I'm looking through you: Mentalizing in frontotemporal dementia and progressive supranuclear palsy

Leonardo Cruz de Souza; Maxime Bertoux; Ratko Radakovic; Michael Hornberger; Luciano Inácio Mariano; Elisa de Paula França Resende; François Quesque; Henrique Cerqueira Guimarães; Leandro Boson Gambogi; Vítor Tumas; Sarah Teixeira Camargos; Francisco Eduardo Costa Cardoso; Antônio Lúcio Teixeira; Paulo Caramelli

doi:10.1016/j.cortex.2022.07.015

I'm looking through you: Mentalizing in frontotemporal dementia and progressive supranuclear palsy

Cortex. 2022 Oct:155:373-389. doi: 10.1016/j.cortex.2022.07.015. Epub 2022 Aug 27.

Authors

Affiliations

¹ Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Departamento de Clínica Médica, Faculdade de Medicina, UFMG, Belo Horizonte, MG, Brazil; Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. Electronic address: leocruzsouza@ufmg.br.
² Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Licend - Lille Centre of Excellence for Neurodegenerative Disorders & DISTALZ - Development of Innovative Strategies for a Transdisciplinary Approach to ALZheimer's disease Lab, Lille, France.
³ Faculty of Medicine and Health Science, University of East Anglia, Norwich, United Kingdom; Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, United Kingdom; Euan MacDonald Centre for MND Research, University of Edinburgh, Edinburgh, United Kingdom.
⁴ Faculty of Medicine and Health Science, University of East Anglia, Norwich, United Kingdom.
⁵ Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
⁶ Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
⁷ Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France.
⁸ Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
⁹ Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Departamento de Clínica Médica, Faculdade de Medicina, UFMG, Belo Horizonte, MG, Brazil.
¹⁰ Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA; Santa Casa BH Ensino e Pesquisa, Belo Horizonte, MG, Brazil.
¹¹ Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Departamento de Clínica Médica, Faculdade de Medicina, UFMG, Belo Horizonte, MG, Brazil; Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

PMID: 36116296
DOI: 10.1016/j.cortex.2022.07.015

Abstract

Mentalizing and emotion recognition are impaired in behavioral variant frontotemporal dementia (bvFTD). It is not clear whether these abilities are also disturbed in other conditions with prominent frontal lobe involvement, such as progressive supranuclear palsy (PSP). Our aim was to investigate social cognition (facial emotion recognition, recognition of social norms violation and mentalizing) in bvFTD and PSP. The neural basis of these functions in PSP and bvFTD groups, by analysis of structural neuroimaging, were also investigated. Twenty-three bvFTD patients, 21 PSP patients and 23 healthy controls were included. All participants underwent 3T brain MRI and a full cognitive exam including the short version of Social and Emotional Assessment (Mini-SEA), which is composed of a facial emotion recognition test (FERT) and the faux pas test. Two components of the faux pas test were distinguished: a score assessing the recognition of social norms violation and a score assessing mentalizing. Compared to controls, bvFTD and PSP patients had significantly reduced scores in all tests of social cognition but did not differ on these measures. PSP and bvFTD had cerebral atrophy in critical regions for social cognition processes, when compared to controls. The cortical correlates of emotion recognition partially overlapped in bvFTD and PSP, with correlations retrieved within the frontal medial cortex, cingulate, insula and limbic structures. PSP and bvFTD patients also displayed similar patterns of brain correlations for the composite score of social norms, with a significant cluster in anterior temporal lobes. Mentalizing scores were associated with frontal and temporal poles bilaterally, in both bvFTD and PSP. These findings support previous observations that PSP patients exhibit impairment in complex cognitive abilities, such as mentalizing. Moreover, these data extend previous findings showing that PSP and bvFTD share key clinical, cognitive and neuroimaging features.

Keywords: Emotion recognition; Frontotemporal dementia; Progressive supranuclear palsy; Richardson’ syndrome; Theory of mind.

Publication types

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

MeSH terms

Frontotemporal Dementia* / diagnostic imaging
Frontotemporal Dementia* / psychology
Humans
Mentalization*
Neuropsychological Tests
Pick Disease of the Brain*
Supranuclear Palsy, Progressive* / diagnostic imaging
Supranuclear Palsy, Progressive* / psychology