title: Orbitofrontal and limbic signatures of empathic concern and intentional harm in the behavioral variant frontotemporal dementia.
abstract: Perceiving and evaluating intentional harms in an interpersonal context engages both cognitive and emotional domains. This process involves inference of intentions, moral judgment, and, crucially, empathy towards others' suffering. This latter skill is notably impaired in behavioral variant frontotemporal dementia (bvFTD). However, the relationship between regional brain atrophy in bvFTD and deficits in the above-mentioned abilities is not well understood. The present study investigated how gray matter (GM) atrophy in bvFTD patients correlates with the perception and evaluation of harmful actions (attribution of intentionality, evaluation of harmful behavior, empathic concern, and moral judgment). First, we compared the behavioral performance of 26 bvFTD patients and 23 healthy controls on an experimental task (ET) indexing intentionality, empathy, and moral cognition during evaluation of harmful actions. Second, we compared GM volume in patients and controls using voxel-based morphometry (VBM). Third, we examined brain regions where atrophy might be associated with specific impairments in the patient group. Finally, we explored whether the patients' deficits in intentionality comprehension and empathic concern could be partially explained by regional GM atrophy or impairments in other relevant factors, such as executive functions (EFs). In bvFTD patients, atrophy of limbic structures (amygdala and anterior paracingulate cortex--APC) was related to impairments in intentionality comprehension, while atrophy of the orbitofrontal cortex (OFC) was associated with empathic concern deficits. Intentionality comprehension impairments were predicted by EFs and orbitofrontal atrophy predicted deficits in empathic concern. Thus, although the perception and evaluation of harmful actions are variously compromised in bvFTD, deficits in empathic concern may be central to this syndrome as they are associated with one of the earliest atrophied region. More generally, our results shed light on social cognition deficits in bvFTD and may have important clinical implications.
authors.affiliation: Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Faculty of Psychology, Diego Portales University, Santiago, Chile; National Scientific and Technical Research Council (CONICET), Argentina. Electronic address: sbaez@ineco.org.ar.
authors.forename: Sandra
authors.initials: S
authors.lastname: Baez
authors.affiliation: UDP-INECO Foundation Core on Neuroscience (UIFCoN), Faculty of Psychology, Diego Portales University, Santiago, Chile. Electronic address: jotapepm@gmail.com.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Morales
authors.affiliation: Departamento de Fisiopatología, ICBM y Departamento de Ciencias Neurológicas Oriente, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Unidad de Neurología Cognitiva y Demencias, Departamento de Neurología Oriente, Facultad de Medicina, Universidad de Chile y Servicio de Neurología, Hospital del Salvador, Santiago, Chile; Centro de Investigación Avanzada en Educación, Universidad de Chile, Santiago, Chile; Servicio de Neurología, Clínica Alemana, Santiago, Chile. Electronic address: aslachevsky@gmail.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Slachevsky
authors.affiliation: Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Faculty of Psychology, Diego Portales University, Santiago, Chile. Electronic address: ttorralva@ineco.org.ar.
authors.forename: Teresa
authors.initials: T
authors.lastname: Torralva
authors.affiliation: Fundación Médica San Cristobal, Santiago, Chile; Hospital de Carabineros de Chile, Santiago, Chile. Electronic address: cmatusy@gmail.com.
authors.forename: Cristian
authors.initials: C
authors.lastname: Matus
authors.affiliation: Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Faculty of Psychology, Diego Portales University, Santiago, Chile; National Scientific and Technical Research Council (CONICET), Argentina; ACR Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, Australia. Electronic address: fmanes@ineco.org.ar.
authors.forename: Facundo
authors.initials: F
authors.lastname: Manes
authors.affiliation: Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Faculty of Psychology, Diego Portales University, Santiago, Chile; National Scientific and Technical Research Council (CONICET), Argentina; Universidad Autónoma del Caribe, Barranquilla, Colombia; ACR Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, Australia. Electronic address: aibanez@ineco.org.ar.
authors.forename: Agustin
authors.initials: A
authors.lastname: Ibanez
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D003071:Cognition / Q000502:physiology*; D004644:Emotions / Q000502:physiology; D004645:Empathy / Q000502:physiology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D057180:Frontotemporal Dementia / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012919:Social Behavior
keywords: Empathy; Gray matter atrophy; Intentional harm; Intentionality comprehension; Moral judgment; bvFTD