Neural substrates of spontaneous narrative production in focal neurodegenerative disease.
Conversational storytelling integrates diverse cognitive and socio-emotional abilities that critically differ across neurodegenerative disease groups. Storytelling patterns may have diagnostic relevance and predict anatomic changes. The present study employed mixed methods discourse and quantitative analyses to delineate patterns of storytelling across focal neurodegenerative disease groups, and to clarify the neuroanatomical contributions to common storytelling characteristics. Transcripts of spontaneous social interactions of 46 participants (15 behavioral variant frontotemporal dementia (bvFTD), 7 semantic variant primary progressive aphasia (svPPA), 12 Alzheimer's disease (AD), and 12 healthy older normal controls (NC)) were analyzed for storytelling frequency and characteristics, and videos of the interactions were rated for patients' level of social attentiveness. Compared to controls, svPPAs told more stories and autobiographical stories, and perseverated on aspects of self during the interaction, whereas ADs told fewer autobiographical stories than NCs. svPPAs and bvFTDs were rated as less attentive to social cues. Aspects of storytelling were related to diverse cognitive and socio-emotional functions, and voxel-based anatomic analysis of structural magnetic resonance imaging revealed that temporal organization, narrative evaluations patterns, and social attentiveness correlated with atrophy corresponding to known intrinsic connectivity networks, including the default mode, limbic, salience, and stable task control networks. Differences in spontaneous storytelling among neurodegenerative groups elucidated diverse cognitive, socio-emotional, and neural contributions to narrative production, with implications for diagnostic screening and therapeutic intervention.
University of California San Francisco, Department of Neurology, USA; University of California Santa Cruz, Department of Psychology, USA. Electronic address: kgola@memory.ucsf.edu.
Kelly A
KA
Gola
University of California Santa Cruz, Department of Psychology, USA.
Avril
A
Thorne
Erasmus MC Rotterdam, Department of Neurology, Netherlands.
Lisa D
LD
Veldhuisen
Erasmus MC Rotterdam, Department of Neurology, Netherlands.
Cordula M
CM
Felix
University of California Santa Cruz, Department of Psychology, USA.
Sarah
S
Hankinson
University of California Santa Cruz, Department of Psychology, USA.
Julie
J
Pham
University of California San Francisco, Department of Neurology, USA.
Tal
T
Shany-Ur
University of California San Francisco, Department of Neurology, USA.
Guido P
GP
Schauer
University of California San Francisco, Department of Neurology, USA.
Christine M
CM
Stanley
University of California San Francisco, Department of Neurology, USA.
Shenly
S
Glenn
University of California San Francisco, Department of Neurology, USA.
Bruce L
BL
Miller
University of California San Francisco, Department of Neurology, USA.
Katherine P
KP
Rankin
D000368:Aged; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D032882:Comprehension / Q000502:physiology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D061212:Memory, Episodic; D008609:Mental Status Schedule; D008875:Middle Aged; D019636:Neurodegenerative Diseases / Q000150:complications / Q000473:pathology / Q000523:psychology; D009483:Neuropsychological Tests; D012919:Social Behavior; D012920:Social Behavior Disorders / Q000209:etiology*
Autobiographical memory; Focal neurodegenerative disease; Narrative; Neural networks; Social functioning