Moral processing deficit in behavioral variant frontotemporal dementia is associated with facial emotion recognition and brain changes in default mode and salience network areas

Abstract

IntroductionBehavioral variant frontotemporal dementia (bvFTD) is associated with abnormal emotion recognition and moral processing.MethodsWe assessed emotion detection, discrimination, matching, selection, and categorization as well as judgments of nonmoral, moral impersonal, moral personal low‐ and high‐conflict scenarios.ResultsbvFTD patients gave more utilitarian responses on low‐conflict personal moral dilemmas. There was a significant correlation between a facial emotion processing measure derived through principal component analysis and utilitarian responses on low‐conflict personal scenarios in the bvFTD group (controlling for MMSE‐score and syntactic abilities). Voxel‐based morphometric multiple regression analysis in the bvFTD group revealed a significant association between the proportion of utilitarian responses on personal low‐conflict dilemmas and gray matter volume in ventromedial prefrontal areas (p height < .0001). In addition, there was a correlation between utilitarian responses on low‐conflict personal scenarios in the bvFTD group and resting‐state fractional Amplitude of Low Frequency Fluctuations (fALFF) in the anterior insula (p height < .005).ConclusionsThe results underscore the importance of emotions in moral cognition and suggest a common basis for deficits in both abilities, possibly related to reduced experience of emotional sensations. At the neural level abnormal moral cognition in bvFTD is related to structural integrity of the medial prefrontal cortex and functional characteristics of the anterior insula. The present findings provide a common basis for emotion recognition and moral reasoning and link them with areas in the default mode and salience network.

The Interplay of Social Cognition Sub-domains in Frontotemporal Dementia

“…In summary, the re-analyses of our dataset inspired by the findings of Strikwerda-Brown reveal that high-conflict moral processing is associated with mentalizing tendency, grey matter volume of the temporo-parietal junction, and with ATL-mPFC as well as ATL-aIns functional connectivity. These and previous findings reveal associations between deficits across social cognitive sub-domains like moral reasoning, social conceptual knowledge, mentalizing and visuo-social processing in FTD 3 , 5 and bear the question whether a single common factor may underly social cognitive sub-components, analogous to the so-called G factor underlying ‘general’ intelligence. Although not all social cognitive measures were significantly linked, which may relate to Type 2 errors in our modestly sized sample, the present findings may provide an incentive for setting up higher - powered confirmation attempts to address this hypothesis.…”

“…the anterior insula. 5 These findings support an interactive account among social-cognitive sub-domains at the neural and psychological level. Here, we follow-up on the suggestions for future research by Strikwerda-Brown et al 3 and investigate the association of moral reasoning with other social cognition domains.…”

<p>Neurocognitive mechanisms of theory of mind impairment in neurodegeneration: a transdiagnostic approach</p>

“…Such difficult moral decisions are proposed to require ToM, as the thoughts and feelings of other people in the scenario are often considered when choosing how to respond 7. The overlap between ToM and moral reasoning is supported at the neural level, with mPFC, ACC/fIN, and PCC implicated across both processes 162–164. Altered moral reasoning in bvFTD correlates with impaired performance on cognitive, but not affective, ToM tasks,165 and morality and ToM can also be simultaneously affected in these patients 166.…”

Reduced tendency to attribute mental states to abstract shapes in behavioral variant frontotemporal dementia links with cerebellar structural integrity

“…For instance, does a deficit at the subordinate level precede a deficit at a higher level, where multiple subordinate processes are integrated (bottom-up progression), or does the deficit in integration of subordinate processes precedes breakdown of specific subordinate processes (top-down progression). Previous studies in bvFTD are in line with a bottom-up progression ( Jastorff et al, 2016 ; Kumfor et al, 2011 ; Van den Stock et al, 2017 ). At the neural level, it remains to be investigated whether the clear differences between the neural correlates of ToM deficits for abstract (cerebellum, as revealed by the present study) versus social stimuli (medial prefrontal, fronto-insular and anterior temporal regions ( Baez et al, 2017 ; Couto et al, 2013 ; Dermody et al, 2016 ; Kumfor et al, 2017b ; Synn et al, 2018 )) derive from different neural substrates rather than from the inclusion of specific confound variables.…”