ABSTRACT
Loss of empathy is an early central symptom and diagnostic criterion of the behavioral variant frontotemporal dementia (bvFTD). Although changes in empathy are evident and strongly affect the social functioning of bvFTD patients, few studies have directly investigated this issue by means of experimental paradigms. The current study assessed multiple components of empathy (affective, cognitive and moral) in bvFTD patients. We also explored whether the loss of empathy constitutes a primary deficit of bvFTD or whether it is explained by impairments in executive functions (EF) or other social cognition domains. Thirty-seven bvFTD patients with early/mild stages of the disease and 30 healthy control participants were assessed with a task that involves the perception of intentional and accidental harm. Participants were also evaluated on emotion recognition, theory of mind (ToM), social norms knowledge and several EF domains. BvFTD patients presented deficits in affective, cognitive and moral aspects of empathy. However, empathic concern was the only aspect primarily affected in bvFTD that was neither related nor explained by deficits in EF or other social cognition domains. Deficits in the cognitive and moral aspects of empathy seem to depend on EF, emotion recognition and ToM. Our findings highlight the importance of using tasks depicting real-life social scenarios because of their greater sensitivity in the assessment of bvFTD. Moreover, our results contribute to the understanding of primary and intrinsic empathy deficits of bvFTD and have important theoretical and clinical implications.
ABSTRACT
IMPORTANCE: Several clinical reports have stated that patients with prefrontal lesions or patients with the behavioral variant of frontotemporal dementia share social cognition impairments. Moral reasoning is impaired in both conditions but there have been few investigations that directly compare this domain in the 2 groups. OBSERVATIONS: This work compared the moral judgments of these patient groups using a task designed to disentangle the contributions of intentions and outcomes in moral judgment. For both disorders, patients judged scenarios where the protagonists believed that they would cause harm but did not as being more permissible than the control group. Moreover, patients with frontotemporal dementia judged harmful outcomes in the absence of harmful intentions as less permissible than the control participants. There were no differences between the 2 conditions. CONCLUSIONS AND RELEVANCE: Both disorders involved impairments in integrating intention and outcome information for moral judgment. This study was the first, to our knowledge, to directly compare a social cognition domain in 2 frontal pathologies with different etiology. Our results highlighted the importance of comparing patients with vascular lesions and patients with neurodegenerative diseases.
Subject(s)
Cerebrovascular Disorders/physiopathology , Frontotemporal Dementia/physiopathology , Morals , Prefrontal Cortex/physiopathology , Social Perception , Adult , Cerebrovascular Disorders/pathology , Frontotemporal Dementia/pathology , Humans , Judgment/physiology , Magnetic Resonance Imaging , Male , Middle Aged , Prefrontal Cortex/pathology , StrokeABSTRACT
Ratas preñadas fueron expuestas a etanol (dos dosis de 6.4 gm/Kg espaciadas por un intervalo de 6 horas, administradas a través de cánulas intragástrica en el 8- día de gestación; las ratas cotroles recibieron dos administraciones idénticas de sucrosa isocalórica. No se encontraron diferencias significativas en el peso corporal ni en el tamaño de las camadas entre las crías controles y experimentales "testadas" 24 horas después del alumbramiento. Cuando las crías de las madres tratadas con etanol fueron "testadas" en diferentes pruebas de conducta post-natales, manifestaron retrasos significativos (en la conducta de succión y en el reflejo de enderezamiento) durante el período de lactancia y una menor respuesta de evitación pasiva a los 40 días de edad comparadas con las crías controles
Subject(s)
Pregnancy , Rats , Animals , Male , Female , Avoidance Learning/drug effects , Behavior, Animal/drug effects , Sucking Behavior/drug effects , Ethanol/pharmacology , Fetal Alcohol Spectrum Disorders/psychology , Rats, Inbred StrainsABSTRACT
Ratas preñadas fueron expuestas a etanol (dos dosis de 6.4 gm/Kg espaciadas por un intervalo de 6 horas, administradas a través de cánulas intragástrica en el 8- día de gestación; las ratas cotroles recibieron dos administraciones idénticas de sucrosa isocalórica. No se encontraron diferencias significativas en el peso corporal ni en el tamaño de las camadas entre las crías controles y experimentales "testadas" 24 horas después del alumbramiento. Cuando las crías de las madres tratadas con etanol fueron "testadas" en diferentes pruebas de conducta post-natales, manifestaron retrasos significativos (en la conducta de succión y en el reflejo de enderezamiento) durante el período de lactancia y una menor respuesta de evitación pasiva a los 40 días de edad comparadas con las crías controles (AU)
