%0 Journal Article %J J Alzheimers Dis %D 2018 %T Mental States in Moving Shapes: Distinct Cortical and Subcortical Contributions to Theory of Mind Impairments in Dementia. %A Synn, Artemis %A Mothakunnel, Annu %A Kumfor, Fiona %A Chen, Yu %A Piguet, Olivier %A Hodges, John R %A Irish, Muireann %K Aged %K Alzheimer Disease %K Brain %K Case-Control Studies %K Female %K Frontotemporal Dementia %K Humans %K Image Processing, Computer-Assisted %K Magnetic Resonance Imaging %K Male %K Memory, Episodic %K Mentalization %K Middle Aged %K Neuropsychological Tests %K Task Performance and Analysis %K Theory of Mind %X

Impaired capacity for Theory of Mind (ToM) represents one of the hallmark features of the behavioral variant of frontotemporal dementia (bvFTD) and is suggested to underpin an array of socioemotional disturbances characteristic of this disorder. In contrast, while social processing typically remains intact in Alzheimer's disease (AD), the cognitive loading of socioemotional tasks may adversely impact mentalizing performance in AD. Here, we employed the Frith-Happé animations as a dynamic on-line assessment of mentalizing capacity with reduced incidental task demands in 18 bvFTD, 18 AD, and 25 age-matched Controls. Participants viewed silent animations in which geometric shapes interact in Random, Goal-Directed, and ToM conditions. An exclusive deficit in ToM classification was observed in bvFTD relative to Controls, while AD patients were impaired in the accurate classification of both Random and ToM trials. Correlation analyses revealed robust associations between ToM deficits and carer ratings of affective empathy disruption in bvFTD, and with episodic memory dysfunction in AD. Voxel-based morphometry analyses further identified dissociable neural correlates contingent on patient group. A distributed network of medial prefrontal, frontoinsular, striatal, lateral temporal, and parietal regions were implicated in the bvFTD group, whereas the right hippocampus correlated with task performance in AD. Notably, subregions of the cerebellum, including lobules I-IV and V, bilaterally were implicated in task performance irrespective of patient group. Our findings reveal new insights into the mechanisms potentially mediating ToM disruption in dementia syndromes, and suggest that the cerebellum may play a more prominent role in social cognition than previously appreciated.

%B J Alzheimers Dis %V 61 %P 521-535 %8 2018 %G eng %U https://content.iospress.com/download/journal-of-alzheimers-disease/jad170809?id=journal-of-alzheimers-disease%2Fjad170809 %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/29172002?dopt=Abstract %R 10.3233/JAD-170809 %0 Journal Article %J J Alzheimers Dis %D 2016 %T Examining the Relationship Between Autobiographical Memory Impairment and Carer Burden in Dementia Syndromes. %A Kumfor, Fiona %A Teo, Drusilla %A Miller, Laurie %A Lah, Suncica %A Mioshi, Eneida %A Hodges, John R %A Piguet, Olivier %A Irish, Muireann %K Adaptation, Psychological %K Aged %K Alzheimer Disease %K Analysis of Variance %K Behavioral Symptoms %K Caregivers %K Female %K Frontotemporal Dementia %K Humans %K Male %K Memory Disorders %K Memory, Episodic %K Middle Aged %K Neuropsychological Tests %K Psychiatric Status Rating Scales %K Statistics as Topic %X

BACKGROUND: Autobiographical memory (ABM) refers to the capacity to remember one's own past, and is known to be central for supporting one's identity and sense of self. This capacity is commonly affected in Alzheimer's disease (AD), as well as semantic dementia (SD) and behavioral-variant frontotemporal dementia (bvFTD). Importantly, ABM plays a critical social function, facilitating relationship intimacy and empathy, and thus loss of ABM may also negatively affect families and carers.

OBJECTIVE: To explore the relationship between ABM disruption and carer burden in AD, SD, and bvFTD, and establish whether characteristic ABM profiles differentially relate to carer burden across dementia syndromes.

METHODS: We recruited 12 AD, 10 SD, and 13 bvFTD patients and their primary carer. All participants completed the Autobiographical Interview to assess memory for recent and remote events. Carers completed: the Zarit Burden Interview; Depression, Anxiety and Stress Scale (DASS-21); and the Intimate Bond Measure (IBM).

RESULTS: In AD, loss of recent ABM was associated with worse psychological wellbeing of carers on the DASS-21. In contrast in SD, remote ABM dysfunction was associated with SD patients showing greater controlling behavior within their intimate relationships. In bvFTD, surprisingly, despite pervasive ABM impairment, no relationship between extent of ABM loss and carer burden was observed.

CONCLUSION: These preliminary results reveal that ABM impairment impacts on patients' families and carers and suggest that these influences vary according to the pattern of ABM dysfunction. Disease-specific interventions focusing on preserved aspects of ABM may improve quality of life for both patients and carers.

%B J Alzheimers Dis %V 51 %P 237-48 %8 2016 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/26836163?dopt=Abstract %R 10.3233/JAD-150740