Unravelling neural correlates of empathy deficits in Subjective Cognitive Decline, Mild Cognitive Impairment and Alzheimer's Disease

Giulia Giacomucci; Giulia Galdo; Cristina Polito; Valentina Berti; Sonia Padiglioni; Salvatore Mazzeo; Eleonora Chiaro; Maria Teresa De Cristofaro; Silvia Bagnoli; Benedetta Nacmias; Sandro Sorbi; Valentina Bessi

doi:10.1016/j.bbr.2022.113893

Unravelling neural correlates of empathy deficits in Subjective Cognitive Decline, Mild Cognitive Impairment and Alzheimer's Disease

Behav Brain Res. 2022 Jun 25:428:113893. doi: 10.1016/j.bbr.2022.113893. Epub 2022 Apr 14.

Affiliations

¹ Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.
² IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.
³ Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy; Nuclear Medicine Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
⁴ Regional Referral Centre for Relational Criticalities - Tuscany Region, Italy; Research and Innovation Centre for Dementia-CRIDEM, AOU Careggi, Florence, Italy.
⁵ Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.
⁶ University of Florence, Florence, Italy.
⁷ Nuclear Medicine Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
⁸ Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy. Electronic address: valentina.bessi@unifi.it.

PMID: 35429513
DOI: 10.1016/j.bbr.2022.113893

Abstract

Empathy is the ability to understand (cognitive empathy) and to feel (affective empathy) what others feel. The aim of the study was to assess empathy deficit and neuronal correlates in Subjective Cognitive Decline (SCD), Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD) dementia. Twenty-four SCD, 41 MCI and 46 CE patients were included. Informer-rated Interpersonal Reactivity Index was used to explore cognitive (Perspective Taking-PT, Fantasy-FT) and affective (Empathic Concern-EC, Personal Distress-PD) empathy, before (T0) and after (T1) cognitive symptoms' onset. Emotion recognition ability was tested through Ekman-60 Faces Test. Cerebral FDG-PET SPM analysis was used to explore neural correlates underlying empathy deficits. FT-T1 scores were lower in AD compared to SCD (13.0 ± 8.0 vs 19.1 ± 4,7 p = 0.008), PD-T1 score were higher in AD compared to MCI and to SCD (27.00 ± 10.00 vs 25.3 ± 5.9 vs 20.5 ± 5.6, p = 0.001). A positive correlation was found between PT-T1 and metabolic disfunction of right middle gyrus (MFG) in MCI and AD. In AD group, a positive correlation between PT-T1 and insula and superior temporal gyrus (STG) metabolism was detected. A negative correlation was found between PD-T1 and superior parietal lobule metabolism in MCI, and between PD-T1 and STG metabolism in AD. Impairment of cognitive empathy starts at MCI stage. Increase of PD starts from preclinical phases and seems to be to be dissociated from cognitive decline. Loss of PT is related to a progressive involvement starting from right MFG in prodromal stage, extending to insula and STG in dementia. Heightened emotional contagion is probably related to derangement of mirror neurons systems in parietal regions in prodromal stages, and to impairment of temporal emotion inhibition system in advanced phases. Further studies are needed to clarify if alterations in emotional contagion might be a predictive feature of a cognitive decline driven by AD.

Keywords: Alzheimer’s Disease; Empathy; Mild Cognitive Impairment; Subjective Cognitive Decline.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Alzheimer Disease* / metabolism
Cognitive Dysfunction* / metabolism
Empathy
Humans
Mirror Neurons*
Positron-Emission Tomography
Prodromal Symptoms