Dissociation in Rating Negative Facial Emotions between Behavioral Variant Frontotemporal Dementia and Major Depressive Disorder.
Features of behavioral variant frontotemporal dementia (bvFTD) such as executive dysfunction, apathy, and impaired empathic abilities are also observed in major depressive disorder (MDD). This may contribute to the reason why early stage bvFTD is often misdiagnosed as MDD. New assessment tools are thus needed to improve early diagnosis of bvFTD. Although emotion processing is affected in bvFTD and MDD, growing evidence indicates that the pattern of emotion processing deficits varies between the two disorders. As such, emotion processing paradigms have substantial potentials to distinguish bvFTD from MDD.



The current study compared 25 patients with bvFTD, 21 patients with MDD, 21 patients with Alzheimer disease (AD) dementia, and 31 healthy participants on a novel facial emotion intensity rating task. Stimuli comprised morphed faces from the Ekman and Friesen stimulus set containing faces of each sex with two different degrees of emotion intensity for each of the six basic emotions.



Analyses of covariance uncovered a significant dissociation between bvFTD and MDD patients in rating the intensity of negative emotions overall (i.e., bvFTD patients underrated negative emotions overall, whereas MDD patients overrated negative emotions overall compared with healthy participants). In contrast, AD dementia patients rated negative emotions similarly to healthy participants, suggesting no impact of cognitive deficits on rating facial emotions.



By strongly differentiating bvFTD and MDDpatients through negative facial emotions, this sensitive and short rating task might help improve the early diagnosis of bvFTD.
Memory Clinic, Felix Platter-Hospital, University Center for Medicine of Aging Basel, Basel, Switzerland; Department of Neurology, University Hospital Basel, Basel, Switzerland.
Isabelle
I
Chiu
Neuroscience Research Australia, University of New South Wales, Sydney, Australia; ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia.
Olivier
O
Piguet
Department of Psychiatry, Technische Universität München, Munich, Germany.
Janine
J
Diehl-Schmid
Department of Psychiatry, Technische Universität München, Munich, Germany.
Lina
L
Riedl
Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, Basel, Switzerland.
Johannes
J
Beck
Center of Old Age Psychiatry, Psychiatric Clinics of the University of Basel, Basel, Switzerland.
Thomas
T
Leyhe
Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, Basel, Switzerland.
Edith
E
Holsboer-Trachsler
Department of Mathematics and Technology, University of Applied Sciences Koblenz, Koblenz, Germany.
Manfred
M
Berres
Department of Neurology, University Hospital Basel, Basel, Switzerland.
Andreas U
AU
Monsch
Memory Clinic, Felix Platter-Hospital, University Center for Medicine of Aging Basel, Basel, Switzerland; Department of Neurology, University Hospital Basel, Basel, Switzerland. Electronic address: marc.sollberger@fps-basel.ch.
Marc
M
Sollberger
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005149:Facial Expression; D005260:Female; D057180:Frontotemporal Dementia / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012938:Social Perception
Alzheimer disease; Emotion recognition; behavioral variant frontotemporal dementia; face morphing; major depressive disorder