Measuring Behavior and Social Cognition in FTLD

Rankin, Katherine P.

doi:10.1007/978-3-030-51140-1_4

Cited by 21 publications

(16 citation statements)

References 67 publications

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“…The novel diagnostic classification proposed here help identify symptoms that are most specifically associated with rATL degeneration. Although the socioemotional evaluations sensitive to FTD can be complicated by the cognitive difficulties, 78 this study suggests that including certain measures such as Famous Faces, CATS, PPVT, PPT-P, emotional and cognitive Theory of Mind, IAS-Coldness, and TASIT in the assessment of patients presenting with behavioral and language symptoms is useful in diagnosing patients with esvFTD.…”

Section: Discussionmentioning

confidence: 89%

Right Anterior Temporal Degeneration, Emotions, and Loss of Nonverbal Semantics: The Emotional Semantic Variant Frontotemporal Dementia

Younes

Borghesani

Montembeault

et al. 2021

Preprint

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Anterior temporal lobe (ATL) degeneration is caused by a pathological process that has a focal onset in the left or right hemisphere. Patients with left-lateralized ATL atrophy typically meet criteria for semantic variant primary progressive aphasia (PPA), a clinical syndrome characterized by loss of verbal semantic knowledge. There is less consensus regarding the symptoms that emerge when atrophy targets the right ATL (rATL), but previous studies have emphasized prosopagnosia as well as alterations in emotion, memory, behavior, and semantic knowledge, symptoms that often lead to a diagnosis of behavioral variant frontotemporal dementia (bvFTD). The goal of the present study was to characterize the cognitive and socioemotional deficits of patients with rATL degeneration in order to refine current conceptualizations of the rATL clinical syndrome. We identified individuals clinically diagnosed as bvFTD or PPA in our cohort of patients prospectively evaluated for FTD-spectrum disorders. We selected patients who also underwent structural MRI and a comprehensive, multidisciplinary evaluation (n = 478). Based on structural MRI atrophy index, individuals with predominant, rATL atrophy (n = 46) were identified and patients with co-occurrence of significant frontal atrophy were excluded. Nineteen patients with rATL degeneration had undergone autopsy. We used the clinical histories to identify early symptoms and examined the cognitive, socioemotional, genetic, and pathological profiles of patients with rATL degeneration. In patients with rATL degeneration, the most common early clinical symptoms were loss of empathy (27%), person-specific semantic knowledge (23%), and complex compulsions (18%). On socioemotional testing and informant-reported measures, patients exhibited diminished interpersonal warmth, empathy, and emotional theory of mind. Neuropsychological testing revealed deficits in identifying famous people and discriminating facial affect despite preserved face perception. FTLD-TDP was the most frequent pathological correlate of rATL degeneration (84%), followed by Pick type (10%), a subtype of FTLD-tau. Our results indicate that patients with early, rATL-predominant degeneration present with a behavioral syndrome that results from loss of empathy for others. The underlying mechanism is a progressive loss of semantic knowledge for concepts of social-emotional relevance. We herein refer to this syndrome as emotional semantic variant frontotemporal dementia. We propose novel diagnostic criteria for this rATL syndrome in order to facilitate early identification in clinical and research settings. This classification is relevant because, if appropriately diagnosed, these patients most often have FTLD-TDP Type-C pathology.

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Section: Discussionmentioning

confidence: 89%

Right Anterior Temporal Degeneration, Emotions, and Loss of Nonverbal Semantics: The Emotional Semantic Variant Frontotemporal Dementia

Younes

Borghesani

Montembeault

et al. 2021

Preprint

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“…However, it cannot be escaped that the inferences it allows are merely correlational and not at all causal. For this reason, the field needs to increasingly turn to patient models such as stroke, temporal lobe epilepsy, and frontotemporal dementia Rankin 2020Rankin , 2021, as well as non-invasive techniques, such as transcranial magnetic stimulation, that can be used to more directly probe the neural architecture of cognition in neurological healthy samples. This will enable us to get a firmer grasp on key questions including those regarding the laterality of function within the ATL and the TPJ, as well as the functional necessity of distinct subregions.…”

Section: Discussionmentioning

confidence: 99%

The Role of the Ventrolateral Anterior Temporal Lobes in Social Cognition

Balgova

Binney

Diveica

et al. 2021

Preprint

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A key challenge for neurobiological models of social cognition is to elucidate whether brain regions are specialised for that domain. In recent years, discussion surrounding the role of the anterior temporal lobe (ATL) epitomises such debates; some argue it is part of a domain-specific network for social processing, while others claim it is a domain-general hub for semantic representation. In the present study, we used ATL-optimised fMRI to map the contribution of different ATL structures to a variety of paradigms frequently used to probe a crucial social ability, namely theory of mind (ToM). Using multiple tasks enables a clearer attribution of activation to ToM as opposed to idiosyncratic features of stimuli. Further, we directly explored whether these same structures are also activated by a non-social task probing semantic representations. We revealed that common to all of the tasks was activation of a key ventrolateral ATL region that is typically invisible to standard fMRI. This constitutes novel evidence in support of the view that the ventrolateral ATL contributes to social cognition via a domain-general role in the retrieval of conceptual knowledge, and against claims of a specialised social function.

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“…Social cognition, also referred to as comportment or socialinterpersonal skill, is commonly assessed through informant interview and, in some cases, by objective measures. 27 In addition to weighing the impact of education and experience on test performance, the neuropsychologist must also consider whether medications or extant medical conditions could be contributing to test performance.…”

Section: The Clinical Neuropsychological Evaluationmentioning

confidence: 99%

Neuropsychological Assessment in Dementia Diagnosis

Weıntraub¹

2022

CONTINUUM: Lifelong Learning in Neurology

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PURPOSE OF REVIEWThis article discusses the application of neuropsychological evaluation to the workup of individuals with age-related cognitive impairment and suspected dementia. Referral questions, principles of evaluation, and common instruments to detect abnormalities in cognition and behavior in this population are reviewed. The integration of neuropsychological test findings with other clinical and biomarker information enhances early detection, differential diagnosis, and care planning.RECENT FINDINGSLife expectancy is increasing in the United States, and, accordingly, the prevalence and incidence of dementia associated with age-related neurodegenerative brain disease are rising. Age is the greatest risk factor for the dementia associated with Alzheimer disease, the most common neurodegenerative cause of dementia in people over 65 years of age; other etiologies, such as the class of frontotemporal lobar degenerations, are increasingly recognized in individuals both younger and older than 65 years of age. The clinical dementia diagnosis, unfortunately, is imperfectly related to disease etiology; however, probabilistic relationships can aid in diagnosis. Further, mounting evidence from postmortem brain autopsies points to multiple etiologies. The case examples in this article illustrate how the neuropsychological evaluation increases diagnostic accuracy and, most important, identifies salient cognitive and behavioral symptoms to target for nonpharmacologic intervention and caregiver education and support. Sharing the diagnosis with affected individuals is also discussed with reference to prognosis and severity of illness.SUMMARYThe clinical neuropsychological examination facilitates early detection of dementia, characterizes the level of severity, defines salient clinical features, aids in differential diagnosis, and points to a pathway for care planning and disease education.

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Measuring Behavior and Social Cognition in FTLD

Cited by 21 publications

References 67 publications

Right Anterior Temporal Degeneration, Emotions, and Loss of Nonverbal Semantics: The Emotional Semantic Variant Frontotemporal Dementia

Right Anterior Temporal Degeneration, Emotions, and Loss of Nonverbal Semantics: The Emotional Semantic Variant Frontotemporal Dementia

The Role of the Ventrolateral Anterior Temporal Lobes in Social Cognition

Neuropsychological Assessment in Dementia Diagnosis

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