Phan Tony X, Lee Jayden J, Siegel Jenifer Z, Yu Hongbo, Reeder Jerica E, Vandekar Simon, Considine Ciaran M, Zald David H, Darby R Ryan
Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Psychology, Jerome L. Greene Science Center, Columbia University, New York, New York, USA.
Alzheimers Dement. 2025 Sep;21(9):e70623. doi: 10.1002/alz.70623.
Antisocial behaviors occur in dementia, but the underlying neurocognitive mechanisms remain underexplored. We administered a decision-making task measuring patients' harm aversion by offering options to shock themselves or another person in exchange for money, hypothesizing that task performance would relate to antisocial behaviors and ventromedial/orbitofrontal cortex (vmPFC/OFC) atrophy.
Among 43 dementia patients (n = 23 behavioral variant frontotemporal dementia [bvFTD], n = 20 Alzheimer's disease [AD]), we used linear regressions to measure relationships between harm aversion and antisocial behavior, psychopathic personality traits, socioemotional functions, and vmPFC/OFC cortical thickness, controlling for age, sex, and cognitive dysfunction.
BvFTD patients demonstrated reduced aversion to harming others and themselves versus AD patients. Reduced aversion to harming others was associated with non-aggressive antisocial behaviors, psychopathic personality traits, impaired empathic concern, impaired perspective taking, and right vmPFC/OFC atrophy.
Changes to harm aversion are associated with right frontopolar atrophy and rule-breaking criminal behavior in dementia patients.
Patients with behavioral variant frontotemporal dementia demonstrate reduced aversion to harming others compared to patients with AD. Reduced aversion to harming others was associated with non-aggressive behavioral changes, psychopathic personality traits, impaired empathic concern, and impaired perspective taking. Reduced aversion to harming others was associated with atrophy in the right vmPFC and OFC, specifically in medial Brodmann area 10.
反社会行为在痴呆症中会出现，但潜在的神经认知机制仍未得到充分探索。我们进行了一项决策任务，通过提供电击自己或他人以换取金钱的选项来测量患者的伤害厌恶，假设任务表现与反社会行为以及腹内侧/眶额叶皮质（vmPFC/OFC）萎缩有关。
在43名痴呆症患者（n = 23行为变异型额颞叶痴呆 [bvFTD]，n = 20阿尔茨海默病 [AD]）中，我们使用线性回归来测量伤害厌恶与反社会行为、精神病态人格特质、社会情感功能以及vmPFC/OFC皮质厚度之间的关系，并控制年龄、性别和认知功能障碍。
与AD患者相比，bvFTD患者对伤害他人和自己的厌恶程度降低。对伤害他人的厌恶程度降低与非攻击性反社会行为、精神病态人格特质、共情关注受损、换位思考受损以及右侧vmPFC/OFC萎缩有关。
伤害厌恶的变化与痴呆症患者的右侧额极萎缩和违规犯罪行为有关。
与AD患者相比，行为变异型额颞叶痴呆患者对伤害他人的厌恶程度降低。对伤害他人的厌恶程度降低与非攻击性行为变化、精神病态人格特质、共情关注受损和换位思考受损有关。对伤害他人的厌恶程度降低与右侧vmPFC和OFC萎缩有关，特别是在Brodmann内侧区10。
