Using a second-person approach to identify disease-specific profiles of social behavior in frontotemporal dementia and Alzheimer's disease

Mandy Visser; Stephanie Wong; Simone Simonetti; Jessica L Hazelton; Emma Devenney; Rebekah M Ahmed; Tim van Langenhove; Deborah Parker; James R Burrell; John R Hodges; Fiona Kumfor

doi:10.1016/j.cortex.2020.09.011

Using a second-person approach to identify disease-specific profiles of social behavior in frontotemporal dementia and Alzheimer's disease

Cortex. 2020 Dec:133:236-246. doi: 10.1016/j.cortex.2020.09.011. Epub 2020 Oct 6.

Authors

Affiliations

¹ Leiden University Medical Center, Department of Public Health and Primary Care, the Netherlands; University of Technology Sydney, Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation (IMPACCT), Australia.
² University of Sydney, Brain and Mind Centre, Australia; University of Sydney, School of Psychology, Australia.
³ University of Technology Sydney, Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation (IMPACCT), Australia.
⁴ University of Sydney, Brain and Mind Centre, Australia; University of Sydney, Central Clinical School, Australia.
⁵ Ghent University Hospital, Department of Neurology, Australia.
⁶ University of Sydney, Concord Clinical School, Australia.
⁷ University of Sydney, Brain and Mind Centre, Australia; University of Sydney, School of Psychology, Australia. Electronic address: fiona.kumfor@sydney.edu.au.

PMID: 33137538
DOI: 10.1016/j.cortex.2020.09.011

Abstract

Changes in social behavior are recognized as potential symptoms of behavioral-variant frontotemporal dementia (bvFTD) and semantic dementia (SD), yet objective ways to assess these behaviors in natural social situations are lacking. This study takes a truly social (or second-person) approach and examines changes in real-world social behavior in different dementia syndromes, by analyzing non-scripted social interactions in bvFTD patients (n = 20) and SD patients (n = 20), compared to patients with Alzheimer's disease (AD) (n = 20). Video recordings of 10-min conversations between patients and behavioral neurologists were analyzed for the presence of socially engaging (e.g., nodding, smiling, gesturing) and disengaging behavior (e.g., avoiding eye contact, self-grooming, interrupting). Results demonstrated disease-specific profiles, with bvFTD patients showing less nodding and more looking away than AD, and SD patients showing more gesturing than AD. A principal components analysis revealed the presence of four unobserved components, showing atypical disengaging patterns of behavior. Whole-brain voxel-based morphometry analyses revealed distinct neurobiological bases for each of these components, with the brain regions identified previously associated with behavior selection, abstract mentalization and processing of multi-sensory and socially-relevant information, in mediating socially engaging and disengaging behavior. This study demonstrates the utility of systematic behavioral observation of social interactions in the differential diagnosis of dementia.

Keywords: Alzheimer's disease; Behavioral-variant frontotemporal dementia; Non-verbal behavior; Semantic dementia; Social neuroscience.

Publication types

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

MeSH terms

Alzheimer Disease*
Frontotemporal Dementia*
Humans
Neuropsychological Tests
Pick Disease of the Brain*
Social Behavior