Berkeley Psychophysiology Laboratory, Department of Psychology, University of California, Berkeley, USA.
Memory and Aging Center, Department of Neurology, University of California, San Francisco, USA.
Soc Cogn Affect Neurosci. 2019 Dec 30;14(12):1453-1465. doi: 10.1093/scan/nsaa007.
Frontotemporal dementia (FTD), a neurodegenerative disease broadly characterized by socioemotional impairments, includes three clinical subtypes: behavioral variant FTD (bvFTD), semantic variant primary progressive aphasia (svPPA) and non-fluent variant primary progressive aphasia (nfvPPA). Emerging evidence has shown emotional reactivity impairments in bvFTD and svPPA, whereas emotional reactivity in nfvPPA is far less studied. In 105 patients with FTD (49 bvFTD, 31 svPPA and 25 nfvPPA) and 27 healthy controls, we examined three aspects of emotional reactivity (physiology, facial behavior and subjective experience) in response to a sad film. In a subset of the sample, we also examined the neural correlates of diminished aspects of reactivity using voxel-based morphometry. Results indicated that all three subtypes of FTD showed diminished physiological responding in respiration rate and diastolic blood pressure; patients with bvFTD and svPPA also showed diminished subjective experience, and no subtypes showed diminished facial behavior. Moreover, there were differences among the clinical subtypes in brain regions where smaller volumes were associated with diminished sadness reactivity. These results show that emotion impairments extend to sadness reactivity in FTD and underscore the importance of considering different aspects of sadness reactivity in multiple clinical subtypes for characterizing emotional deficits and associated neurodegeneration in FTD.
额颞叶痴呆（FTD）是一种神经退行性疾病，其特征广泛表现为社交情感障碍，包括三种临床亚型：行为变异型额颞叶痴呆（bvFTD）、语义变异型原发性进行性失语（svPPA）和非流利型原发性进行性失语（nfvPPA）。新出现的证据表明，bvFTD 和 svPPA 存在情绪反应障碍，而 nfvPPA 的情绪反应则研究较少。在 105 名 FTD 患者（49 名 bvFTD、31 名 svPPA 和 25 名 nfvPPA）和 27 名健康对照者中，我们检查了对悲伤电影的情绪反应的三个方面（生理、面部行为和主观体验）。在样本的一个亚组中，我们还使用基于体素的形态测量学检查了反应性减弱方面的神经相关性。结果表明，FTD 的所有三种亚型的呼吸率和舒张压的生理反应都减弱；bvFTD 和 svPPA 患者的主观体验也减弱，没有任何亚型的面部行为减弱。此外，在与悲伤反应性降低相关的大脑区域中，临床亚型之间存在差异。这些结果表明，在 FTD 中情绪障碍会延伸到悲伤反应，强调了在多个临床亚型中考虑悲伤反应的不同方面对于表征 FTD 中的情绪缺陷和相关神经退行性变的重要性。
