期刊
ALZHEIMERS & DEMENTIA
卷 19, 期 7, 页码 2842-2852出版社
WILEY
DOI: 10.1002/alz.12898
关键词
behavioral variant frontotemporal dementia; clinical trials; cognitive empathy; emotional empathy; Interpersonal Reactivity Index; volumetric MRI
This study modeled the changes in empathy in behavioral variant frontotemporal dementia (bvFTD) and found that empathic concern and perspective taking decline in the early stages of the disease regardless of genetic factors. The loss of empathy is progressive and correlates with subcortical atrophy.
IntroductionEmpathy relies on fronto-cingular and temporal networks that are selectively vulnerable in behavioral variant frontotemporal dementia (bvFTD). This study modeled when in the disease process empathy changes begin, and how they progress. MethodsFour hundred thirty-one individuals with asymptomatic genetic FTD (n = 114), genetic and sporadic bvFTD (n = 317), and 163 asymptomatic non-carrier controls were enrolled. In sub-samples, we investigated empathy measured by the informant-based Interpersonal Reactivity Index (IRI) at each disease stage and over time (n = 91), and its correspondence to underlying atrophy (n = 51). ResultsEmpathic concern (estimate = 4.38, 95% confidence interval [CI] = 2.79, 5.97; p < 0.001) and perspective taking (estimate = 5.64, 95% CI = 3.81, 7.48; p < 0.001) scores declined between the asymptomatic and very mild symptomatic stages regardless of pathogenic variant status. More rapid loss of empathy corresponded with subcortical atrophy. DiscussionLoss of empathy is an early and progressive symptom of bvFTD that is measurable by IRI informant ratings and can be used to monitor behavior in neuropsychiatry practice and treatment trials.
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