Physiological, behavioral and subjective sadness reactivity in frontotemporal dementia subtypes
Physiological, behavioral and subjective sadness reactivity in frontotemporal dementia subtypes
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DOI：
10.1093/scan/nsaa007
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发表时间：
2019-12-01
影响因子：
4.2
通讯作者：
Levenson, Robert W.
中科院分区：
文献类型：
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作者：
Hua, Alice Y.;Chen, Kuan-Hua;Levenson, Robert W.
额颞叶痴呆（Frontotemporal dementia，FTD）是一种以社会情感障碍为主要特征的神经退行性疾病，分为行为变异型（behavioral variant FTD，bvFTD）、语义变异型原发性进行性失语（semantic variant primary progressive aphasia，svPPA）和非流利变异型原发性进行性失语（non-fluent variant primary progressive aphasia，nfvPPA）三种亚型。新出现的证据显示bvFTD和svPPA的情绪反应性受损，而nfvPPA的情绪反应性研究少得多。在105例FTD患者（49例bvFTD、31例svPPA和25例nfvPPA）和27例健康对照中，我们检查了对悲伤电影的三个方面的情绪反应（生理、面部行为和主观体验）。在样本的一个子集中，我们还使用基于体素的形态测定法研究了反应性减弱方面的神经相关性。结果表明，所有三种FTD亚型均显示呼吸频率和舒张压的生理反应减弱; bvFTD和svPPA患者也显示主观体验减弱，无亚型显示面部行为减弱。此外，在较小的体积与悲伤反应减弱相关的大脑区域中，临床亚型之间存在差异。这些结果表明，情感障碍扩展到FTD的悲伤反应，并强调了在多个临床亚型中考虑悲伤反应的不同方面以表征FTD的情感缺陷和相关神经退行性变的重要性。
Frontotemporal dementia (FTD), a neurodegenerative disease broadly characterized by socioemotional impairments, includes three clinical subtypes: behavioral variant FTD (bvFTD), semantic variant primary progressive aphasia (svPPA) and non-fluent variant primary progressive aphasia (nfvPPA). Emerging evidence has shown emotional reactivity impairments in bvFTD and svPPA, whereas emotional reactivity in nfvPPA is far less studied. In 105 patients with FTD (49 bvFTD, 31 svPPA and 25 nfvPPA) and 27 healthy controls, we examined three aspects of emotional reactivity (physiology, facial behavior and subjective experience) in response to a sad film. In a subset of the sample, we also examined the neural correlates of diminished aspects of reactivity using voxel-based morphometry. Results indicated that all three subtypes of FTD showed diminished physiological responding in respiration rate and diastolic blood pressure; patients with bvFTD and svPPA also showed diminished subjective experience, and no subtypes showed diminished facial behavior. Moreover, there were differences among the clinical subtypes in brain regions where smaller volumes were associated with diminished sadness reactivity. These results show that emotion impairments extend to sadness reactivity in FTD and underscore the importance of considering different aspects of sadness reactivity in multiple clinical subtypes for characterizing emotional deficits and associated neurodegeneration in FTD.