Oops! Resolving social dilemmas in frontotemporal dementia

Eslinger, Paul J.; Moore, Peachie; Troiani, Vanessa; Antani, Shweta; Cross, Katy A.; Kwok, Shaleigh; Grossman, Murray

doi:10.1136/jnnp.2006.098228

Cited by 126 publications

(122 citation statements)

References 20 publications

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“…On the other hand, the subgroup of patients with bvFTD have significant executive-function deficits, 42,43 and it is reasonable to propose that the social disorder in bvFTD is due in part to their executive-resource limitations. Although we demonstrated this in our previous assessments of social problem-solving and self-awareness, 12,15 such associations between social-emotional and executive-cognitive functioning may not have been seen in other work because of limited ascertainment of cognitive measures, such as assessment of a partial range of relevant measures. For example, Lough and coworkers 9,41 examined a limited range of executive measures requiring cognitive estimation, but did not assess measures of mental flexibility that may be a more pertinent cognitive component of empathy.…”

Section: Discussionmentioning

confidence: 46%

“…Such correlations have been suspected in bvFTD patients on the basis of results of clinical studies, and overlapping pathophysiology that has been identified in focal frontal lesion cases 17 and in previous assessments of social cognition in bvFTD. 12,15 For example, during a three-alternative, forced-choice, social problem-solving task, we identified a significant deficit in bvFTD. Correlational analyses revealed that performance was related to theory of mind, empathy, and cognitive flexibility measures.…”

Section: Discussionmentioning

confidence: 87%

“…Measures of social cognition and executive functions, as previously reported for FTD samples, 6,15 are briefly described here and included the following: Cartoon Predictions—a shortened, 10-item version of Form A 32 assessed prediction of social consequences. Performance was untimed, after a practice item established that participants understood the task; Theory of Mind—12 vignettes assessed judgment of story facts and first- and second-order beliefs of characters in social situations.…”

Section: Methodsmentioning

confidence: 99%

“…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%

“…We related these deficits to cortical atrophy in a large-scale neural network encompassing at least orbital frontal, medial frontal, and superior temporal regions, more prominently in the right hemisphere. 12,14,15 …”

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confidence: 99%

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

Eslinger

Moore

Anderson

et al. 2011

Journal of Neuropsychiatry

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137

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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.

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Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 87%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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

Eslinger

Moore

Anderson

et al. 2011

Journal of Neuropsychiatry

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162

137

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Emotion and Moral Cognition

Koenigs

2011

From DNA to Social Cognition

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Accurate Assessment of Behavioral Variant Frontotemporal Dementia

LaMarre

Kramer

2012

Handbook on the Neuropsychology of Aging and Dementia

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Behavioral variant Frontotemporal dementia (bvFTD) is a neurodegenerative syndrome characterized by profound changes in personality and behavior, including social disinhibition, loss of empathy, apathy and compulsive behaviors. While cognitive decline does occur (typically beginning with executive dysfunction), these issues tend to emerge mid-disease course, rather than early on. Onset is insidious, typically beginning between ages 45-65 and prevalence is equal to Alzheimer's disease (AD) in individuals under the age of 65. Despite signifi cant advancements in our understanding of bvFTD over the past 12 years, misdiagnosis remains common. For example, a signifi cant subset of individuals with bvFTD initially receive a diagnosis of early-onset AD, or late life psychiatric disturbance. Given their expertise in the assessment of cognition, behavior and emotion, neuropsychologists can play an important role in the differential diagnosis and management of this disease. This chapter begins with an up-to-date discussion of the clinical, neuropathological and genetic features of the disease, and then moves into a review of the neuropsychological literature. A structured discussion of key aspects to cover in a neuropsychological assessment is provided, and a case example of a 'typical' bvFTD patient is presented. Behavioral variant frontotemporal dementia (bvFTD) is one of three neurodegenerative syndromes that are collectively referred to as frontotemporal dementia (FTD). Initially thought to be rare, we now know that it is equally as common as Alzheimer's disease in individuals under the age of 65 [ 1 ] and is the third most common dementia after Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) [ 2 ] . While estimates of the prevalence of FTD vary, population-based studies in both the United States and United Kingdom estimate a sporadic occurrence at around 3.3-3.5/100,000 in individuals between 45 and 65 years of age [ 3,4 ] . Age of onset is typically in the presenium, though onset ranges considerably from the 30s to 90s [ 1,5,6 ] . The usual duration of FTD ranges from 8 to 11 years [ 7 ] .Clinically, FTD is expressed as three main variants [ 8 ] . BvFTD is characterized by profound and early changes in personality and behavior [ 8 ] . This phenotype is most common and accounts for approximately 70% of the clinical expression of the disease [ 9 ] . As such, bvFTD will be the focus of this chapter. The other two variants are primary progressive aphasic syndromes. The semantic variant (svPPA) is associated with the loss of word knowledge (e.g., semantic structure of language), while the non fl uent variant (nfPPA) is characterized by early disturbances in motor speech output and loss of syntax (e.g., grammatical structure of language) [ 8,10 ] . These two variants account for approximately 15% and 10% of the phenotypic expression of the disease, respectively [ 9 ] . Gender distribution tends to vary by clinical syndrome. Many studies fi nd a male bias in bvFTD and svPPA and a female bias in nfPPA [ ...

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Oops! Resolving social dilemmas in frontotemporal dementia

Cited by 126 publications

References 20 publications

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

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

Emotion and Moral Cognition

Accurate Assessment of Behavioral Variant Frontotemporal Dementia

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