Chandra Sadanandavalli Retnaswami, Patwardhan Ketaki, Pai Anupama Ramakanth
Department of Neurology, Faculty Block, Neurocentre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Indian J Psychol Med. 2017 Sep-Oct;39(5):653-658. doi: 10.4103/IJPSYM.IJPSYM_90_17.
Faces are very special as they are most essential for social cognition in humans. It is partly understood that face processing in its abstractness involves several extra striate areas. One of the most important causes for caregiver suffering in patients with anterior dementia is lack of empathy. This apart from being a behavioral disorder could be also due to failure to categorize the emotions of the people around them.
Inlusion criteria: DSM IV for Bv FTD Tested for prosopagnosia - familiar faces, famous face, smiling face, crying face and reflected face using a simple picture card (figure 1).
Advanced illness and mixed causes.
46 patients (15 females, 31 males) 24 had defective face recognition. (mean age 51.5),10/15 females (70%) and 14/31males(47. Familiar face recognition defect was found in 6/10 females and 6/14 males. Total- 40%(6/15) females and 19.35%(6/31)males with FTD had familiar face recognition. Famous Face: 9/10 females and 7/14 males. Total- 60% (9/15) females with FTD had famous face recognition defect as against 22.6%(7/31) males with FTD Smiling face defects in 8/10 female and no males. Total- 53.33% (8/15) females. Crying face recognition defect in 3/10 female and 2 /14 males. Total- 20%(3/15) females and 6.5%(2/31) males. Reflected face recognition defect in 4 females.
Famous face recognition and positive emotion recognition defect in 80%, only 20% comprehend positive emotions, Face recognition defects are found in only 45% of males and more common in females.
Face recognition is more affected in females with FTD There is differential involvement of different aspects of the face recognition could be one of the important factor underlying decline in the emotional and social behavior of these patients. Understanding these pathological processes will give more insight regarding patient behavior.
面部非常特殊,因为它们对人类的社会认知至关重要。人们部分了解到,面部处理的抽象性涉及几个纹外区域。额颞叶痴呆患者的照料者痛苦的最重要原因之一是缺乏同理心。这除了是一种行为障碍外,也可能是由于无法对周围人的情绪进行分类。
纳入标准:依据《精神疾病诊断与统计手册》第四版诊断为行为变异型额颞叶痴呆;使用简单图片卡片(图1)对人面失认症进行测试,包括熟悉面孔、名人面孔、笑脸、哭脸和镜像面孔。
晚期疾病和多种病因。
46例患者(15例女性,31例男性),24例存在面部识别缺陷。(平均年龄51.5岁),10/15例女性(70%)和14/31例男性(47%)。熟悉面孔识别缺陷在6/10例女性和6/14例男性中被发现。总计——40%(6/15)的额颞叶痴呆女性和19.35%(6/31)的额颞叶痴呆男性存在熟悉面孔识别缺陷。名人面孔:9/10例女性和7/14例男性。总计——60%(9/15)的额颞叶痴呆女性存在名人面孔识别缺陷,而额颞叶痴呆男性为22.6%(7/31)。笑脸缺陷在8/10例女性中存在,男性中无。总计——53.33%(8/15)的女性。哭脸识别缺陷在3/10例女性和2/14例男性中存在。总计——20%(3/15)的女性和6.5%(2/31)的男性。镜像面孔识别缺陷在4例女性中存在。
80%的患者存在名人面孔识别和积极情绪识别缺陷,只有20%的患者能理解积极情绪,面部识别缺陷仅在45%的男性中发现,在女性中更常见。
额颞叶痴呆女性的面部识别受影响更大。面部识别不同方面的差异参与可能是这些患者情绪和社会行为下降的重要潜在因素之一。了解这些病理过程将有助于更深入地理解患者行为。