Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Departamento de Clínica Médica, Faculdade de Medicina, UFMG, Belo Horizonte, MG, Brazil; Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Licend - Lille Centre of Excellence for Neurodegenerative Disorders & DISTALZ - Development of Innovative Strategies for a Transdisciplinary Approach to ALZheimer's disease Lab, Lille, France.
Cortex. 2022 Oct;155:373-389. doi: 10.1016/j.cortex.2022.07.015. Epub 2022 Aug 27.
Mentalizing and emotion recognition are impaired in behavioral variant frontotemporal dementia (bvFTD). It is not clear whether these abilities are also disturbed in other conditions with prominent frontal lobe involvement, such as progressive supranuclear palsy (PSP). Our aim was to investigate social cognition (facial emotion recognition, recognition of social norms violation and mentalizing) in bvFTD and PSP. The neural basis of these functions in PSP and bvFTD groups, by analysis of structural neuroimaging, were also investigated. Twenty-three bvFTD patients, 21 PSP patients and 23 healthy controls were included. All participants underwent 3T brain MRI and a full cognitive exam including the short version of Social and Emotional Assessment (Mini-SEA), which is composed of a facial emotion recognition test (FERT) and the faux pas test. Two components of the faux pas test were distinguished: a score assessing the recognition of social norms violation and a score assessing mentalizing. Compared to controls, bvFTD and PSP patients had significantly reduced scores in all tests of social cognition but did not differ on these measures. PSP and bvFTD had cerebral atrophy in critical regions for social cognition processes, when compared to controls. The cortical correlates of emotion recognition partially overlapped in bvFTD and PSP, with correlations retrieved within the frontal medial cortex, cingulate, insula and limbic structures. PSP and bvFTD patients also displayed similar patterns of brain correlations for the composite score of social norms, with a significant cluster in anterior temporal lobes. Mentalizing scores were associated with frontal and temporal poles bilaterally, in both bvFTD and PSP. These findings support previous observations that PSP patients exhibit impairment in complex cognitive abilities, such as mentalizing. Moreover, these data extend previous findings showing that PSP and bvFTD share key clinical, cognitive and neuroimaging features.
心理理论和情绪识别在行为变异额颞叶痴呆（bvFTD）中受损。目前尚不清楚这些能力是否也在其他额叶明显受累的情况下受到干扰，例如进行性核上性麻痹（PSP）。我们的目的是研究 bvFTD 和 PSP 中的社会认知（面部情绪识别、违反社会规范的识别和心理理论）。还通过分析结构神经影像学研究了 PSP 和 bvFTD 组这些功能的神经基础。共纳入 23 名 bvFTD 患者、21 名 PSP 患者和 23 名健康对照者。所有参与者均接受了 3T 脑 MRI 检查和全面认知检查，包括社会和情感评估的简短版本（Mini-SEA），其中包括面部情绪识别测试（FERT）和失礼测试。失礼测试区分了两个组成部分：一个评估识别违反社会规范的分数，另一个评估心理理论的分数。与对照组相比，bvFTD 和 PSP 患者在所有社会认知测试中的得分均明显降低，但在这些测试中无差异。与对照组相比，PSP 和 bvFTD 的关键社会认知过程区域存在脑萎缩。情绪识别的皮质相关性在 bvFTD 和 PSP 中部分重叠，在额叶内侧皮质、扣带回、岛叶和边缘结构中检索到相关性。PSP 和 bvFTD 患者的社会规范综合评分的大脑相关性也显示出相似的模式，在前颞叶有一个显著的聚类。心理理论评分与双侧额叶和颞极相关，在 bvFTD 和 PSP 中均如此。这些发现支持了之前的观察结果，即 PSP 患者在心理理论等复杂认知能力方面存在障碍。此外，这些数据扩展了之前的发现，表明 PSP 和 bvFTD 具有关键的临床、认知和神经影像学特征。
