ABSTRACT
Las emociones básicas están biológicamente determinadas y ligadas a conductas fundamentales para la supervivencia. Las emociones secundarias son aquellas que para su reconocimiento, requieren la elaboración cognitiva de un contexto social, por lo tanto, de la Teoría de la Mente (TdM). La TdM fue definida como la habilidad de conceptualizar estados mentales de otros individuos para explicar y predecir gran parte de su comportamiento. No es un concepto unitario, existen disociaciones entre los componentes cognitivo y el emocional de la TdM. Han sido establecidas las alteraciones en el reconocimiento facial de emociones básicas (RFEB) y en las tareas de TdM en la variante conductual de la demencia frontotemporal (DFTvc). El objetivo del trabajo que se informa fue estudiar el reconocimiento de emociones básicas o primarias y su relación con la TdM en pacientes con DFTvc. El 81% de los pacientes mostró alteraciones en por lo menos uno de los tests de RFEB y el 35% en el reconocimiento de la prosodia emocional. El subtest Denominación y el Puntaje Total Emociones mostraron correlaciones con el Test Lectura de la Mente en los Ojos, mientras que todas las tareas de RFEB correlacionaron con la tarea de falsa creencia. Se encontraron dobles disociaciones entre TdM emocional y cognitiva, con mayor afectación del componente emocional. Como conclusión se corrobora la presencia de alteraciones en el RFEB con prosodia emocional conservada en la DFTvc. La ausencia de correlaciones entre emociones básicas y secundarias parecería indicar que se trata de procesos independientes entre sí.
Behavioral variant of frontotemporal dementia (bvFTD) is associated with dramatic changes in personality. The behavioral manifestations that show these patients may be due, to one hand, to abnormal emotional processing as a result of the anatomical regions concerned, and on the other, to alterations in Theory of Mind (ToM). Basic emotions are biologically determined. Joy, sadness, anger, disgust and fear are the emotional states that have received most agreement. ToM allows representing, inferring and interpreting mental and emotional states of others. It has been suggested that it is not a unitary concept. Cognitive Theory of Mind refers to the representations regarding the cognitive status of others. Affective ToM refers to the representation of emotional and motivational states. The objectives were to study the presence of alterations in the recognition of basic emotions in the face and voice in patients with bvFTD, aswell as examine the relation ships that exist between the recognition of basic emotions and TdM, to know if there are, or not, independent processes. To study, finally, the presence of dissociations between emotional and cognitive ToM, to know which one of these types of ToM shows greater alteration in our population. 26 bvFTD patients were assessed, diagnosed on the basis of the criteria proposed by the International Consortium Behavioral Variant FTD Criteria, and 23 control subjects. A battery for facial recognition of basic emotions (FRBE) was administered, selecting 60 photographs of the Pictures of Facial Affect. Three tasks were created, comprising 60 sheets each, 10 forevery basic emotion. A test for recognition of emotional prosody was also administered. Among the ToM tests were Reading the Mind in the Eyes (RME), Faux Pas, and Firs Order False Belief Task (FOFBT). 81% of the patients showed alterations in at least one of the tests RFEB, and 35% in emotional prosody recognition. All RFEB tasks showed a significantly moderate statistical correlation with the emotional prosody task. The Naming subtest and the Total Emotions Score (RFEB) showed correlations with RME test, while all tasks RFEB correlated with FC1ºO. Finally, 10 simple dissociations between altered FRBE and preserved emotional prosody were found, and double dissociations between emotional and cognitive ToM, with greater impairment of the emotional component of ToM Discussion: A decreased performance is corroborated in the bvFTD patients group, relative to a control group, in all FRBE tasks. The recognition of emotional prosody is preserved. The presence of correlations between RME and all FRBE tasks may be explained by the neuropsychological structure of the tasks. The correlations found between RME and under standing of emotional prosody may be due to the fact that both tests assess emotional comprehension. As for the correlations found between FC1ºO and all FRBE tasks, taking into account that there seems to be no bibliographic outcome regarding to this correlation, that the neuropsychological tasks structure is completely different, and that FC1ºO showed no correlations with the emotional prosody task, it seems not possible for us to explain this result, leaving open the possibility for the development of a acceptable conclusion. Because of the absence of significant correlations between all of the recognition of basic and complex emotions tasks, we infer that the basic emotions are a qualitatively different kind of emotional state that secondary emotions, this lasts ones processed through ToM.
ABSTRACT
La variante frontal de la Demencia Frontotemporal (DFTvf) se caracteriza por un severo trastorno de la conducta y la personalidad, explicado por alteraciones en el procesamiento emocional y/o en la Teoría de la Mente (TdM). Objetivo: Evaluar los procesos cognitivos involucrados en a resolución del Test de Caras (Baron-Cohen et al., 1997) en comparación con el test Lectura de la Mente en los Ojos (LMO) (Baron-Cohen et al., 2001) y la utilidad de ambos para el diagnóstico de alteraciones en la TdM en pacientes con DFTvf. Población: 20 pacientes con diagnóstico de DFTvf, media de edad 66,9 años y escolaridad 6,25 años. Resultados: Correlación significativa entre LMO y el Test de Caras. Doble disociación entre ambas pruebas. Conclusión: La presencia de correlaciones indica que ambas pruebas se afectan en esta demencia, resultando herramientas de igual valor clínico. El hallazgo de disociaciones indica que cada una de ellas evalúa procesos cognitivos parcialmente independientes.
The frontal variant of frontotemporal dementia (FTDfv) is characterized by a severe behavioural and personality impairment, explained by alterations in the emotional process and/or in Theory of Mind (ToM). Objective: To assess the cognitive processes involved in performing the Faces Test (Baron-Cohen et al., 1997) in comparison with Reading de Mind in the Eyes Test (RME) (Baron-Cohen et al., 2001), and the utility of both in the diagnosis of ToM alterations in FTDfv patients. Subjects: 20 patients diagnosed with FTDfv, mean age 66,9 years and mean education 6,25 years. Results: Significative correlation between RME and Faces Test. Double dissociation between these tests. Conclusion: The presence of correlations indicates that both tests are affected in this dementia, being both useful as clinical tools. The dissociations founded indicates that each one assesses partially-independent cognitive processes.