Social cognitive deficits and their neural correlates in progressive supranuclear palsy

Abstract

Although progressive supranuclear palsy is defined by its akinetic rigidity, vertical supranuclear gaze palsy and falls, cognitive impairments are an important determinant of patients’ and carers’ quality of life. Here, we investigate whether there is a broad deficit of modality-independent social cognition in progressive supranuclear palsy and explore the neural correlates for these. We recruited 23 patients with progressive supranuclear palsy (using clinical diagnostic criteria, nine with subsequent pathological confirmation) and 22 age- and education-matched controls. Participants performed an auditory (voice) emotion recognition test, and a visual and auditory theory of mind test. Twenty-two patients and 20 controls underwent structural magnetic resonance imaging to analyse neural correlates of social cognition deficits using voxel-based morphometry. Patients were impaired on the voice emotion recognition and theory of mind tests but not auditory and visual control conditions. Grey matter atrophy in patients correlated with both voice emotion recognition and theory of mind deficits in the right inferior frontal gyrus, a region associated with prosodic auditory emotion recognition. Theory of mind deficits also correlated with atrophy of the anterior rostral medial frontal cortex, a region associated with theory of mind in health. We conclude that patients with progressive supranuclear palsy have a multimodal deficit in social cognition. This deficit is due, in part, to progressive atrophy in a network of frontal cortical regions linked to the integration of socially relevant stimuli and interpretation of their social meaning. This impairment of social cognition is important to consider for those managing and caring for patients with progressive supranuclear palsy.

Cerebellar atrophy in neurodegeneration—a meta-analysis

“…Finally, greater cerebellar atrophy in patients with PSP correlated with lower Frontal Assessment Battery scores, greater postural instability (lobules I–IV) and disease duration (lobules I–IV, VIIIb),36 decreased phonological verbal and letter fluency (left lobule VI, right I–IV)36 37 and impaired emotion recognition and theory of mind (right Crus II) 38…”

Language, executive function and social cognition in the diagnosis of frontotemporal dementia syndromes

“…Multiple studies have demonstrated impaired social cognition in AD, including deficits in moral judgments and decision making (Torralva et al, 2000) and deficient reasoning regarding psychological versus physical causation (Verdon et al, 2007). Additionally, other patient populations including PSP, VaD and PD have been reported to have social cognitive changes to varying degrees (Allain et al, 2011; Bodden et al, 2010; Ghosh et al, 2012; Kawamura et al, 2007; Roca et al, 2010; Yu et al, 2012). However, a recent study directly comparing dementia groups revealed more severe social cognitive deficits in bvFTD as compared to non-FTD groups.…”

Disease-Specific Regions Outperform Whole-Brain Approaches in Identifying Progressive Supranuclear Palsy: A Multicentric MRI Study

“…Many studies found a diminished gray matter density (GMD) in the left and right insulae (Brenneis et al, 2004; Padovani et al, 2006; Ghosh et al, 2012). Several papers reported a reduced GMD in the thalamus (Cordato et al, 2005; Boxer et al, 2006; Padovani et al, 2006; Shi et al, 2013), but other papers did not find GMD changes here (Brenneis et al, 2004; Ghosh et al, 2012). Volumetric analysis of structural MRI showed a significantly smaller putamen in PSP patients in comparison to healthy controls (Messina et al, 2011).…”