title: Oops! Resolving social dilemmas in frontotemporal dementia.
abstract: OBJECTIVE
  Our social cognition model posits that social knowledge and executive resources guide interpersonal decision making. We investigated this model by examining the resolution of standardised social dilemmas in patients with a social and executive disorder (SOC/EXEC) caused by frontotemporal dementia (FTD).
  
  
  METHODS
  Patients with SOC/EXEC (n = 12) and those with progressive aphasia (APH, n = 14) completed measures requiring resolution of social dilemmas (Guilford's Cartoon Predictions Test), social cognition (theory of mind false belief vignettes and a behavioural rating measure of empathy) and executive measures of cognitive flexibility (Visual Verbal Test). Regression analysis related judgments of social dilemmas to cortical volume using voxel based morphometry of high resolution structural MRI.
  
  
  RESULTS
  Patients with SOC/EXEC were impaired in judgments of social dilemmas as well as theory of mind, self-awareness of empathy and cognitive flexibility. Patients with APH were much less impaired in the social and cognitive measures. There were strong correlations among social dilemma, theory of mind and mental flexibility measures in patients with SOC/EXEC, and stepwise regression showed that mental flexibility was most predictive of social dilemma judgments. Social dilemma impairments in the SOC/EXEC sample correlated with cortical atrophy in the orbital frontal, superior temporal, visual association and posterior cingulate regions of the right hemisphere.
  
  
  CONCLUSIONS
  Deficits in patients with SOC/EXEC in resolving social dilemmas are related to depleted executive resources and social knowledge that appear to arise from disease that interrupts a right frontal-temporal neural network crucial for mediating social cognition.
authors.affiliation: Department of Neurology, College of Medicine, Pennsylvania State University, The Milton S Hershey Medical Center, Hershey, PA 17033-0850, USA. peslinger@psu.edu
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Eslinger
authors.forename: Peachie
authors.initials: P
authors.lastname: Moore
authors.forename: Vanessa
authors.initials: V
authors.lastname: Troiani
authors.forename: Shweta
authors.initials: S
authors.lastname: Antani
authors.forename: Katy
authors.initials: K
authors.lastname: Cross
authors.forename: Shaleigh
authors.initials: S
authors.lastname: Kwok
authors.forename: Murray
authors.initials: M
authors.lastname: Grossman
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology; D003072:Cognition Disorders; D003657:Decision Making; D003704:Dementia / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008279:Magnetic Resonance Imaging; D008297:Male; D008960:Models, Psychological; D012044:Regression Analysis; D012919:Social Behavior