Chatzidimitriou Electra, Chen Yu, Moraitou Despina, Ioannidis Panagiotis, Aretouli Eleni, Kramer Joel H, Miller Bruce L, Gorno-Tempini Marilu, Seeley William W, Rosen Howard J, Rankin Katherine P
Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
Department of Cognition, Brain and Behavior, School of Psychology, Faculty of Philosophy, Aristotle University of Thessaloniki, Thessaloniki, Greece.
J Neurol. 2025 Jul 21;272(8):526. doi: 10.1007/s00415-025-13254-2.
Behavioral variant frontotemporal dementia (bvFTD) is characterized by prominent socioemotional deficits that negatively impact daily living. This study aims to identify the strongest socioemotional predictors of functional status at 1-year follow-up and examine whether socioemotional assessment provides additional predictive value for functional outcomes beyond neuroimaging data in bvFTD.
A total of 78 bvFTD patients were assessed at baseline using a comprehensive social cognition battery and the Functional Activities Questionnaire (FAQ), and were reassessed 1 year later to examine longitudinal changes in their functional abilities. Regression modeling was performed to identify the strongest socioemotional predictors of functional outcomes at 1-year follow-up. In a subset of 57 patients with available baseline MRI data, the volumes of functional brain networks particularly vulnerable in bvFTD were obtained using voxel-based morphometry. Hierarchical regression analysis was employed to compare the predictive value of social cognition measures above neuroimaging data.
Neuropsychological tests assessing socioemotional semantic knowledge, sarcasm perception and cognitive perspective taking appeared to be the strongest socioemotional predictors of FAQ at the 1-year-follow-up assessment. The structural MRI data alone accounted for 42.01% of the variance in FAQ outcome, but increased to 55.85% when social cognition measures were included in the model (p < 0.001).
This study highlights the significant contribution of quantifying social cognition in predicting which bvFTD patients are more likely to quickly develop adverse functional outcomes. Integrating socioemotional assessments in clinical practice with bvFTD can significantly enhance clinicians' prognostic accuracy for functional outcomes, thus informing refined treatment strategies for these individuals.
行为变异型额颞叶痴呆（bvFTD）的特征是显著的社会情感缺陷，对日常生活产生负面影响。本研究旨在确定1年随访时功能状态的最强社会情感预测因素，并检验社会情感评估是否能为bvFTD患者的功能结局提供超越神经影像学数据的额外预测价值。
共78例bvFTD患者在基线时使用综合社会认知量表和功能活动问卷（FAQ）进行评估，并在1年后重新评估，以检查其功能能力的纵向变化。进行回归建模以确定1年随访时功能结局的最强社会情感预测因素。在57例有可用基线MRI数据的患者子集中，使用基于体素的形态学方法获取bvFTD中特别易损的功能性脑网络体积。采用分层回归分析比较社会认知测量在神经影像学数据之上的预测价值。
在1年随访评估中，评估社会情感语义知识、讽刺感知和认知观点采择的神经心理学测试似乎是FAQ最强的社会情感预测因素。仅结构MRI数据占FAQ结局变异的42.01%，但当模型中纳入社会认知测量时，这一比例增至55.85%（p<0.001）。
本研究强调了量化社会认知在预测哪些bvFTD患者更可能迅速出现不良功能结局方面的重要贡献。将社会情感评估纳入bvFTD的临床实践中，可显著提高临床医生对功能结局的预后准确性，从而为这些个体制定更精细的治疗策略提供依据。
