Wessex Neurosciences Centre, Mailpoint 101, Southampton University Hospitals NHS Trust, Tremona Road, Southampton SO16 6YD, UK.
Brain. 2012 Jul;135(Pt 7):2089-102. doi: 10.1093/brain/aws128. Epub 2012 May 26.
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.
尽管进行性核上性麻痹的特征是运动不能性僵硬、垂直性核上性眼球运动不能和跌倒，但认知障碍是患者及其照顾者生活质量的重要决定因素。在这里，我们研究了进行性核上性麻痹是否存在广泛的模态独立社会认知缺陷，并探讨了这些缺陷的神经相关性。我们招募了 23 名进行性核上性麻痹患者（使用临床诊断标准，其中 9 名随后通过病理证实）和 22 名年龄和教育程度匹配的对照者。参与者进行了听觉（声音）情绪识别测试以及视觉和听觉心理理论测试。22 名患者和 20 名对照者接受了结构磁共振成像，以使用基于体素的形态计量学分析社会认知缺陷的神经相关性。患者在声音情绪识别和心理理论测试中受损，但在听觉和视觉对照条件中没有受损。患者的灰质萎缩与右侧下额回的声音情绪识别和心理理论缺陷相关，该区域与韵律听觉情绪识别有关。心理理论缺陷还与前额内侧额前皮质的萎缩相关，该区域与健康状态下的心理理论有关。我们得出结论，进行性核上性麻痹患者存在多模态社会认知缺陷。这种缺陷部分归因于与整合与社会相关的刺激和解释其社会意义相关的额皮质区域网络的进行性萎缩。对于管理和照顾进行性核上性麻痹患者的人来说，这种社会认知障碍很重要。
