Deficits in emotion recognition monitoring in dementia patients

CORDERO, I. R. G.; J. MIGEOT; A. AQUINO; S. FITTIPALDI; M. D. RIVERA; L. SEDEÑO; A. M. GARCIA ; A. IBANEZ

Conferencia; Alzheimer's Association International Conference; 2020

Alzheimer's Association

Background: The capacity to ascertain other people?s emotional states is crucial forestablishing and maintaining social interactions. In particular, accurate recognition offacial expressions and beliefs about whether we trust what a face transmits are fundamentalfor guiding and adjusting this social behavior. Yet, although emotion recognitionimpairments are well documented in neurodegenerative diseases, the role of monitoringskills in this domain remains poorly understood in the field of dementia.Method: We recruited patients with behavioral variant frontotemporal dementia(bvFTD, n = 18), Alzheimer?s disease (AD, n = 27), and demographically-matched controls(n=38). Participants performed a classic test of facial expression recognition and,after each trial, they provided a confidence judgment about their performance. A monitoringindex was calculated considering both performance on each emotion type andassociated confidence ratings (with higher values of the index indicating worse monitoring).Then,whole-brain greymatter volume was analyzed via voxel-based morphometry(VBM) to track possible associations with the monitoring index.Results: Compared to controls, both groups of patients exhibited difficulties in monitoringnegative emotions. Monitoring of disgust was specifically impaired in bvFTD,and monitoring of sadness and neutral faces, inAD.VBMresults showed that, in bvFTD,reduced grey matter volume in areas belonging to the limbic system and subcorticalregions was associated with emotion recognition deficits.Monitoring impairmentswere also related with different subcortical and cortical areas, including the prefrontallobe, insula and the cingulate cortex. On the other hand, in AD, temporal and parietalareas were associated with emotion recognition and parietal and frontal regions, withmonitoring.Conclusion: These results indicate that dementia patients present emotion recognitionmonitoring impairments and that these deficits are associated with damage of corticaland subcortical regions as well as limbic circuits. In both groups, recognition and monitoringof emotions shared several structural substrates. The monitoring impairmentspresented in bvFTD and AD could be related with the changes in social cognition andbehavior that these patients presented in daily life. Therefore, these preliminary findingscould contribute to a better understanding of emotion monitoring processes.