Greece (Karavasilis, Seimenis); the Second Department of Radiology, University General Hospital Attikon, National and Kapodistrian University of Athens, Greece (Karavasilis); the Department of Neurology, Memory and Aging Center, University of California San Francisco (Rankin, Miller); the Department of Pediatrics, Division of Clinical Neurosciences, University of Tennessee Health Science Center, Memphis; Neuroscience Institute, Le Bonheur Children's Hospital, Memphis; Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis (Papanicolaou); and the Second Department of Neurology, University General Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece (Papageorgiou)
| | - Sokratis G Papageorgiou
- The 3rd Age Day Care Center IASIS, Glyfada, Greece (Parthimos, Leftherioti, Papatriantafyllou); the Department of Medical Physics, Medical School, Democritus University of Thrace, Alexandroupolis, Greece (Karavasilis, Seimenis); the Second Department of Radiology, University General Hospital Attikon, National and Kapodistrian University of Athens, Greece (Karavasilis); the Department of Neurology, Memory and Aging Center, University of California San Francisco (Rankin, Miller); the Department of Pediatrics, Division of Clinical Neurosciences, University of Tennessee Health Science Center, Memphis; Neuroscience Institute, Le Bonheur Children's Hospital, Memphis; Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis (Papanicolaou); and the Second Department of Neurology, University General Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece (Papageorgiou)
| | - John D Papatriantafyllou
- The 3rd Age Day Care Center IASIS, Glyfada, Greece (Parthimos, Leftherioti, Papatriantafyllou); the Department of Medical Physics, Medical School, Democritus University of Thrace, Alexandroupolis, Greece (Karavasilis, Seimenis); the Second Department of Radiology, University General Hospital Attikon, National and Kapodistrian University of Athens, Greece (Karavasilis); the Department of Neurology, Memory and Aging Center, University of California San Francisco (Rankin, Miller); the Department of Pediatrics, Division of Clinical Neurosciences, University of Tennessee Health Science Center, Memphis; Neuroscience Institute, Le Bonheur Children's Hospital, Memphis; Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis (Papanicolaou); and the Second Department of Neurology, University General Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece (Papageorgiou)
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5
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Abstract
BACKGROUND Social cognition is not routinely assessed in older adults. We report population-based normative data on the Social Norms Questionnaire (SNQ22) which asks individuals about the appropriateness of specific behaviors in hypothetical scenarios, errors being related either to breaking with norms or to over-adhering to perceived norms. Total SNQ scores represent the number of correct responses while subscale scores are error totals. METHODS We administered the SNQ22 to 744 adults aged 65+ within a population-based study, and examined the distribution of scores by demographics, other cognitive measures, and Clinical Dementia Rating (CDR). RESULTS Most participants performed well with few errors. Women and young-old individuals performed significantly better than men and older individuals on total score and over-adherence; women had fewer break-norms errors than men. No race or education effects were observed. Worse (higher) total scores and (lower) over-adherence errors were inversely associated with literacy, CDR, Mini-Mental State Examination, attention, memory, language, executive, and visuospatial domains. Break-norms errors were rare and not associated with any of the above. CONCLUSIONS In population-based normative data on the SNQ22. age and sex influenced total score and over-adherence errors, which showed the expected associations with CDR and other cognitive domains. Social norms screening may be useful in the cognitive assessment of older adults.
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Ranasinghe KG, Rankin KP, Pressman PS, Perry DC, Lobach IV, Seeley WW, Coppola G, Karydas AM, Grinberg LT, Shany-Ur T, Lee SE, Rabinovici GD, Rosen HJ, Gorno-Tempini ML, Boxer AL, Miller ZA, Chiong W, DeMay M, Kramer JH, Possin KL, Sturm VE, Bettcher BM, Neylan M, Zackey DD, Nguyen LA, Ketelle R, Block N, Wu TQ, Dallich A, Russek N, Caplan A, Geschwind DH, Vossel KA, Miller BL. Distinct Subtypes of Behavioral Variant Frontotemporal Dementia Based on Patterns of Network Degeneration. JAMA Neurol 2017; 73:1078-88. [PMID: 27429218 DOI: 10.1001/jamaneurol.2016.2016] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Clearer delineation of the phenotypic heterogeneity within behavioral variant frontotemporal dementia (bvFTD) will help uncover underlying biological mechanisms and improve clinicians' ability to predict disease course and to design targeted management strategies. OBJECTIVE To identify subtypes of bvFTD syndrome based on distinctive patterns of atrophy defined by selective vulnerability of specific functional networks targeted in bvFTD using statistical classification approaches. DESIGN, SETTING AND PARTICIPANTS In this retrospective observational study, 90 patients meeting the Frontotemporal Dementia Consortium consensus criteria for bvFTD underwent evaluation at the Memory and Aging Center of the Department of Neurology at University of California, San Francisco. Patients underwent a multidisciplinary clinical evaluation, including clinical demographics, genetic testing, symptom evaluation, neurologic examination, neuropsychological bedside testing, and socioemotional assessments. All patients underwent structural magnetic resonance imaging at their earliest evaluation at the memory clinic. From each patient's structural imaging scans, the mean volumes of 18 regions of interest (ROI) constituting the functional networks specifically vulnerable in bvFTD, including the salience network (SN), with key nodes in the frontoinsula and pregenual anterior cingulate, and the semantic appraisal network (SAN), anchored in the anterior temporal lobe and subgenual cingulate, were estimated. Principal component and cluster analyses of ROI volumes were used to identify patient clusters with anatomically distinct atrophy patterns. Data were collected from from June 19, 2002, to January 13, 2015. MAIN OUTCOMES AND MEASURES Evaluation of brain morphology and other clinical features, including presenting symptoms, neurologic examination signs, neuropsychological performance, rate of dementia progression, and socioemotional function, in each patient cluster. RESULTS Ninety patients (54 men [60%]; 36 women [40%]; mean [SD] age at evaluation, 55.1 [9.7] years) were included in the analysis. Four subgroups of patients with bvFTD with distinct anatomic patterns of network degeneration were identified, including 2 salience network-predominant subgroups (frontal/temporal [SN-FT] and frontal [SN-F]), a semantic appraisal network-predominant group (SAN), and a subcortical-predominant group. Subgroups demonstrated distinct patterns of cognitive, socioemotional, and motor symptoms, as well as genetic compositions and estimated rates of disease progression. CONCLUSIONS AND RELEVANCE Divergent patterns of vulnerability in specific functional network components make an important contribution to the clinical heterogeneity of bvFTD. The data-driven anatomic classification identifies biologically meaningful anatomic phenotypes and provides a replicable approach to disambiguate the bvFTD syndrome.
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Affiliation(s)
- Kamalini G Ranasinghe
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Katherine P Rankin
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Peter S Pressman
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - David C Perry
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Iryna V Lobach
- Memory and Aging Center, Department of Neurology, University of California, San Francisco2Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - William W Seeley
- Memory and Aging Center, Department of Neurology, University of California, San Francisco3Department of Pathology, University of California, San Francisco
| | - Giovanni Coppola
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Anna M Karydas
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Lea T Grinberg
- Memory and Aging Center, Department of Neurology, University of California, San Francisco3Department of Pathology, University of California, San Francisco
| | - Tal Shany-Ur
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Suzee E Lee
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | | | - Adam L Boxer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Zachary A Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Winston Chiong
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Mary DeMay
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Katherine L Possin
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Virginia E Sturm
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Brianne M Bettcher
- Memory and Aging Center, Department of Neurology, University of California, San Francisco5Departments of Neurosurgery and Neurology, University of Colorado Anschutz School of Medicine, Aurora
| | - Michael Neylan
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Diana D Zackey
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Lauren A Nguyen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Robin Ketelle
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Nikolas Block
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Teresa Q Wu
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Alison Dallich
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Natanya Russek
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Alyssa Caplan
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Daniel H Geschwind
- Center for Autism Research and Treatment, University of California, Los Angeles
| | - Keith A Vossel
- Memory and Aging Center, Department of Neurology, University of California, San Francisco7Gladstone Institute of Neurological Disease, San Francisco, California
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
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García-Cordero I, Sedeño L, de la Fuente L, Slachevsky A, Forno G, Klein F, Lillo P, Ferrari J, Rodriguez C, Bustin J, Torralva T, Baez S, Yoris A, Esteves S, Melloni M, Salamone P, Huepe D, Manes F, García AM, Ibañez A. Feeling, learning from and being aware of inner states: interoceptive dimensions in neurodegeneration and stroke. Philos Trans R Soc Lond B Biol Sci 2016; 371:rstb.2016.0006. [PMID: 28080965 DOI: 10.1098/rstb.2016.0006] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2016] [Indexed: 12/19/2022] Open
Abstract
Interoception is a complex process encompassing multiple dimensions, such as accuracy, learning and awareness. Here, we examined whether each of those dimensions relies on specialized neural regions distributed throughout the vast interoceptive network. To this end, we obtained relevant measures of cardiac interoception in healthy subjects and patients offering contrastive lesion models of neurodegeneration and focal brain damage: behavioural variant fronto-temporal dementia (bvFTD), Alzheimer's disease (AD) and fronto-insular stroke. Neural correlates of the three dimensions were examined through structural and functional resting-state imaging, and online measurements of the heart-evoked potential (HEP). The three patient groups presented deficits in interoceptive accuracy, associated with insular damage, connectivity alterations and abnormal HEP modulations. Interoceptive learning was differentially impaired in AD patients, evidencing a key role of memory networks in this skill. Interoceptive awareness results showed that bvFTD and AD patients overestimated their performance; this pattern was related to abnormalities in anterior regions and associated networks sub-serving metacognitive processes, and probably linked to well-established insight deficits in dementia. Our findings indicate how damage to specific hubs in a broad fronto-temporo-insular network differentially compromises interoceptive dimensions, and how such disturbances affect widespread connections beyond those critical hubs. This is the first study in which a multiple lesion model reveals fine-grained alterations of body sensing, offering new theoretical insights into neuroanatomical foundations of interoceptive dimensions.This article is part of the themed issue 'Interoception beyond homeostasis: affect, cognition and mental health'.
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Affiliation(s)
- Indira García-Cordero
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB, Buenos Aires, Argentina
| | - Lucas Sedeño
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Avenida Rivadavia 1917, Buenos Aires, Argentina
| | - Laura de la Fuente
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Avenida Rivadavia 1917, Buenos Aires, Argentina
| | - Andrea Slachevsky
- Physiopathology Department, ICBM; East Neuroscience Department, Faculty of Medicine, University of Chile, Avenida Salvador 486, Providencia, Santiago, Chile.,Cognitive Neurology and Dementia, Neurology Department, Hospital del Salvador, Avenida Salvador 386, Providencia, Santiago, Chile.,Gerosciences Center for Brain Health and Metabolism, Avenida Salvador 486, Providencia, Santiago, Chile.,Centre for Advanced Research in Education, Periodista Jose Carrasco Tapia 75, Santiago, Chile.,Neurology Department, Clínica Alemana, Avenida Manquehue 1410, Santiago, Chile
| | - Gonzalo Forno
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB, Buenos Aires, Argentina
| | - Francisco Klein
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB, Buenos Aires, Argentina.,Stroke Center, Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - Patricia Lillo
- Gerosciences Center for Brain Health and Metabolism, Avenida Salvador 486, Providencia, Santiago, Chile.,Departamento de Neurología Sur, Facultad de Medicina, Universidad de Chile Santiago, Chile
| | - Jesica Ferrari
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB, Buenos Aires, Argentina
| | - Clara Rodriguez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB, Buenos Aires, Argentina
| | - Julian Bustin
- Geriatric psychiatry and Memory Clinic; Institute of Translational and Cognitive Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB Buenos Aires, Argentina
| | - Teresa Torralva
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB, Buenos Aires, Argentina
| | - Sandra Baez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Avenida Rivadavia 1917, Buenos Aires, Argentina
| | - Adrian Yoris
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Avenida Rivadavia 1917, Buenos Aires, Argentina
| | - Sol Esteves
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB, Buenos Aires, Argentina
| | - Margherita Melloni
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Avenida Rivadavia 1917, Buenos Aires, Argentina
| | - Paula Salamone
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Avenida Rivadavia 1917, Buenos Aires, Argentina
| | - David Huepe
- Centro de Neurociencia Social y Cognitiva (CSCN), Escuela de Psicología-Universidad Adolfo Ibáñez, Diagonal Las Torres 2640, Santiago, Chile
| | - Facundo Manes
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Avenida Rivadavia 1917, Buenos Aires, Argentina.,Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR), Macquarie University, 16 University Avenue, NSW 2109, Sydney, New South Wales, Australia
| | - Adolfo M García
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Avenida Rivadavia 1917, Buenos Aires, Argentina.,Faculty of Elementary and Special Education (FEEyE), National University of Cuyo (UNCuyo), Sobremonte 74, C5500 Mendoza, Argentina
| | - Agustín Ibañez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB, Buenos Aires, Argentina .,National Scientific and Technical Research Council (CONICET), Avenida Rivadavia 1917, Buenos Aires, Argentina.,Centro de Neurociencia Social y Cognitiva (CSCN), Escuela de Psicología-Universidad Adolfo Ibáñez, Diagonal Las Torres 2640, Santiago, Chile.,Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR), Macquarie University, 16 University Avenue, NSW 2109, Sydney, New South Wales, Australia.,Universidad Autónoma del Caribe, Calle 90, N° 46-112, C2754 Barranquilla, Colombia
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8
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Cosentino S, Zahodne LB, Brandt J, Blacker D, Albert M, Dubois B, Stern Y. Social cognition in Alzheimer's disease: a separate construct contributing to dependence. Alzheimers Dement 2014; 10:818-26. [PMID: 24656839 PMCID: PMC3980672 DOI: 10.1016/j.jalz.2013.12.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 11/20/2013] [Accepted: 12/15/2013] [Indexed: 10/25/2022]
Abstract
The extent to which social cognitive changes reflect a discrete constellation of symptoms dissociable from general cognitive changes in Alzheimer's disease (AD) is unclear. Moreover, whether social cognitive symptoms contribute to disease severity and progression is unknown. The current multicenter study investigated cross-sectional and longitudinal associations between social cognition measured with six items from the Blessed Dementia Rating Scale, general cognition, and dependence in 517 participants with probable AD. Participants were monitored every 6 months for 5.5 years. Results from multivariate latent growth curve models adjusted for sex, age, education, depression, and recruitment site revealed that social cognition and general cognition were unrelated cross-sectionally and throughout time. However, baseline levels of each were related independently to dependence, and change values of each were related independently to change in dependence. These findings highlight the separability of social and general cognition in AD. Results underscore the relevance of considering social cognition when modeling disease and estimating clinical outcomes related to patient disability.
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Affiliation(s)
- Stephanie Cosentino
- Cognitive Neuroscience Division, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians and Surgeons, New York, NY, USA.
| | - Laura B Zahodne
- Cognitive Neuroscience Division, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Jason Brandt
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Deborah Blacker
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Marilyn Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Bruno Dubois
- Université Pierre et Marie Curie (Sorbonne Université), Paris, France; UMRS 975, Institut du Cerveau et de la Moelle Epinière, Institut National de la Santé et de la Recherche Médicale, Paris, France; Institut de la Mémoire et de la Maladie d'Alzheimer, Paris, France; Centre de Références Démences Rares, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Yaakov Stern
- Cognitive Neuroscience Division, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians and Surgeons, New York, NY, USA
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9
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Couto B, Manes F, Montañés P, Matallana D, Reyes P, Velasquez M, Yoris A, Baez S, Ibáñez A. Structural neuroimaging of social cognition in progressive non-fluent aphasia and behavioral variant of frontotemporal dementia. Front Hum Neurosci 2013; 7:467. [PMID: 23966929 PMCID: PMC3744869 DOI: 10.3389/fnhum.2013.00467] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Accepted: 07/26/2013] [Indexed: 11/13/2022] Open
Abstract
Social cognition impairments are pervasive in the frontotemporal dementias (FTD). These deficits would be triggered by (a) basic emotion and face recognition processes as well as by (b) higher level social cognition (e.g., theory of mind, ToM). Both emotional processing and social cognition impairments have been previously reported in the behavioral variant of FTD (bvFTD) and also in other versions of FTDs, including primary progressive aphasia. However, no neuroanatomic comparison between different FTD variants has been performed. We report selective behavioral impairments of face recognition, emotion recognition, and ToM in patients with bvFTD and progressive non-fluent aphasia (PNFA) when compared to controls. Voxel-based morphometry (VBM) shows a classical impairment of mainly orbitofrontal (OFC), anterior cingulate (ACC), insula and lateral temporal cortices in patients. Comparative analysis of regional gray matter related to social cognition deficits (VBM) reveals a differential pattern of fronto-insulo-temporal atrophy in bvFTD and an insulo-temporal involvement in PNFA group. Results suggest that in spite of similar social cognition impairments reported in bvFTD and PNFA, the former represents an inherent ToM affectation whereas in the PNFA these deficits could be related to more basic processes of face and emotion recognition. These results are interpreted in the frame of the fronto-insulo-temporal social context network model (SCNM).
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Affiliation(s)
- Blas Couto
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University Buenos Aires, Argentina ; Institute of Neuroscience, Favaloro University Buenos Aires, Argentina ; National Scientific and Technical Research Council (CONICET) Buenos Aires, Argentina
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10
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Harciarek M, Cosentino S. Language, executive function and social cognition in the diagnosis of frontotemporal dementia syndromes. Int Rev Psychiatry 2013; 25:178-96. [PMID: 23611348 PMCID: PMC4481322 DOI: 10.3109/09540261.2013.763340] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Frontotemporal dementia (FTD) represents a spectrum of non-Alzheimer's degenerative conditions associated with focal atrophy of the frontal and/or temporal lobes. Frontal and temporal regions of the brain have been shown to be strongly involved in executive function, social cognition and language processing and, thus, deficits in these domains are frequently seen in patients with FTD or may even be hallmarks of a specific FTD subtype (i.e. relatively selective and progressive language impairment in primary progressive aphasia). In this review we have attempted to delineate how language, executive function, and social cognition may contribute to the diagnosis of FTD syndromes, namely the behavioural variant FTD as well as the language variants of FTD including the three subtypes of primary progressive aphasia (PPA): non-fluent/agrammatic, semantic and logopenic. This review also addresses the extent to which deficits in these cognitive areas contribute to the differential diagnosis of FTD versus Alzheimer's disease (AD). Finally, early clinical determinants of pathology are briefly discussed and contemporary challenges to the diagnosis of FTD are presented.
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Affiliation(s)
- Michał Harciarek
- Division of Clinical Psychology and Neuropsychology, Institute of Psychology, University of Gdańsk, Poland.
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11
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Abstract
PURPOSE OF REVIEW Neurodegenerative diseases often cause focal damage to brain structures mediating social cognition and personality, resulting in altered interpersonal communication and behavior. We review recent research describing this phenomenon in various aspects of social cognition. RECENT FINDINGS Corresponding to their pervasive socioemotional deficits, patients with frontotemporal dementia perform poorly on laboratory-based tasks including recognizing emotions, attending to salient information that guides social behavior, representing social knowledge, comprehending others' mental states, and maintaining insight to their own difficulties. Together with poor executive and regulation mechanisms, these social cognition deficits ultimately impact behavior. Patients with logopenic and nonfluent primary progressive aphasia have some deficits recognizing emotional prosody, whereas those with the semantic variant show more widespread deficits in social comprehension. Although Alzheimer's disease patients perform poorly on some social cognition tasks, this typically reflects general cognitive impairment, and their real-life social functioning is less affected than in diseases targeting frontotemporal structures. Studies in motor diseases such as Parkinson's suggest some degradation of emotion recognition and social comprehension, which should be investigated further. SUMMARY We summarize recent findings concerning perception and evaluation of socioemotional information, social knowledge storage and access, advanced information processing mechanisms, and behavioral response selection and regulation across various neurodegenerative diseases.
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