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额颞叶痴呆患者情感道德的改变

Altered emotional morality in frontotemporal dementia.

作者信息

Mendez Mario F, Shapira Jill S

机构信息

Departments of Neurology and Psychiatry & Biobehavioral Sciences, University of California at Los Angeles V.A. Greater Los Angeles Healthcare Center, 11301 Wilshire Blvd., Los Angeles, CA 90073, USA.

出版信息

Cogn Neuropsychiatry. 2009 May;14(3):165-79. doi: 10.1080/13546800902924122.

Abstract

INTRODUCTION

Frontotemporal dementia (FTD), a disorder characterised by abnormal social behaviour and potential sociopathy, provides a window to the neurobiology of moral behaviour. This study investigated the basis of altered moral judgements in patients with FTD.

METHODS

We administered an inventory of moral knowledge, five "reasoned" moral dilemmas, and five "emotional" moral dilemmas where subjects may cause direct harm to another through their own actions, to 21 patients with FTD compared to 21 comparably mildly impaired patients with Alzheimer's disease (AD) and 21 normal controls. Among the FTD patients, the results were compared to findings on functional neuroimaging.

RESULTS

All groups showed retention of knowledge for moral behaviour and the ability to make reasoned moral judgements. In contrast to the other groups, the FTD patients were altered in their ability to make emotional moral judgements. Among the FTD patients, the altered moral judgements corresponded to right hemisphere frontotemporal involvement.

CONCLUSIONS

In FTD patients, these findings suggest a decreased emotional responsiveness to others and a tendency to respond to moral dilemmas in a calculated fashion. Such a disturbance may result from ventromedial frontal dysfunction in FTD and supports the presence of a "morality" network in the brain, predominantly in the right hemisphere.

摘要

引言

额颞叶痴呆(FTD)是一种以异常社会行为和潜在反社会人格为特征的疾病,为道德行为的神经生物学研究提供了一个窗口。本研究调查了FTD患者道德判断改变的基础。

方法

我们对21例FTD患者、21例轻度认知功能受损的阿尔茨海默病(AD)患者和21名正常对照者进行了道德知识量表测试,以及五个“理性”道德困境和五个“情感”道德困境测试,在这些困境中,受试者可能通过自己的行为直接伤害他人。在FTD患者中,将结果与功能神经影像学的研究结果进行比较。

结果

所有组在道德行为知识保留和做出理性道德判断的能力方面均表现良好。与其他组不同的是,FTD患者在做出情感道德判断的能力方面有所改变。在FTD患者中,道德判断的改变与右侧半球额颞叶受累有关。

结论

在FTD患者中,这些发现表明对他人的情感反应降低,以及以一种精打细算的方式应对道德困境的倾向。这种紊乱可能是由FTD患者腹内侧额叶功能障碍引起的,并支持大脑中存在一个“道德”网络,主要位于右侧半球。

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