Loss of empathy is an early central symptom and diagnostic criterion of the behavioral variant frontotemporal dementia (bvFTD). Although changes in empathy are evident and strongly affect the social functioning of bvFTD patients, few studies have directly investigated this issue by means of experimental paradigms. The current study assessed multiple components of empathy (affective, cognitive and moral) in bvFTD patients. We also explored whether the loss of empathy constitutes a primary deficit of bvFTD or whether it is explained by impairments in executive functions (EF) or other social cognition domains. Thirty-seven bvFTD patients with early/mild stages of the disease and 30 healthy control participants were assessed with a task that involves the perception of intentional and accidental harm. Participants were also evaluated on emotion recognition, theory of mind (ToM), social norms knowledge and several EF domains. BvFTD patients presented deficits in affective, cognitive and moral aspects of empathy. However, empathic concern was the only aspect primarily affected in bvFTD that was neither related nor explained by deficits in EF or other social cognition domains. Deficits in the cognitive and moral aspects of empathy seem to depend on EF, emotion recognition and ToM. Our findings highlight the importance of using tasks depicting real-life social scenarios because of their greater sensitivity in the assessment of bvFTD. Moreover, our results contribute to the understanding of primary and intrinsic empathy deficits of bvFTD and have important theoretical and clinical implications.
Executive dysfunction may result from prefrontal circuitry involvement occurring
in both neurodegenerative diseases and psychiatric disorders. Moreover, multiple
neuropsychiatric conditions, may present with overlapping behavioral and
cognitive symptoms, making differential diagnosis challenging, especially during
earlier stages. In this sense, cognitive assessment may contribute to the
differential diagnosis by providing an objective and quantifiable set of
measures that has the potential to distinguish clinical conditions otherwise
perceived in everyday clinical settings as quite similar.OBJECTIVEThe goal of this study was to investigate the utility of the INECO Frontal
Screening (IFS) for differentiating bv-FTD patients from patients with Major
Depression.METHODSWe studied 49 patients with bv-FTD diagnosis and 30 patients diagnosed with
unipolar depression compared to a control group of 26 healthy controls using
the INECO Frontal Screening (IFS), the Mini Mental State Examination (MMSE)
and the Addenbrooke's Cognitive Examination-Revised (ACE-R).RESULTSPatient groups differed significantly on the motor inhibitory control
(U=437.0, p<0.01), verbal working memory (U=298.0, p<0.001), spatial
working memory (U=300.5, p<0.001), proverbs (U=341.5, p<0.001) and
verbal inhibitory control (U=316.0, p<0.001) subtests, with bv-FTD
patients scoring significantly lower than patients with depression.CONCLUSIONOur results suggest the IFS can be considered a useful tool for detecting
executive dysfunction in both depression and bv-FTD patients and, perhaps
more importantly, that it has the potential to help differentiate these two
conditions.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.