Warren Alison
The Department of Clinical Research and Leadership, George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
Front Dement. 2022 Sep 30;1:983331. doi: 10.3389/frdem.2022.983331. eCollection 2022.
Social and emotional communication is an integral tenant of life quality and well-being. Aberrations in functional connectivity can alter social emotional behavior in numerous disease states, including dementia. This paper aims to review the major network changes observed in Alzheimer's disease, with a focus on the tri-network model. The central executive network, default mode network, and principally the salience network will be discussed as they relate to both pathology and compensatory behavioral manifestations in persons with dementia. The psychological and behavioral correlates of these network changes will be reviewed with the intent of increasing understanding about the conscious experience and communication modalities utilized by persons with dementia, the understanding of which may promote meaningful communication with care providers and loved ones. This paper further seeks to reframe social emotional communication methods used by persons with dementia by marrying current knowledge of neuroscience, psychology, and person-centered care. In this way, a perspective is offered that considers the heightened emotional states experienced by persons with dementia as a potential compensatory mechanism that may hold practical value under some circumstances. The many ways in which the brain adapts to physical and psychological changes, aging, and injury are still under exploration. Emotion processing may provide clinical insight into the subjective experience of dementia in this regard. Emotions, therefore, may serve to promote social bonds, provide an avenue for non-verbal communication, and act as a construct to maintain agency in persons who ultimately lose autonomy.
社会和情感交流是生活质量和幸福感不可或缺的要素。功能连接异常可在包括痴呆症在内的多种疾病状态下改变社会情感行为。本文旨在综述阿尔茨海默病中观察到的主要网络变化，重点关注三网络模型。将讨论中央执行网络、默认模式网络，主要是突显网络，因为它们与痴呆症患者的病理和代偿性行为表现相关。将综述这些网络变化的心理和行为相关性，目的是增进对痴呆症患者的意识体验和交流方式的理解，而这种理解可能促进与护理人员和亲人的有意义交流。本文还试图通过结合当前神经科学、心理学和以患者为中心的护理知识，重新构建痴呆症患者使用的社会情感交流方法。通过这种方式，提供了一种观点，将痴呆症患者经历的 heightened emotional states 视为一种潜在的代偿机制，在某些情况下可能具有实际价值。大脑适应身体和心理变化、衰老和损伤的多种方式仍在探索中。在这方面，情绪处理可能为痴呆症的主观体验提供临床见解。因此，情绪可能有助于促进社会联系，提供非语言交流的途径，并作为一种结构来维持最终失去自主性的人的能动性。
