Oliver Lindsay D, Mitchell Derek G V, Dziobek Isabel, MacKinley Julia, Coleman Kristy, Rankin Katherine P, Finger Elizabeth C
Schulich School of Medicine & Dentistry, Graduate Program in Neuroscience, University of Western Ontario, London, Ontario, Canada; Department of Psychology, Brain and Mind Institute, University of Western Ontario, London, Ontario, Canada.
Department of Psychiatry, University of Western Ontario, London, Ontario, Canada; Department of Anatomy & Cell Biology, University of Western Ontario, London, Ontario, Canada; Schulich School of Medicine & Dentistry, Graduate Program in Neuroscience, University of Western Ontario, London, Ontario, Canada; Department of Psychology, Brain and Mind Institute, University of Western Ontario, London, Ontario, Canada.
Neuropsychologia. 2015 Jan;67:14-26. doi: 10.1016/j.neuropsychologia.2014.11.022. Epub 2014 Nov 29.
Behavioural variant frontotemporal dementia (bvFTD) is a debilitating neurodegenerative disorder characterized by frontal and temporal lobe atrophy primarily affecting social cognition and emotion, including loss of empathy. Many consider empathy to be a multidimensional construct, including cognitive empathy (the ability to adopt and understand another's perspective) and emotional empathy (the capacity to share another's emotional experience). Cognitive and emotional empathy deficits have been associated with bvFTD; however, little is known regarding the performance of patients with bvFTD on behavioural measures of emotional empathy, and whether empathic responses differ for negative versus positive stimuli.
24 patients with bvFTD and 24 healthy controls completed the Multifaceted Empathy Test (MET; Dziobek et al., 2008), a performance-based task that taps both cognitive and emotional facets of empathy, and allows for the discrimination of responses to negative versus positive realistic images. MET scores were also compared with caregiver ratings of patient behaviour on the Interpersonal Reactivity Index, which assesses patients' everyday demonstrations of perspective taking and empathic concern.
Patients with bvFTD were less accurate than controls at inferring mental states for negative and positive stimuli. They also demonstrated lower levels of shared emotional experience, more positive emotional reactions, and diminished arousal to negative social stimuli relative to controls. Patients showed reduced emotional reactions to negative non-social stimuli as well. Lastly, the MET and IRI measures of emotional empathy were found to be significantly correlated within the bvFTD group.
The results suggest that patients with bvFTD show a global deficit in cognitive empathy, and deficient emotional empathy for negative, but not positive, experiences. Further, a generalized emotional processing impairment for negative stimuli was observed, which could contribute to the emotional empathy deficit. This work highlights potential treatment targets and a means to assess the impact of novel therapies on socioemotional impairment in bvFTD.
行为变异型额颞叶痴呆（bvFTD）是一种使人衰弱的神经退行性疾病，其特征是额叶和颞叶萎缩，主要影响社会认知和情感，包括同理心丧失。许多人认为同理心是一个多维度的概念，包括认知同理心（采纳和理解他人观点的能力）和情感同理心（分享他人情感体验的能力）。认知和情感同理心缺陷与bvFTD有关；然而，关于bvFTD患者在情感同理心行为测量方面的表现，以及负面与正面刺激的同理心反应是否存在差异，我们知之甚少。
24名bvFTD患者和24名健康对照者完成了多维度同理心测试（MET；Dziobek等人，2008年），这是一项基于表现的任务，涉及同理心的认知和情感方面，并能够区分对负面与正面现实图像的反应。MET分数还与人际反应指数中患者行为的照料者评分进行了比较，该指数评估患者在日常中的换位思考和同理心关注表现。
与对照组相比，bvFTD患者在推断负面和正面刺激的心理状态时准确性较低。他们还表现出较低水平的共享情感体验、更多的积极情绪反应，以及相对于对照组对负面社会刺激的唤醒减弱。患者对负面非社会刺激的情绪反应也有所减少。最后，发现在bvFTD组中，MET和IRI的情感同理心测量结果显著相关。
结果表明，bvFTD患者在认知同理心方面存在整体缺陷，对负面而非正面体验存在情感同理心缺陷。此外，观察到对负面刺激存在普遍化的情感加工障碍，这可能导致情感同理心缺陷。这项工作突出了潜在的治疗靶点以及评估新疗法对bvFTD社会情感障碍影响的一种方法。
