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Holtmann O, Schloßmacher I, Franz M, Moenig C, Tenberge JG, Preul C, Schwindt W, Bruchmann M, Melzer N, Miltner WHR, Straube T. Effects of emotional valence and intensity on cognitive and affective empathy after insula lesions. Cereb Cortex 2022; 33:4562-4573. [PMID: 36124830 DOI: 10.1093/cercor/bhac362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/11/2022] [Accepted: 08/22/2022] [Indexed: 01/10/2023] Open
Abstract
The insula plays a central role in empathy. However, the complex structure of cognitive (CE) and affective empathy (AE) deficits following insular damage is not fully understood. In the present study, patients with insular lesions (n = 20) and demographically matched healthy controls (n = 24) viewed ecologically valid videos that varied in terms of valence and emotional intensity. The videos showed a person (target) narrating a personal life event. In CE conditions, subjects continuously rated the affective state of the target, while in AE conditions, they continuously rated their own affect. Mean squared error (MSE) assessed deviations between subject and target ratings. Patients differed from controls only in negative, low-intensity AE, rating their own affective state less negative than the target. This deficit was not related to trait empathy, neuropsychological or clinical parameters, or laterality of lesion. Empathic functions may be widely spared after insular damage in a naturalistic, dynamic setting, potentially due to the intact interpretation of social context by residual networks outside the lesion. The particular role of the insula in AE for negative states may evolve specifically in situations that bear higher uncertainty pointing to a threshold role of the insula in online ratings of AE.
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Affiliation(s)
- Olga Holtmann
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Straße 52, Muenster 48149, Germany.,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Fliednerstraße 21, Muenster 48149, Germany
| | - Insa Schloßmacher
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Straße 52, Muenster 48149, Germany.,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Fliednerstraße 21, Muenster 48149, Germany
| | - Marcel Franz
- Department of Clinical Psychology, Friedrich Schiller University Jena, Am Steiger 3, Jena 07743, Germany
| | - Constanze Moenig
- Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Muenster 48149, Germany
| | - Jan-Gerd Tenberge
- Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Muenster 48149, Germany
| | - Christoph Preul
- Department of Neurology, University Hospital Jena, Am Klinikum 1, Jena 07747, Germany
| | - Wolfram Schwindt
- Institute of Clinical Radiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Muenster 48149, Germany
| | - Maximilian Bruchmann
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Straße 52, Muenster 48149, Germany.,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Fliednerstraße 21, Muenster 48149, Germany
| | - Nico Melzer
- Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Muenster 48149, Germany.,Department of Neurology, Heinrich-Heine University of Düsseldorf, Moorenstraße 5, Düsseldorf 40225, Germany
| | - Wolfgang H R Miltner
- Department of Clinical Psychology, Friedrich Schiller University Jena, Am Steiger 3, Jena 07743, Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Straße 52, Muenster 48149, Germany.,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Fliednerstraße 21, Muenster 48149, Germany
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Mueller C, Langenbruch LM, Rau JMH, Brix T, Strippel C, Dik A, Golombeck KS, Moenig C, Raeuber SJ, Kovac S, Wiendl H, Meuth SG, Bölte J, Johnen A, Melzer N. Determinants of cognition in autoimmune limbic encephalitis-A retrospective cohort study. Hippocampus 2021; 31:1092-1103. [PMID: 34270832 DOI: 10.1002/hipo.23375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/29/2021] [Accepted: 07/03/2021] [Indexed: 12/24/2022]
Abstract
Autoimmune limbic encephalitis (ALE) is the most common type of autoimmune encephalitis (AIE). Subacute memory disturbance, temporal lobe seizures, and psychiatric symptoms are clinical hallmarks of the disease. However, little is known on the factors contributing to cognitive functioning in ALE. Hence, we here investigate major determinants of cognitive functioning in ALE. In a retrospective analysis of 102 patients with ALE, we first compared verbal learning capacity, nonverbal learning capacity, and attentional and executive functioning by absence or presence of different types of neural autoantibodies (AABs). Subsequently we established three linear regression models including 63, 38, and 61 patients, respectively to investigate how cognitive functioning in these domains may depend on common markers of ALE such as intrathecal inflammation, blood-cerebrospinal fluid (CSF)-barrier function, mesiotemporal epileptiform discharges and slowing, determined by electroencephalography (EEG) and structural mesiotemporal changes, measured with magnetic resonance imaging (MRI). We also accounted for possible effects of cancer- and immunotherapy and other centrally effective medication. There was no effect of AAB status on cognitive functioning. Although the regression models could not predict verbal and nonverbal learning capacity, structural mesiotemporal neural network alterations on T2-/fluid attenuated inversion recovery (FLAIR)-signal-weighted MRI and mesiotemporal epileptiform discharges or slowing on EEG exerted a significant impact on memory functions. In contrast, the regression model significantly predicted attentional and executive functioning with CSF white blood cell count and centrally effective medication being significant determinants. In this cohort, cognitive functioning in ALE does not depend on the AAB status. Common markers of ALE cannot predict memory functioning that only partially depends on structural and functional alterations of mesiotemporal neural networks. Common markers of ALE significantly predict attentional and executive functioning that is significantly related to centrally effective medication and CSF white blood cell count, which may point toward inflammation affecting brain regions beyond the limbic system.
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Affiliation(s)
- Christoph Mueller
- Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-University of Münster, Münster, Germany
| | - Lisa M Langenbruch
- Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-University of Münster, Münster, Germany
| | - Johanna M H Rau
- Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-University of Münster, Münster, Germany
| | - Tobias Brix
- Institute of Medical Informatics, Westfälische Wilhelms-University of Münster, Münster, Germany
| | - Christine Strippel
- Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-University of Münster, Münster, Germany
| | - Andre Dik
- Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-University of Münster, Münster, Germany
| | - Kristin S Golombeck
- Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-University of Münster, Münster, Germany
| | - Constanze Moenig
- Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-University of Münster, Münster, Germany
| | - Saskia J Raeuber
- Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-University of Münster, Münster, Germany.,Department of Neurology, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany
| | - Stjepana Kovac
- Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-University of Münster, Münster, Germany
| | - Heinz Wiendl
- Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-University of Münster, Münster, Germany
| | - Sven G Meuth
- Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-University of Münster, Münster, Germany.,Department of Neurology, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany
| | - Jens Bölte
- Institute of Psychology, Westfälische Wilhelms-University of Münster, Münster, Germany
| | - Andreas Johnen
- Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-University of Münster, Münster, Germany
| | - Nico Melzer
- Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-University of Münster, Münster, Germany.,Department of Neurology, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany
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Rudolph V, Moenig C, Lubos E, Lubs D, Knap M, Schlüter M, Kuß O, Koschyk D, Schwoerer AP, Treede H, Schirmer J, Reichenspurner H, Ehmke H, Blankenberg S, Baldus S. Baseline systolic left ventricular function determines hemodynamic adaptation following percutaneous mitral valve repair. Int J Cardiol 2013; 167:3039-40. [PMID: 23219314 DOI: 10.1016/j.ijcard.2012.11.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Accepted: 11/11/2012] [Indexed: 11/19/2022]
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Rudolph V, Moenig C, Lubos E, Lubs D, Schirmer J, Reichenspurner H, Blankenberg S, Baldus S. TCT-780 Baseline Systolic Left Ventricular Function Determines Hemodynamic Adaptation Following Percutaneous Mitral Valve Repair - Assessment By Conductance Catheter. J Am Coll Cardiol 2012. [DOI: 10.1016/j.jacc.2012.08.825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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