Emotion Recognition Deficits in the Differential Diagnosis of Amnestic Mild Cognitive Impairment: A Cognitive Marker for the Limbic-Predominant Phenotype

Abstract Objective: Late-onset amnestic mild cognitive impairment (aMCI) with long disease course and slow progression has been recently recognized as a possible phenotypical expression of a limbic-predominant neurodegenerative disorder. Basic emotion recognition ability crucially depending on temporo-limbic integrity is supposed to be impaired in this group of MCI subjects presenting a selective vulnerability of medio-temporal and limbic regions. However, no study specifically investigated this issue. Methods: Hereby, we enrolled 30 aMCI with a biomarker-based diagnosis of Alzheimer’s disease (i.e., aMCI-AD, n = 16) or a biomarker evidence of selective medio-temporal and limbic degeneration (aMCI-mTLD, n = 14). Ekman-60 Faces Test (Ek-60F) was administered to each subject, comparing the performance with that of 20 healthy controls (HCs). Results: aMCI-mTLD subjects showed significantly lower Ek-60F global scores compared to HC (p = 0.001), whose performance was comparable to aMCI-AD. Fear (p = 0.02), surprise (p = 0.005), and anger (p = 0.01) recognition deficits characterized the aMCI-mTLD performance. Fear recognition scores were significantly lower in aMCI-mTLD compared to aMCI-AD (p = 0.04), while no differences were found in other emotions. Conclusions: Impaired social cognition, suggested by defective performance in emotion recognition tasks, may be a useful cognitive marker to detect limbic-predominant aMCI subjects among the heterogeneous aMCI population.

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Emotion recognition deficits in the differential diagnosis of amnestic mild cognitive impairment: a cognitive marker of the limbic-predominant variant?

10.31234/osf.io/u9ze3 ◽

2020 ◽

Author(s):

Alessandra Dodich ◽

Chiara Crespi ◽

Gaia Santi ◽

Alessandra Marcone ◽

Sandro Iannaccone ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Emotion Recognition ◽

Neurodegenerative Disorder ◽

Late Onset ◽

Selective Vulnerability ◽

Amnestic Mild Cognitive Impairment ◽

Recognition Ability ◽

Predominant Variant ◽

Emotion Recognition Ability

Objective: Late onset amnestic mild cognitive impairment (aMCI) with long disease course and slow progression has been recently recognized as a possible phenotypical expression of a limbic-predominant neurodegenerative disorder. Basic emotion recognition ability crucially depending on temporo-limbic integrity is supposed to be impaired in this group of MCI subjects presenting a selective vulnerability of medio-temporal and limbic regions. However, no study specifically investigated this issue. Methods: Hereby, we enrolled 30 aMCI with a biomarker-based diagnosis of Alzheimer’s disease (i.e., aMCI-AD, n=16) or a biomarker evidence of selective medio-temporal and limbic degeneration (aMCI-mTLD, n=14). Ekman-60 Faces Test (Ek-60F) was administered to each subject, comparing then the performance with that of 20 healthy controls (HC). Results: AMCI-mTLD subjects showed significantly lower Ek-60F global scores compared to HC, whose performance was comparable to aMCI-AD. Fear, surprise and anger recognition deficits characterized the aMCI-mTLD performance. Fear recognition scores were significantly lower in aMCI-mTLD compared to aMCI-AD. Conclusions: Impaired social cognition, suggested by defective performance in emotion recognition tasks, may be a useful cognitive marker to detect limbic-predominant aMCI subjects among the heterogeneous aMCI population.

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Atrophy and cognitive profiles in older adults with temporal lobe epilepsy are similar to mild cognitive impairment

Brain ◽

10.1093/brain/awaa397 ◽

2020 ◽

Author(s):

Erik Kaestner ◽

Anny Reyes ◽

Austin Chen ◽

Jun Rao ◽

Anna Christina Macari ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Medial Temporal Lobe ◽

Late Onset ◽

Amnestic Mild Cognitive Impairment

Abstract Epilepsy incidence and prevalence peaks in older adults yet systematic studies of brain ageing and cognition in older adults with epilepsy remain limited. Here, we characterize patterns of cortical atrophy and cognitive impairment in 73 older adults with temporal lobe epilepsy (>55 years) and compare these patterns to those observed in 70 healthy controls and 79 patients with amnestic mild cognitive impairment, the prodromal stage of Alzheimer’s disease. Patients with temporal lobe epilepsy were recruited from four tertiary epilepsy surgical centres; amnestic mild cognitive impairment and control subjects were obtained from the Alzheimer’s Disease Neuroimaging Initiative database. Whole brain and region of interest analyses were conducted between patient groups and controls, as well as between temporal lobe epilepsy patients with early-onset (age of onset <50 years) and late-onset (>50 years) seizures. Older adults with temporal lobe epilepsy demonstrated a similar pattern and magnitude of medial temporal lobe atrophy to amnestic mild cognitive impairment. Region of interest analyses revealed pronounced medial temporal lobe thinning in both patient groups in bilateral entorhinal, temporal pole, and fusiform regions (all P < 0.05). Patients with temporal lobe epilepsy demonstrated thinner left entorhinal cortex compared to amnestic mild cognitive impairment (P = 0.02). Patients with late-onset temporal lobe epilepsy had a more consistent pattern of cortical thinning than patients with early-onset epilepsy, demonstrating decreased cortical thickness extending into the bilateral fusiform (both P < 0.01). Both temporal lobe epilepsy and amnestic mild cognitive impairment groups showed significant memory and language impairment relative to healthy control subjects. However, despite similar performances in language and memory encoding, patients with amnestic mild cognitive impairment demonstrated poorer delayed memory performances relative to both early and late-onset temporal lobe epilepsy. Medial temporal lobe atrophy and cognitive impairment overlap between older adults with temporal lobe epilepsy and amnestic mild cognitive impairment highlights the risks of growing old with epilepsy. Concerns regarding accelerated ageing and Alzheimer’s disease co-morbidity in older adults with temporal lobe epilepsy suggests an urgent need for translational research aimed at identifying common mechanisms and/or targeting symptoms shared across a broad neurological disease spectrum.

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