Neuroanatomy of Apathy and Disinhibition in Frontotemporal Lobar Degeneration

Massimo, Lauren; Powers, Chivon; Moore, Peachie; Vesely, Luisa; Avants, Brian B.; Gee, James C.; Libon, David J.; Grossman, Murray

doi:10.1159/000194658

Cited by 148 publications

(142 citation statements)

References 62 publications

Supporting

Mentioning

123

Contrasting

Unclassified

Order By: Relevance

“…4,29 Similarly, ventrolateral prefrontal cortex atrophy has been associated with inappropriate social behaviours in patients with FTD. 36 Contrary to predictions, we did not find significant group differences in amygdala activation during the presentation of fearful faces despite the frequent association of this region with fearful face processing in healthy adults. Further examination of the data indicates that there was limited amygdala activity relative to baseline in response to fearful faces in both patients and controls.…”

Section: Discussioncontrasting

confidence: 99%

Functional neural correlates of emotional expression processing deficits in behavioural variant frontotemporal dementia

Virani

Jesso

Mitchell

et al. 2013

J Psychiatry Neurosci

View full text Add to dashboard Cite

IntroductionBehavioural variant frontotemporal dementia (bvFTD) is a neurodegenerative disorder characterized by progressive dysfunction in social behaviour typically beginning in midlife (50s-60s). A hallmark of bvFTD is the loss of empathy for others, a symptom thought to be partially accounted for by a reduction in emotion recognition.1 Facial expressions are one way in which we communicate emotional information critical for successful social behaviour.2,3 Deficient facial expression recognition, particularly for negative expressions, such as fear and anger, is associated with inappropriate social behaviours. 4,5 Previous studies have demonstrated that patients with bvFTD with frontally or temporally predominant atrophy show deficits in facial expression recognition, while general face processing abilities, such as facial identity and gender discrimination are preserved. [6][7][8] Whereas a growing body of research has associated regions of atrophy with bvFTD clinical symptoms, to our knowledge, the Background: Frontotemporal dementia (FTD) is a neurodegenerative disorder resulting in social-cognitive deficits partially attributed to abnormalities processing social cues, such as facial expressions. However, to our knowledge, the functional neuroanatomy of deficient social cue processing in individuals with FTD has not been examined. The objective of this study was to delineate the functional abnormalities under lying altered facial expression processing in individuals with FTD using functional magnetic resonance imaging (fMRI). Methods: Patients meeting Neary criteria for behavioural variant FTD (bvFTD) with supportive neuroimaging and 18 age-matched healthy controls completed an implicit facial expression task during fMRI. We conducted volumetric brain morphometry to correct functional imaging data for volume differences. Results: We included 20 patients with bvFTD and 18 controls in our study. The results demonstrate emotion-specific functional abnormalities in frontal and limbic regions in patients with bvFTD. Patients also showed decreased activity in posterior ventral visual regions, specifically the fusiform cortex, possibly reflecting reduced afferent input from limbic regions. Finally, bvFTD was associated with increased activity in posterior regions, including the inferior parietal cortex. Limitations: Autopsy validation of frontotemporal dementia is not yet available for this cohort. Conclusion: Together, these findings suggest that fMRI combined with tasks targeting social-cognitive deficits is a powerful technique to objectively measure neural systems involved in emotion processing in individuals with bvFTD. As viewing emotional expressions is known to engage many of the same neural systems that are active when experiencing the emotion itself, fMRI during expression processing provides a novel window into the emotions of patients with FTD.

show abstract

Section: Discussioncontrasting

confidence: 99%

Functional neural correlates of emotional expression processing deficits in behavioural variant frontotemporal dementia

Virani

Jesso

Mitchell

et al. 2013

J Psychiatry Neurosci

View full text Add to dashboard Cite

show abstract

“…9,26 The lack of empathy in bvFTD is extraordinarily disturbing to caregivers. 14 Such changes were not evident in the caregiver ratings for the PNFA and SD samples, supporting the specificity of the results for the consensus diagnosis of bvFTD disorders and presumed frontal-limbic involvement. The lack of observed empathic changes in SD patients, as seen by Rankin et al, 26 may be related in part to an ascertainment bias.…”

Section: Discussionmentioning

confidence: 55%

“…9–14 In a neural-systems model of social cognition, we have proposed important interrelationships of social and cognitive domains in a social executor framework of deficits in bvFTD, 15 drawing from social-cognitive studies in adult patients with acquired focal lesions of the frontal lobe. 16–18 Social executors encompass social knowledge and executive resources (including self-awareness and self-regulation), as well as motivational and emotional components associated with interpersonal actions.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Social Cognition, Executive Functioning, and Neuroimaging Correlates of Empathic Deficits in Frontotemporal Dementia

Eslinger

Moore

Anderson

et al. 2011

Journal of Neuropsychiatry

163

137

View full text Add to dashboard Cite

The authors investigated aspects of interpersonal sensitivity and perspective-taking in relation to empathy, social cognitions, and executive functioning in 26 frontotemporal dementia (FTD) patients. Behavioral-variant FTD (bvFTD) patients were significantly impaired on caregiver assessments of empathy, although self-ratings were normal. Progressive nonfluent aphasia and semantic-dementia samples were rarely abnormal. In bvFTD, empathy ratings were found to be correlated with social cognition and executive functioning measures, but not depression. Voxel-based morphometry revealed that reduced empathic perspective-taking was related to bifrontal and left anterior temporal atrophy, whereas empathic emotions were related to right medial frontal atrophy. Findings suggest that bvFTD causes multiple types of breakdown in empathy, social cognition, and executive resources, mediated by frontal and temporal disease.

show abstract

“…Given the multifunctionality of the insula (BA 13), this region also contributes to the cognition and emotion in conjunction with ACC [50]. Damage to these structures in patients with bvFTD results in diverse cognitive, emotional, and behavioral disturbances [51,52]. A previous meta-analysis with only three structural MRI studies in bvFTD did not identify GM reduction in ACC.…”

Section: Discussionmentioning

confidence: 99%

Gray Matter Atrophy in Behavioral Variant Frontotemporal Dementia: A Meta-Analysis of Voxel-Based Morphometry Studies

Pan

Song²,

Yang³

et al. 2012

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

Background: Structural neuroimaging studies on behavioral variant frontotemporal dementia (bvFTD) using the voxel-based morphometry (VBM) method reported not entirely consistent findings. Methods: A systematic review of VBM studies of bvFTD patients and healthy controls (HC) published in PubMed and Embase databases from 2000 to June 2011 was conducted. Meta-analysis was performed using a newly improved voxel-based meta-analytic tool, namely, effect size signed differential mapping, to quantitatively explore the gray matter (GM) changes between bvFTD patients and HC subjects. Results: 11 VBM studies involving 237 bvFTD patients and 297 HC subjects met the inclusion criteria. Considerable regional GM volume decrease was detected in the anterior medial frontal cortex (BA 9), extending to other frontal areas (BA 8, 10, 46, 24, 32), and other brain areas, such as the insula cortex, as well as the subcortical striatal regions in patients with bvFTD compared with HC subjects. The findings of the present study remain largely unchanged in the entire brain jackknife sensitivity analyses. Conclusions: The present meta-analysis provides evidence of GM changes in the frontal-striatal-limbic brain areas in patients with bvFTD. Furthermore, GM atrophy in the fron-toinsular cortex and anterior cingulate cortex may be important anatomical changes for the diagnosis of patients with bvFTD.

show abstract

Neuroanatomy of Apathy and Disinhibition in Frontotemporal Lobar Degeneration

Cited by 148 publications

References 62 publications

Functional neural correlates of emotional expression processing deficits in behavioural variant frontotemporal dementia

Functional neural correlates of emotional expression processing deficits in behavioural variant frontotemporal dementia

Social Cognition, Executive Functioning, and Neuroimaging Correlates of Empathic Deficits in Frontotemporal Dementia

Gray Matter Atrophy in Behavioral Variant Frontotemporal Dementia: A Meta-Analysis of Voxel-Based Morphometry Studies

Contact Info

Product

Resources

About