Exploring sarcasm detection in amyotrophic lateral sclerosis using ecologically valid measures

Abstract

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive condition involving degeneration of both upper and lower motor neurons. Recent research suggests that a proportion of persons with ALS show a profile similar to that of frontotemporal dementia (FTD), with this group of ALS patients exhibiting social cognitive deficits. Although social cognitive deficits have been partially explored in ALS, research has yet to investigate such changes using ecologically valid measures. Therefore, this study aimed to further characterize the scope of social cognitive and emotion recognition deficits in non-demented ALS patients using an ecologically valid measure of social cognition. A sample of 35 ALS patients and 30 age-and-education matched controls were assessed using the Addenbrooke's Cognitive Examination, the Brixton Spatial Anticipation Test, and The Awareness of Social Inference Test, where participants were required to discriminate between various emotions and decipher socially challenging scenarios enacted in video vignettes. Participants with ALS showed significant difficulties in recognizing both sarcastic and paradoxical sarcastic statements, but not sincere statements, when compared to controls. After controlling for executive difficulties, ALS patients still displayed significant difficulties on tasks that assessed their comprehension of both sarcastic and paradoxical sarcastic statements. The inability to read social cues and make social inferences has the potential to place significant strain on familial/interpersonal relationships in ALS. The findings of this study highlight the importance of employing a broader range of neuropsychological assessment tools to aid in early detection of frontal lobe impairment in non-demented ALS patients.

Executive dysfunction predicts social cognition impairment in amyotrophic lateral sclerosis

“…The TASIT thus places fewer demands on executive function, a mechanism suggested to underlie previously reported deficits on the Happé tasks in ALS and FTD [18,45]. The current study failed to replicate the ALS group deficits reported previously on the TASIT [15]. At the individual level, some participants with ALS showed difficulty with the sarcastic exchanges, particularly on the SI-M component of the task where additional contextual cues, such as a visual cue or a scene prologue, were not available to aid interpretation (see Table 3).…”

“…Social cognition was assessed using a variety of measures used in previous studies of ALS but not together [13,15,18]: the Reading the Mind in the Eyes task (RME) [29]; three subtests of The Awareness of Social Inference Test (TASIT) [30] and three subtests of the Happé Cartoon and Written Scenarios tasks [31]. Executive function was assessed using the sorting and description trials of the Card Sorting Task of the Delis-Kaplan Executive Function Test (D-KEFS) [32]; the 'S' and 'C' trials of the modified Verbal Fluency Index (VFI) [33] and number of errors on the Brixton Test [34].…”

“…The investigation of social cognition in ALS has focussed on basic emotion recognition and Theory of Mind (ToM), the ability to infer others' mental and emotional states so as to understand and predict their behaviour [11]. Deficits in the recognition of emotion from faces have been reported in ALS patients [2,12,13], albeit not consistently [14,15], with one study suggesting that such impairments only emerge with FTD comorbidity [16]. These studies have used a range of different measures and impairment criteria, across typically small samples (n \ 35), sometimes including patients with FTD [12], all of which may contribute to the variance in findings reported.…”

“…The investigation of ToM in ALS has relied exclusively on cartoons and written or video vignettes [see [17] for review]. Relative to healthy controls, people with ALS have shown difficulty with describing the intentions and feelings of characters [15,18,19], identifying and explaining social faux pas [20] and estimating characters' preferences for objects based on their eye gaze direction [13,21].…”

Manifestaciones neuropsiquiátricas y cognitivas en demencia frontotemporal y esclerosis lateral amiotrófica: dos polos de una entidad común

“…Un estudio con RM funcional demostró una mayor activación en el giro supramarginal derecho en pacientes con una sensibilidad alterada a claves sociales y emocionales 83,84 . También se han reportado déficits en la Teoría de la Mente y detección del sarcasmo 77,85,86 .…”