23 January 2009

Behavioural frontotemporal dementia

Behavioural frontotemporal dementia: processing emotion and sarcasm
Dementia News (Alzheimer's Australia): 23 January 2009
Most of us take for granted being able to tell another’s emotional state, and, although we may not have thought about it, successful relationships depend, at least in part, on having this apability and responding appropriately.

One of the complex processes that we master as we become adults is recognising sarcasm. It requires understanding the facts of a situation as well as the mental state of the speaker so that we can know the true meaning, which is so often the opposite of the literal meaning. Sarcasm is conveyed with a number of cues, including facial expression and tone of voice, and is often used to deliver criticism. It is never pleasant to be the recipient of sarcasm, but if we couldn’t recognise it for what it is we wouldn’t know the real intent of the speaker.

Some people lose the capacity for normal emotional processing and become unable to detect the emotional states of others. People with behavioural frontotemporal dementia are amongst them. Behavioural frontotemporal dementia is a condition resulting from progressive degeneration of the frontal and temporal lobes of the brain. It affects social skills, personal conduct, self-awareness, and the capacity for processing emotions. Especially impaired is the capacity to recognise negative emotions in others, such as anger, disgust, fear, and sadness. These people also fail to detect sarcasm as they lose the ability to process facial expression and the patterns of stress and intonation in speech.

A team of researchers led by Dr Kipps from the Department of Neurology, Westmead Hospital, Sydney, studied 51 individuals (26 with behavioural frontotemporal dementia, 9 with Alzheimer’s disease, and 16 controls), to quantify aspects of behavioural frontotemporal dementia and to see whether there were links to abnormalities in socially relevant brain regions. Thirty-three participants went on to have brain scans within six months of assessment.

Participants’ ability to identify emotions and sarcasm was assessed with The Awareness of Social Inference Test. They were shown videos in which trained method actors portrayed exchanges depicting basic emotions, and more complex exchanges involving sarcasm. Those people whose brain scans showed deficits in the lateral orbitofrontal cortex, insula, amygdala and temporal pole regions of the brain were those who had marked impairment in their ability to recognise sarcasm and negative emotions. However, they had no difficulty recognising sincerity.

Those people who had been clinically diagnosed with behavioural frontotemporal dementia but who did not have any changes on their brain scans, had no difficulty recognizing negative emotions or sarcasm, and nor did people with Alzheimer’s disease.

The paper, Understanding Social Dysfunction in bvFTD: the role of emotion and sarcasm processing, by Dr Kipp and colleagues.

Adapted from University of New South Wales Press Release

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