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Latgé-Tovar S, Bertrand E, Piolino P, Mograbi DC. The use of virtual reality as a perspective-taking manipulation to improve self-awareness in Alzheimer's disease. Front Aging Neurosci 2024; 16:1376413. [PMID: 38725536 PMCID: PMC11079167 DOI: 10.3389/fnagi.2024.1376413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/08/2024] [Indexed: 05/12/2024] Open
Abstract
Lack of awareness of symptoms or having a condition referred to as anosognosia is a common feature of individuals with Alzheimer's Disease (AD). Previous literature on AD reported difficulties in evaluating self-abilities, often showing underestimation of limitations. There is increasing evidence that the perspective through which information is presented may moderate the performance appraisal and that anosognosia in AD might be a consequence of a deficit in assuming a third-person perspective. In this context, some studies showed that subjects may better recognize self-and other-difficulties when exposed to a third-person perspective. Considering the variety of approaches aiming to investigate the lack of awareness, there is still a scarcity of methods that provide great ecological validity and consider more than one facet of awareness, thus failing to offer more accurate evaluations of daily experiences. The present paper primarily addresses the theme of the multidimensional character of awareness of abilities in AD and the effect of perspective-taking on its trajectories. The focus turns to virtual reality as a promising tool for a greater evaluation of perspective-taking and self-awareness. Particularly, these systems offer the possibility to involve users in cognitive and sensorimotor tasks that simulate daily life conditions within immersive and realistic environments, and a great sense of embodiment. We propose that virtual reality might allow a great level of complexity, veracity, and safety that is needed for individuals with AD to behave according to their actual abilities and enable to explore the liaison between the subject's viewpoint, performance, and self-evaluation. In addition, we suggest promising clinical implications of virtual reality-based methods for individualized assessments, investigating specific impacts on subjects' life and possible improvements in their awareness.
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Affiliation(s)
- Sofia Latgé-Tovar
- Institute of Psychiatry - Center for Alzheimer’s Disease, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Elodie Bertrand
- Laboratoire Mémoire, Cerveau et Cognition (LMC), Institut de Psychologie, Université Paris Cité, Paris, France
| | - Pascale Piolino
- Laboratoire Mémoire, Cerveau et Cognition (LMC), Institut de Psychologie, Université Paris Cité, Paris, France
| | - Daniel C. Mograbi
- Institute of Psychiatry - Center for Alzheimer’s Disease, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
- Institute of Psychiatry – Psychology and Neuroscience King’s College London, London, United Kingdom
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Giacomucci G, Moschini V, Piazzesi D, Padiglioni S, Caruso C, Nuti C, Munarin A, Mazzeo S, Galdo G, Polito C, Emiliani F, Frigerio D, Morinelli C, Bagnoli S, Ingannato A, Nacmias B, Sorbi S, Berti V, Bessi V. Disentangling empathy impairment along Alzheimer's disease continuum: From subjective cognitive decline to Alzheimer's dementia. Cortex 2024; 172:125-140. [PMID: 38301390 DOI: 10.1016/j.cortex.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/14/2023] [Accepted: 12/19/2023] [Indexed: 02/03/2024]
Abstract
Little is known about empathy changes from the early stages of Alzheimer's Disease (AD) continuum. The aim of this study is to investigate empathy across AD spectrum from Subjective Cognitive Decline (SCD) to Mild Cognitive Impairment (MCI) and AD dementia (AD-d). Forty-five SCD, 83 MCI and 80 AD-d patients were included. Empathy was assessed by Interpersonal Reactivity Index (IRI) (Perspective Taking - PT, Fantasy - FT, Empathic Concern - EC, and Personal Distress - PD), rated by caregivers before (T0) and after (T1) cognitive symptoms' onset. IRI was also administered to SCD patients to have a self-reported empathy evaluation. Facial emotion recognition was assessed by Ekman-60 Faces Test. Twenty-two SCD, 54 MCI and 62 AD-d patients underwent CSF biomarkers analysis and were classified as carriers of AD pathology (AP+) when they were A+/T+ (regardless of N), or non-carriers (AP-) when they were A- (regardless of T and N), or A+/T-/N-, or A+/T-/N+ according to the A/T(N) system. Cerebral FDG-PET SPM analysis was used to explore neural correlates underlying empathy deficits. PD scores significantly increased from T0 to T1 in SCD, MCI and AD-d (p < .001), while PT scores decreased in MCI and in AD-d (p < .001). SCD AP+ showed a greater increase in PD scores over time (ΔPD T0 - T1) than SCD AP- (p < .001). SCD self-reported PT scores were lower than those of general Italian population (14.94 ± 3.94, 95% C.I. [13.68-16.20] vs 17.70 ± 4.36, 95% C.I. [17.30-18.10]). In AD continuum (SCD AP+, MCI AP+, AD-d), a positive correlation was detected between PT-T1 and brain metabolism in left posterior cingulate gyrus, precuneus and right frontal gyri; a negative correlation was found between ΔPT and brain metabolism in bilateral posterior cingulate gyri. PT may be subtly involved since the preclinical phase of AD. Changes over time of PD are influenced by the underlying Alzheimer's pathology and could potentially serve as an early AD neuropsychological marker.
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Affiliation(s)
- Giulia Giacomucci
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Valentina Moschini
- SOD Neurologia I, Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, AOU Careggi, Florence, Italy
| | - Diletta Piazzesi
- SOD Neurologia I, Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, AOU Careggi, Florence, Italy
| | - Sonia Padiglioni
- Regional Referral Centre for Relational Criticalities - Tuscany Region, Italy; Research and Innovation Centre for Dementia-CRIDEM, AOU Careggi, Italy
| | | | | | | | - Salvatore Mazzeo
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Giulia Galdo
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | | | - Filippo Emiliani
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Daniele Frigerio
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Carmen Morinelli
- SOD Neurologia I, Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, AOU Careggi, Florence, Italy
| | - Silvia Bagnoli
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Assunta Ingannato
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Valentina Berti
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy; Nuclear Medicine Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Valentina Bessi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.
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Mentzou A, Sixsmith J, Ellis MP, Ross J. Change in the psychological self in people living with dementia: A scoping review. Clin Psychol Rev 2023; 101:102268. [PMID: 36898295 DOI: 10.1016/j.cpr.2023.102268] [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: 10/17/2022] [Revised: 02/02/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023]
Abstract
Alterations in one's sense of self are often considered a significant psychological symptom of dementia. However, the self is not a unified construct; it consists of a set of closely connected, yet substantive, manifestations which might not be equally impacted by dementia. Recognising the multidimensional nature of the self, the current scoping review aimed to explore the nature and scope of the evidence demonstrating change in the psychological self in people living with dementia. Adopting a cognitive psychological framework, a hundred and five (105) quantitative and qualitative studies were reviewed, and findings were organised into three main types of self-manifestations: high-order manifestations, functional aspects of the self, and foundational manifestations. Overall, the results show that although there are alterations in some of these different manifestations of the self, these do not imply a global loss of selfhood. Despite notable cognitive changes during dementia, it seems that preserved aspects of self may be enough to compensate for potential weakening of some self-processes such as autobiographical recall. Better understanding alterations in selfhood is key to addressing psychological symptoms of people living with dementia, such as feelings of disconnection and reduced agency, and may inform new pathways for dementia care interventions.
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Affiliation(s)
- Aikaterini Mentzou
- School of Humanities, Social Sciences and Law, Division of Psychology, University of Dundee, Scotland, UK.
| | - Judith Sixsmith
- School of Health Sciences, University of Dundee, Scotland, UK
| | - Maggie P Ellis
- School of Psychology and Neuroscience, University of St Andrews, Scotland, UK
| | - Josephine Ross
- School of Humanities, Social Sciences and Law, Division of Psychology, University of Dundee, Scotland, UK
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Giacomucci G, Polito C, Berti V, Padiglioni S, Galdo G, Mazzeo S, Bergamin E, Moschini V, Morinelli C, Nuti C, De Cristofaro MT, Ingannato A, Bagnoli S, Nacmias B, Sorbi S, Bessi V. Differences and Similarities in Empathy Deficit and Its Neural Basis between Logopenic and Amnesic Alzheimer's Disease. J Pers Med 2023; 13:jpm13020208. [PMID: 36836442 PMCID: PMC9966635 DOI: 10.3390/jpm13020208] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/27/2023] Open
Abstract
The aims of the study were to assess empathy deficit and neuronal correlates in logopenic primary progressive aphasia (lv-PPA) and compare these data with those deriving from amnesic Alzheimer's disease (AD). Eighteen lv-PPA and thirty-eight amnesic AD patients were included. Empathy in both cognitive and affective domains was assessed by Informer-rated Interpersonal Reactivity Index (perspective taking, PT, and fantasy, FT, for cognitive empathy; empathic concern, EC, and personal distress, PD, for affective empathy) before (T0) and after (T1) cognitive symptoms' onset. Emotion recognition was explored through the Ekman 60 Faces Test. Cerebral FDG-PET was used to explore neural correlates underlying empathy deficits. From T0 to T1, PT scores decreased, and PD scores increased in both lv-PPA (PT z = -3.43, p = 0.001; PD z = -3.62, p < 0.001) and in amnesic AD (PT z = -4.57, p < 0.001; PD z = -5.20, p < 0.001). Delta PT (T0-T1) negatively correlated with metabolic disfunction of the right superior temporal gyrus, fusiform gyrus, and middle frontal gyrus (MFG) in amnesic AD and of the left inferior parietal lobule (IPL), insula, MFG, and bilateral superior frontal gyrus (SFG) in lv-PPA (p < 0.005). Delta PD (T0-T1) positively correlated with metabolic disfunction of the right inferior frontal gyrus in amnesic AD (p < 0.001) and of the left IPL, insula, and bilateral SFG in lv-PPA (p < 0.005). Lv-PPA and amnesic AD share the same empathic changes, with a damage of cognitive empathy and a heightening of personal distress over time. The differences in metabolic disfunctions correlated with empathy deficits might be due to a different vulnerability of specific brain regions in the two AD clinical presentations.
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Affiliation(s)
- Giulia Giacomucci
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50134 Florence, Italy
| | | | - Valentina Berti
- Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy
- Nuclear Medicine Unit, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Sonia Padiglioni
- Regional Referral Centre for Relational Criticalities—Tuscany Region, 50134 Florence, Italy
- Research and Innovation Centre for Dementia-CRIDEM, AOU Careggi, 50134 Florence, Italy
| | - Giulia Galdo
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50134 Florence, Italy
| | - Salvatore Mazzeo
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50134 Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy
| | | | - Valentina Moschini
- SOD Neurologia I, Dipartmento Neuromuscolo-Scheletrico e degli Organi di Senso, AOU Careggi, 50134 Florence, Italy
| | - Carmen Morinelli
- SOD Neurologia I, Dipartmento Neuromuscolo-Scheletrico e degli Organi di Senso, AOU Careggi, 50134 Florence, Italy
| | | | | | - Assunta Ingannato
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50134 Florence, Italy
| | - Silvia Bagnoli
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50134 Florence, Italy
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50134 Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50134 Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy
| | - Valentina Bessi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50134 Florence, Italy
- Correspondence: ; Tel.: +39-05-7948660; Fax: +39-05-7947484
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Baez S, Trujillo-Llano C, de Souza LC, Lillo P, Forno G, Santamaría-García H, Okuma C, Alegria P, Huepe D, Ibáñez A, Decety J, Slachevsky A. Moral Emotions and Their Brain Structural Correlates Across Neurodegenerative Disorders. J Alzheimers Dis 2023; 92:153-169. [PMID: 36710684 PMCID: PMC11181819 DOI: 10.3233/jad-221131] [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] [Indexed: 01/25/2023]
Abstract
BACKGROUND Although social cognition is compromised in patients with neurodegenerative disorders such as behavioral variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD), research on moral emotions and their neural correlates in these populations is scarce. No previous study has explored the utility of moral emotions, compared to and in combination with classical general cognitive state tools, to discriminate bvFTD from AD patients. OBJECTIVE To examine self-conscious (guilt and embarrassment) and other-oriented (pity and indignation) moral emotions, their subjective experience, and their structural brain underpinnings in bvFTD (n = 31) and AD (n = 30) patients, compared to healthy controls (n = 37). We also explored the potential utility of moral emotions measures to discriminate bvFTD from AD. METHODS We used a modified version of the Moral Sentiment Task measuring the participants' accuracy scores and their emotional subjective experiences. RESULTS bvFTD patients exhibited greater impairments in self-conscious and other-oriented moral emotions as compared with AD patients and healthy controls. Moral emotions combined with general cognitive state tools emerged as useful measures to discriminate bvFTD from AD patients. In bvFTD patients, lower moral emotions scores were associated with lower gray matter volumes in caudate nucleus and inferior and middle temporal gyri. In AD, these scores were associated with lower gray matter volumes in superior and middle frontal gyri, middle temporal gyrus, inferior parietal lobule and supramarginal gyrus. CONCLUSION These findings contribute to a better understanding of moral emotion deficits across neurodegenerative disorders, highlighting the potential benefits of integrating this domain into the clinical assessment.
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Affiliation(s)
| | - Catalina Trujillo-Llano
- Facultad de Psicología, Universidad del Valle, Cali, Colombia
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Leonardo Cruz de Souza
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Patricia Lillo
- Geroscience Center for Brain Health and Metabolism, Santiago, Chile
- Departamento de Neurologia Sur, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Gonzalo Forno
- Universidad de los Andes, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department - ICBM, Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Hernando Santamaría-García
- Centro de Memoria y Cognición Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia
- Global Brain Health Institute, University of California, San Francisco, CA, USA
- Universidad Javeriana, PhD Program of Neuroscience, Bogotá, Colombia
| | - Cecilia Okuma
- Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Servicio de Neurorradiología, Instituto de Neurocirugía Dr. Asenjo, Servicio de Salud Metropolitano Oriente, Santiago, Chile
| | - Patricio Alegria
- Servicio de Radiología, Hospital Barros Luco Trudeau, San Miguel, Chile
| | - David Huepe
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Agustín Ibáñez
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council, Buenos Aires, Argentina
| | | | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department - ICBM, Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Memory and Neuropsychiatric Center, Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
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Giacomucci G, Galdo G, Polito C, Berti V, Padiglioni S, Mazzeo S, Chiaro E, De Cristofaro MT, Bagnoli S, Nacmias B, Sorbi S, Bessi V. Unravelling neural correlates of empathy deficits in Subjective Cognitive Decline, Mild Cognitive Impairment and Alzheimer’s Disease. Behav Brain Res 2022; 428:113893. [DOI: 10.1016/j.bbr.2022.113893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/16/2022] [Accepted: 04/11/2022] [Indexed: 12/14/2022]
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Huntley JD, Fleming SM, Mograbi DC, Bor D, Naci L, Owen AM, Howard R. Understanding Alzheimer's disease as a disorder of consciousness. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12203. [PMID: 34877398 PMCID: PMC8630359 DOI: 10.1002/trc2.12203] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/28/2021] [Accepted: 07/28/2021] [Indexed: 11/07/2022]
Abstract
People with Alzheimer's disease (AD) demonstrate a range of alterations in consciousness. Changes in awareness of cognitive deficit, self-awareness, and introspection are seen early in AD, and dysfunction of awareness and arousal progresses with increasing disease severity. However, heterogeneity of deficits between individuals and a lack of empirical studies in people with severe dementia highlight the importance of identifying and applying biomarkers of awareness in AD. Impairments of awareness in AD are associated with neuropathology in regions that overlap with proposed neural correlates of consciousness. Recent developments in consciousness science provide theoretical frameworks and experimental approaches to help further understand the conscious experience of people with AD. Recognition of AD as a disorder of consciousness is overdue, and important to both understand the lived experience of people with AD and to improve care.
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Affiliation(s)
- Jonathan D. Huntley
- Division of PsychiatryUniversity College LondonLondonUK
- Wellcome Centre for Human NeuroimagingUniversity College LondonLondonUK
| | - Stephen M. Fleming
- Wellcome Centre for Human NeuroimagingUniversity College LondonLondonUK
- Department of Experimental PsychologyUniversity College LondonLondonUK
- Max Planck‐UCL Centre for Computational Psychiatry and Ageing ResearchUniversity College LondonLondonUK
| | - Daniel C. Mograbi
- Department of PsychologyPontifical Catholic University of Rio de JaneiroRio de JaneiroBrazil
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Daniel Bor
- Department of PsychologyUniversity of CambridgeCambridgeUK
| | - Lorina Naci
- School of PsychologyGlobal Brain Health InstituteTrinity College DublinDublinIreland
| | - Adrian M. Owen
- Brain and Mind InstituteDepartment of Physiology and Pharmacology and Department of PsychologyUniversity of Western OntarioLondonOntarioCanada
| | - Robert Howard
- Division of PsychiatryUniversity College LondonLondonUK
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Fischer A, Landeira-Fernandez J, Sollero de Campos F, Mograbi DC. Empathy in Alzheimer’s Disease: Review of Findings and Proposed Model. J Alzheimers Dis 2019; 69:921-933. [DOI: 10.3233/jad-180730] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Anna Fischer
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brasil
| | - Jesus Landeira-Fernandez
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brasil
| | - Flavia Sollero de Campos
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brasil
| | - Daniel C. Mograbi
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brasil
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Brugada-Ramentol V, de Polavieja GG, Román ÁC. Toward a Molecular Profile of Self-Representation. Front Hum Neurosci 2016; 10:602. [PMID: 27965556 PMCID: PMC5124566 DOI: 10.3389/fnhum.2016.00602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 11/11/2016] [Indexed: 11/17/2022] Open
Abstract
Feeling embodiment over our body or body part has a major role in the understanding of the self and control of self-actions. Even though it is crucial in our daily life, embodiment is not an homogenous phenotype across population, as quantified by implicit and explicit measures (i.e., neuroimaging or self-reports). Studies have shown differences in neuropathological conditions compared to healthy controls, but also across healthy individuals. We discuss examples of self-perception differences, and the molecular origin of embodiment, focusing on clinical cases, during the first and second section. We then discuss two important questions in this molecular-to-embodiment relationship: (i) which are the molecular levels (and their associated techniques) that can be relevant to embodiment, and (ii) which are the most adequate experiments to correlate molecular profiles and embodiment quantification across individuals. Potential answers for both questions will be outlined during the third and fourth sections, respectively, in order to design a framework to study the molecular profile of body embodiment.
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Affiliation(s)
| | | | - Ángel-Carlos Román
- Collective Behavior Lab, Champalimaud Research, Fundaçao Champalimaud Lisboa, Portugal
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10
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Bertrand E, Landeira-Fernandez J, Mograbi DC. Metacognition and Perspective-Taking in Alzheimer's Disease: A Mini-Review. Front Psychol 2016; 7:1812. [PMID: 27909421 PMCID: PMC5112262 DOI: 10.3389/fpsyg.2016.01812] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 11/02/2016] [Indexed: 12/22/2022] Open
Abstract
Metacognition refers to the monitoring and regulation of cognitive processes and its impairment can lead to a lack of self-awareness of deficits, or anosognosia. In the context of different neurological and psychiatric disorders (e.g., traumatic brain injury, dementia, and schizophrenia), studies have shown that patients who present impairments in metacognitive abilities may be able to recognize such difficulties in others and in themselves when exposed to material in a third-person perspective. Considering that metacognitive impairments are an important characteristic of dementia, especially in Alzheimer's Disease (AD), studies of the relationship between metacognition and perspective-taking may be relevant to improve the quality of life of people with dementia. The current paper first briefly addresses the theme of metacognition and the impact of metacognitive deficits in people with AD. The focus then turns to the relationship between metacognition and perspective-taking in different neurological and psychiatric disorders, particularly AD. This relationship is also discussed based on theoretical models, particularly the Cognitive Awareness Model (CAM). Specifically, the CAM suggests the existence of distinct memory systems for self- and other-information, an idea which is supported by neuroimaging findings. We suggest that the Default Mode Network, as it has been shown to be implicated in self vs. other processing and is affected early in AD, could explain the impact of perspective-taking on awareness of deficits in AD. Finally, we present possible clinical implications of the relationship between metacognition and perspective-taking in AD. Indeed, we considered the possibility of improving patient's awareness through the use of a third-person perspective, which, consequently, may decrease the negative impacts of anosognosia in AD.
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Affiliation(s)
- Elodie Bertrand
- Department of Psychology, Pontifícia Universidade Católica do Rio de JaneiroRio de Janeiro, Brazil
| | - Jesus Landeira-Fernandez
- Department of Psychology, Pontifícia Universidade Católica do Rio de JaneiroRio de Janeiro, Brazil
| | - Daniel C. Mograbi
- Department of Psychology, Pontifícia Universidade Católica do Rio de JaneiroRio de Janeiro, Brazil
- Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondon, UK
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