Physiological phenotyping of dementias using emotional sounds

Fletcher, Phillip D.; Nicholas, Jennifer M.; Shakespeare, Timothy J.; Downey, Laura; Golden, Hannah L.; Agustus, Jennifer L.; Clark, Camilla N.; Mummery, Catherine J.; Schott, Jonathan M.; Crutch, Sebastian J.; Warren, Jason D.

doi:10.1016/j.dadm.2015.02.003

Cited by 23 publications

(48 citation statements)

References 50 publications

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“…Taken together, these findings are consistent with the known targeting of core cerebral autonomic fronto‐cingulo‐insular circuitry in bvFTD and nfvPPA 27, 28, 29, 30. svPPA has also been associated with deficits in afferent interoceptive signal processing 20, 26, 31, 32. Altered autonomic reactivity to others’ emotions is a plausible pathophysiological basis for the socio‐emotional symptoms exhibited by these patients.…”

Section: Introductionsupporting

confidence: 85%

“…[27][28][29][30] svPPA has also been associated with deficits in afferent interoceptive signal processing. 20,26,31,32 Altered autonomic reactivity to others' emotions is a plausible pathophysiological basis for the socio-emotional symptoms exhibited by these patients. Moreover, autonomic responses and explicit identification of emotions are likely to be separably vulnerable in FTD syndromes.…”

Section: Introductionmentioning

confidence: 98%

“…We chose a simple heart rate response metric designed to incorporate both the cardiac orienting response and its potentiation by emotional content, with a view to easy replicability in future studies and potential clinical utility without the need for complex modeling of heart rate patterns. We hypothesized that cardiac modulation would be attenuated in bvFTD and nfvPPA due to degeneration of fronto‐insular networks in these diseases, but relatively preserved (and separable from emotion identification) in syndromes targeting the anterior temporal lobes (svPPA and rtvFTD) 18, 20, 21. We further hypothesized that emotion recognition ability but not cardiac reactivity would be associated with semantic knowledge, while cardiac reactivity would correlate with atrophy in components of the central autonomic regulatory network (ACC, insula, OFC) 15, 16, 24…”

Section: Introductionmentioning

confidence: 99%

“…9 If autonomic mechanisms contribute to aberrant emotion processing in FTD, one would anticipate associated changes in physiological reactivity, as has previously been documented in FTD syndromes. In particular, bvFTD has been associated with abnormal autonomic reactivity to affectively charged stimuli, [18][19][20][21][22] alterations of resting skin conductance and heart rate variability, 23,24 and abnormal brain-heart coupling, 24,25 while nfvPPA has been associated with reduced pupil responses to arousing stimuli. 20,26 Taken together, these findings are consistent with the known targeting of core cerebral autonomic fronto-cingulo-insular circuitry in bvFTD and nfvPPA.…”

Section: Introductionmentioning

confidence: 99%

“…In particular, bvFTD has been associated with abnormal autonomic reactivity to affectively charged stimuli, [18][19][20][21][22] alterations of resting skin conductance and heart rate variability, 23,24 and abnormal brain-heart coupling, 24,25 while nfvPPA has been associated with reduced pupil responses to arousing stimuli. 20,26 Taken together, these findings are consistent with the known targeting of core cerebral autonomic fronto-cingulo-insular circuitry in bvFTD and nfvPPA. [27][28][29][30] svPPA has also been associated with deficits in afferent interoceptive signal processing.…”

Section: Introductionmentioning

confidence: 99%

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Cardiac responses to viewing facial emotion differentiate frontotemporal dementias

Marshall

Hardy

Allen

et al. 2018

Ann Clin Transl Neurol

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ObjectiveTo establish proof‐of‐principle for the use of heart rate responses as objective measures of degraded emotional reactivity across the frontotemporal dementia spectrum, and to demonstrate specific relationships between cardiac autonomic responses and anatomical patterns of neurodegeneration.MethodsThirty‐two patients representing all major frontotemporal dementia syndromes and 19 healthy older controls performed an emotion recognition task, viewing dynamic, naturalistic videos of facial emotions while ECG was recorded. Cardiac reactivity was indexed as the increase in interbeat interval at the onset of facial emotions. Gray matter associations of emotional reactivity were assessed using voxel‐based morphometry of patients’ brain MR images.ResultsRelative to healthy controls, all patient groups had impaired emotion identification, whereas cardiac reactivity was attenuated in those groups with predominant fronto‐insular atrophy (behavioral variant frontotemporal dementia and nonfluent primary progressive aphasia), but preserved in syndromes focused on the anterior temporal lobes (right temporal variant frontotemporal dementia and semantic variant primary progressive aphasia). Impaired cardiac reactivity correlated with gray matter atrophy in a fronto‐cingulo‐insular network that overlapped correlates of cognitive emotion processing.InterpretationAutonomic indices of emotional reactivity dissociate from emotion categorization ability, stratifying frontotemporal dementia syndromes and showing promise as novel biomarkers. Attenuated cardiac responses to the emotions of others suggest a core pathophysiological mechanism for emotional blunting and degraded interpersonal reactivity in these diseases.

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Section: Introductionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Cardiac responses to viewing facial emotion differentiate frontotemporal dementias

Marshall

Hardy

Allen

et al. 2018

Ann Clin Transl Neurol

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Hearing and dementia

et al. 2016

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Hearing deficits associated with cognitive impairment have attracted much recent interest, motivated by emerging evidence that impaired hearing is a risk factor for cognitive decline. However, dementia and hearing impairment present immense challenges in their own right, and their intersection in the auditory brain remains poorly understood and difficult to assess. Here, we outline a clinically oriented, symptom-based approach to the assessment of hearing in dementias, informed by recent progress in the clinical auditory neuroscience of these diseases. We consider the significance and interpretation of hearing loss and symptoms that point to a disorder of auditory cognition in patients with dementia. We identify key auditory characteristics of some important dementias and conclude with a bedside approach to assessing and managing auditory dysfunction in dementia.

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Primary progressive aphasia: a clinical approach

et al. 2018

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The primary progressive aphasias are a heterogeneous group of focal ‘language-led’ dementias that pose substantial challenges for diagnosis and management. Here we present a clinical approach to the progressive aphasias, based on our experience of these disorders and directed at non-specialists. We first outline a framework for assessing language, tailored to the common presentations of progressive aphasia. We then consider the defining features of the canonical progressive nonfluent, semantic and logopenic aphasic syndromes, including ‘clinical pearls’ that we have found diagnostically useful and neuroanatomical and other key associations of each syndrome. We review potential diagnostic pitfalls and problematic presentations not well captured by conventional classifications and propose a diagnostic ‘roadmap’. After outlining principles of management, we conclude with a prospect for future progress in these diseases, emphasising generic information processing deficits and novel pathophysiological biomarkers.Electronic supplementary materialThe online version of this article (10.1007/s00415-018-8762-6) contains supplementary material, which is available to authorized users.

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Physiological phenotyping of dementias using emotional sounds

Cited by 23 publications

References 50 publications

Cardiac responses to viewing facial emotion differentiate frontotemporal dementias

Cardiac responses to viewing facial emotion differentiate frontotemporal dementias

Hearing and dementia

Primary progressive aphasia: a clinical approach

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