Music models aberrant rule decoding and reward valuation in dementia

Clark, Camilla N.; Golden, Hannah L.; McCallion, Oliver; Nicholas, Jennifer M.; Cohen, Miriam; Slattery, Catherine F.; Paterson, Ross W.; Fletcher, Phillip D.; Mummery, Catherine J.; Rohrer, Jonathan D.; Crutch, Sebastian J.; Warren, Jason D.

doi:10.1093/scan/nsx140

Cited by 19 publications

(11 citation statements)

References 102 publications

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“…Reinforcement learning per se might be affected in the next stage as cognitive decline progresses. The ability to process quantities and quantifier statements per se may still be preserved in concrete laboratory contexts like the present study when quantifiers and quantities are presented on the screen, but quantities may at the same time lose their reinforcement value in real life (Clark et al, 2018;Wong et al, 2018). This may be associated with the deficit in adapting persondirected behavior to the requirements of the social context, which is also defined by abstract rules (e.g., Zakzanis, 1998;Ibañez and Manes, 2012;Carr et al, 2015) and in which intact meta-cognitive abilities would be required (Eslinger et al, 2005).…”

Section: Discussionmentioning

confidence: 78%

“…Likewise, cognitive flexibility, adaptation to a situational context and re-evaluation of circumstances are becoming more and more difficult (e.g., Zakzanis, 1998;Ibañez and Manes, 2012;Carr et al, 2015). Also, the processing of rewards and values per se (Clark et al, 2018;Wong et al, 2018) is impaired. Whereas bvFTD patients seem to have maintained their memory abilities to recall the value of words used as rewards in a learning paradigm, they failed to apply that knowledge in overt behavior.…”

Section: Introductionmentioning

confidence: 99%

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So Many Are “Few,” but so Few Are Also “Few” – Reduced Semantic Flexibility in bvFTD Patients

et al. 2020

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The processing of quantifier words such as "many" or "few" is a complex operation supported by a plastic fronto-parietal network predominantly in the left hemisphere. The internal reference criterion defining a quantifier (e.g., ≥50% for "many") can be modified in a learning paradigm. Most interestingly, changing the criterion for one quantifier also leads to a change in the criterion for the untrained quantifier, i.e., a semantic restructuring effect, which is supported by Broca's region in the left inferior frontal cortex. Here, we applied this paradigm to patients with the behavioral variant of fronto-temporal dementia (bvFTD) because they suffer from loss of cognitive flexibility, reduced ability to process quantities and their values, impaired reinforcement learning, and language comprehension deficits. The question was whether the patients would be able to perform the task, show direct learning of the new quantifier meanings, and exhibit cognitive flexibility in terms of semantic restructuring. Eleven bvFTD patients took part in two behavioral experiments. In Experiment 1, in a first baseline block, each individual's criterion for "many" and "few" was assessed. In block 2, subjects received feedback about their decisions. Contrary to their initial notion, a proportion of 40% yellow circles was reinforced as "many." In block 3, the effect of this training on their judgments of "many" and "few" was reassessed. The group of bvFTD patients showed a learning effect for the new criterion trained for the quantifier "many," but failed to generalize this criterion shift to the other quantifier "few." Experiment 2 was similar to Experiment 1, but the patients were trained in Block 2 to judge 60% of circles as "few," with no training for "many." Again, there was an average learning effect for the trained quantifier "few" over the entire group, but no generalization to "many." Since the patients were still able to perform the task and showed learning of "many" to direct feedback, the data suggest that the generalization process, rather than initial learning, is more vulnerable to fronto-temporal degeneration.

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Section: Discussionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

So Many Are “Few,” but so Few Are Also “Few” – Reduced Semantic Flexibility in bvFTD Patients

et al. 2020

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“…Within the inferior frontal cortex, pars orbitalis acts as a hub zone for the cognitive and affective decoding of auditory signals (89), particularly where these constitute patterns bound by 'rules' and expectancies. Besides its well-known role in linguistic grammar processing, this region is involved in processing musical syntax (90) and affective evaluation of harmonic progressions in melodies (76). Anteromedial prefrontal and anterior cingulate cortices behave as an integrated functional 'hub' in appraising the social value of heard laughter and disambiguating its social intent (44,45,91) and programming adaptive output behaviours, including own laughter and the subjective experience of mirth (92)(93)(94)(95)(96).…”

Section: Discussionmentioning

confidence: 99%

Laughter as a Paradigm of Socio-emotional Signal Processing in Dementia

Sivasathiaseelan

Marshall

Benhamou

et al. 2020

Preprint

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Background: Laughter is a fundamental communicative signal in our relations with other people and is used to convey a diverse repertoire of social and emotional information. It is therefore potentially a useful probe of impaired socio-emotional signal processing in neurodegenerative diseases. Here we investigated the cognitive and affective processing of laughter systematically in patients representing all major syndromes of frontotemporal dementia, a disease spectrum characterised by severe socio-emotional dysfunction, as well as typical amnestic Alzheimer’s disease in relation to healthy age-matched individuals. Methods: We assessed cognitive labelling and valence rating of samples of spontaneous (mirthful and hostile) and volitional (posed) laughter versus two auditory control conditions (a synthetic laughter-like stimulus and spoken numbers) in 47 patients with frontotemporal dementia (22 with behavioural variant frontotemporal dementia, 12 with semantic variant primary progressive aphasia and 13 with nonfluent-agrammatic primary progressive aphasia), 15 patients with typical amnestic Alzheimer’s disease and 20 healthy age-matched individuals. Neuroanatomical associations of laughter processing were assessed using voxel-based morphometry of patients’ brain MR images. Results: While all dementia syndromes were associated with impaired identification of laughter subtypes relative to healthy controls, this was significantly more severe overall in frontotemporal dementia than in Alzheimer’s disease and particularly in the behavioural and semantic variants, which also showed abnormal affective evaluation of laughter. Certain striking syndromic signatures emerged, including enhanced liking for hostile laughter in behavioural variant frontotemporal dementia, impaired processing of synthetic laughter in the nonfluent-agrammatic variant (consistent with a generic complex auditory perceptual deficit) and ‘numerophilia’ in the semantic variant. Across the patient cohort, overall laughter identification accuracy correlated with regional grey matter in a core network encompassing inferior frontal and cingulo-insular cortices; and more specific correlates of laughter identification accuracy were delineated in cortical regions mediating affective disambiguation (identification of hostile and posed laughter in orbitofrontal cortex) and authenticity (social intent) decoding (identification of mirthful and posed laughter in anteromedial prefrontal cortex).Conclusions: These findings reveal a rich diversity of cognitive and affective laughter phenotypes in canonical dementia syndromes and suggest that laughter is an informative probe of neural mechanisms underpinning socio-emotional dysfunction in neurodegenerative disease.

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“…Only a few objective tasks have been used to assess reward processing in bvFTD but they showed that reward processing deficits are also very commonly observed in this disease. Patients could present a general deficit in reward valuation (262, 263) and thus, stimulus-reinforcement learning impairment (264). In patients in earlier stages of the disease who were not impaired in reinforcement learning, difficulties to suppress a previously rewarded behavior when it becomes punishing were observed (215), a lack of “reversal learning” that could prevent the quick adjustments that are needed on a daily basis in the social life.…”

Section: Promising Cognitive and Psychological Markers For Bvftd Beyomentioning

confidence: 99%

Psychological and Cognitive Markers of Behavioral Variant Frontotemporal Dementia–A Clinical Neuropsychologist's View on Diagnostic Criteria and Beyond

Johnen

Bertoux

2019

Front. Neurol.

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Behavioral variant frontotemporal dementia (bvFTD) is the second leading cognitive disorder caused by neurodegeneration in patients under 65 years of age. Characterized by frontal, insular, and/or temporal brain atrophy, patients present with heterogeneous constellations of behavioral and psychological symptoms among which progressive changes in social conduct, lack of empathy, apathy, disinhibited behaviors, and cognitive impairments are frequently observed. Since the histopathology of the disease is heterogeneous and identified genetic mutations only account for ~30% of cases, there are no reliable biomarkers for the diagnosis of bvFTD available in clinical routine as yet. Early detection of bvFTD thus relies on correct application of clinical diagnostic criteria. Their evaluation however, requires expertise and in-depth assessments of cognitive functions, history taking, clinical observations as well as caregiver reports on behavioral and psychological symptoms and their respective changes. With this review, we aim for a critical appraisal of common methods to access the behavioral and psychological symptoms as well as the cognitive alterations presented in the diagnostic criteria for bvFTD. We highlight both, practical difficulties as well as current controversies regarding an overlap of symptoms and particularly cognitive impairments with other neurodegenerative and primary psychiatric diseases. We then review more recent developments and evidence on cognitive, behavioral and psychological symptoms of bvFTD beyond the diagnostic criteria which may prospectively enhance the early detection and differential diagnosis in clinical routine. In particular, evidence on specific impairments in social and emotional processing, praxis abilities as well as interoceptive processing in bvFTD is summarized and potential links with behavior and classic cognitive domains are discussed. We finally outline both, future opportunities and major challenges with regard to the role of clinical neuropsychology in detecting bvFTD and related neurocognitive disorders.

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Music models aberrant rule decoding and reward valuation in dementia

Cited by 19 publications

References 102 publications

So Many Are “Few,” but so Few Are Also “Few” – Reduced Semantic Flexibility in bvFTD Patients

So Many Are “Few,” but so Few Are Also “Few” – Reduced Semantic Flexibility in bvFTD Patients

Laughter as a Paradigm of Socio-emotional Signal Processing in Dementia

Psychological and Cognitive Markers of Behavioral Variant Frontotemporal Dementia–A Clinical Neuropsychologist's View on Diagnostic Criteria and Beyond

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