title: Neural correlates of empathic impairment in the behavioral variant of frontotemporal dementia.
abstract: OBJECTIVE
  Loss of empathy is a symptom of the behavioral variant of frontotemporal dementia (bvFTD), constituting a clue for early diagnosis. In this study, we directly compared two empathy components (intention attribution [IA] and emotion attribution [EA]), correlating them with possible specific patterns of gray-matter density reduction within the mentalizing network.
  
  
  METHODS
  We evaluated IA and EA in 18 mild bvFTD patients compared with 36 healthy controls (HCs) using a single nonverbal test. A subgroup entered a voxel-based morphometry study.
  
  
  RESULTS
  Compared with HC, bvFTD patients showed IA and EA impairments. EA performance correlated with gray-matter reduction in the right amygdala, left insula, and posterior-superior temporal sulcus extending into the temporoparietal junction.
  
  
  CONCLUSIONS
  We proved an empathic impairment, with the ability to infer emotional states showing the most severe deficit. These results provide further evidence of selective disease-specific vulnerability of the limbic and frontoinsular network in bvFTD and highlight the usefulness of empathy assessment in early patients.
authors.affiliation: Università Vita-Salute San Raffaele, Milan, Italy; Department of Clinical Neurosciences, San Raffaele Scientific Institute, Milan, Italy; Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Cerami
authors.affiliation: Università Vita-Salute San Raffaele, Milan, Italy; Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Dodich
authors.affiliation: Università Vita-Salute San Raffaele, Milan, Italy; Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Canessa
authors.affiliation: Università Vita-Salute San Raffaele, Milan, Italy; Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Crespi
authors.affiliation: Department of Clinical Neurosciences, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Marcone
authors.affiliation: Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Cortese
authors.affiliation: Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Chierchia
authors.affiliation: Università Vita-Salute San Raffaele, Milan, Italy; Neuroradiology-CERMAC, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Scola
authors.affiliation: Università Vita-Salute San Raffaele, Milan, Italy; Neuroradiology-CERMAC, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Falini
authors.affiliation: Università Vita-Salute San Raffaele, Milan, Italy; Department of Clinical Neurosciences, San Raffaele Scientific Institute, Milan, Italy; Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy. Electronic address: cappa.stefano@hsr.it.
authors.forename: Stefano F
authors.initials: SF
authors.lastname: Cappa
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D004645:Empathy / Q000502:physiology*; D005260:Female; D057180:Frontotemporal Dementia / Q000150:complications* / Q000523:psychology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology* / Q000473:pathology*; D009483:Neuropsychological Tests; D055815:Young Adult
keywords: Behavioral variant of frontotemporal dementia; Empathy; Mentalizing; Social cognition disorders; Voxel-based morphometry