Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina.
Soc Neurosci. 2011;6(2):113-22. doi: 10.1080/17470919.2010.506751. Epub 2010 Aug 12.
Patients with behavioral variant frontotemporal dementia (bvFTD) exhibit a set of behavioral disturbances that have been strongly associated with involvement of the prefrontal cortex (PFC). Many such disturbances have been linked to impaired moral behavior, especially in regard to "personal" or "emotionally driven" moral dilemmatic judgment, which has been demonstrated to also depend on the integrity of the PFC. In this study, we administered a personal moral dilemma (the footbridge dilemma) and social cognition measures to patients with early bvFTD, who were also assessed with an extensive neuropsychological battery, including moral knowledge, cognitive and emotional empathy, and affective decision-making. BvFTD patients who would push a man off a footbridge (knowing this would kill him) to save the life of five workers who would have been otherwise killed by the train showed significantly lower scores on affective Theory of Mind (ToM) relative to those bvFTD patients who responded negatively. No significant differences were found on other sociodemographic, neuropsychological or social cognition variables. This study reveals that altered dilemmatic judgment may be related to impaired affective ToM, which has important clinical and theoretical implications.
行为变异额颞叶痴呆（bvFTD）患者表现出一系列行为障碍，这些障碍与额皮质（PFC）的参与密切相关。许多此类障碍与道德行为受损有关，尤其是在涉及“个人”或“情感驱动”的道德困境判断方面，这也已被证明取决于 PFC 的完整性。在这项研究中，我们向早期 bvFTD 患者提供了个人道德困境（桥牌困境）和社会认知措施，还对他们进行了广泛的神经心理学测试，包括道德知识、认知和情感同理心以及情感决策。那些会将一个人推下桥（知道这会杀死他）以拯救五名原本会被火车撞死的工人的 bvFTD 患者，在情感心理理论（ToM）方面的得分明显低于那些做出否定反应的 bvFTD 患者。在其他社会人口统计学、神经心理学或社会认知变量上没有发现显著差异。这项研究表明，改变困境判断可能与情感心理理论受损有关，这具有重要的临床和理论意义。
