Universidad de San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago de Chile, Chile.
Cortex. 2021 Apr;137:93-107. doi: 10.1016/j.cortex.2020.12.023. Epub 2021 Jan 28.
Metacognition (monitoring) of emotion recognition is fundamental for social interactions. Correct recognition of and confidence in the emotional meaning inferred from others' faces are fundamental for guiding and adjusting interpersonal behavior. Yet, although emotion recognition impairments are well documented across neurodegenerative diseases, the role of metacognition in this domain remains poorly understood. Here, we evaluate multimodal neurocognitive markers of metacognition in 83 subjects, encompassing patients with behavioral variant frontotemporal dementia [bvFTD, n = 18], Alzheimer's disease [AD, n = 27], and demographically-matched controls (n = 38). Participants performed a classical facial emotion recognition task and, after each trial, they rated their confidence in their performance. We examined two measures of metacognition: (i) calibration: how well confidence tracks accuracy; and (ii) a metacognitive index (MI) capturing the magnitude of the difference between confidence and accuracy. Then, whole-brain grey matter volume and fMRI-derived resting-state functional connectivity were analyzed to track associations with metacognition. Results showed that metacognition deficits were linked to basic emotion recognition. Metacognition of negative emotions was compromised in patients, especially disgust in bvFTD as well as sadness in AD. Metacognition impairments were associated with reduced volume of fronto-temporo-insular and subcortical areas in bvFTD and fronto-parietal regions in AD. Metacognition deficits were associated with disconnection of large-scale fronto-posterior networks for both groups. This study reveals a link between emotion recognition and metacognition in neurodegenerative diseases. The characterization of metacognitive impairments in bvFTD and AD would be relevant for understanding patients' daily life changes in social behavior.
元认知（监控）对情绪识别至关重要，因为它是社会互动的基础。正确识别和信任从他人面部推断出的情绪意义，对于指导和调整人际行为至关重要。然而，尽管在神经退行性疾病中已经明确记录了情绪识别障碍，但元认知在这一领域的作用仍知之甚少。在这里，我们评估了 83 名受试者的多模态神经认知元认知标志物，其中包括行为变异型额颞叶痴呆[bvFTD，n=18]、阿尔茨海默病[AD，n=27]和年龄匹配的对照组[n=38]。参与者执行了经典的面部情绪识别任务，并且在每次试验后，他们对自己的表现进行了信心评分。我们检查了元认知的两个度量标准：（i）校准：信心与准确性的匹配程度；（ii）元认知指数（MI），捕获信心与准确性之间差异的大小。然后，分析了全脑灰质体积和 fMRI 衍生的静息状态功能连接，以追踪与元认知相关的关联。结果表明，元认知缺陷与基本情绪识别有关。负面情绪的元认知在患者中受损，尤其是 bvFTD 中的厌恶情绪和 AD 中的悲伤情绪。元认知障碍与额颞岛皮质下区域和 bvFTD 中的额顶叶区域以及 AD 中的额顶叶区域的体积减少有关。元认知障碍与两组的额后大型网络的连接中断有关。这项研究揭示了神经退行性疾病中情绪识别和元认知之间的联系。在 bvFTD 和 AD 中，对元认知障碍的特征描述对于理解患者日常生活中社交行为的变化将具有重要意义。
