Progressive Impairment of Decision-Making in Behavioral-Variant Frontotemporal Dementia

2013 ◽  
Vol 25 (2) ◽  
pp. E20-E21 ◽  
Author(s):  
Michele Poletti ◽  
Filippo Baldacci ◽  
Gabriele Cipriani ◽  
Angelo Nuti ◽  
Ubaldo Bonuccelli
2020 ◽  
Vol 15 (6) ◽  
pp. 681-694
Author(s):  
Aurélie L Manuel ◽  
Daniel Roquet ◽  
Ramon Landin-Romero ◽  
Fiona Kumfor ◽  
Rebekah M Ahmed ◽  
...  

Abstract Negative and positive emotions are known to shape decision-making toward more or less impulsive responses, respectively. Decision-making and emotion processing are underpinned by shared brain regions including the ventromedial prefrontal cortex (vmPFC) and the amygdala. How these processes interact at the behavioral and brain levels is still unclear. We used a lesion model to address this question. Study participants included individuals diagnosed with behavioral-variant frontotemporal dementia (bvFTD, n = 18), who typically present deficits in decision-making/emotion processing and atrophy of the vmPFC, individuals with Alzheimer’s disease (AD, n = 12) who present with atrophy in limbic structures and age-matched healthy controls (CTRL, n = 15). Prior to each choice on the delay discounting task participants were cued with a positive, negative or neutral picture and asked to vividly imagine witnessing the event. As hypothesized, our findings showed that bvFTD patients were more impulsive than AD patients and CTRL and did not show any emotion-related modulation of delay discounting rate. In contrast, AD patients showed increased impulsivity when primed by negative emotion. This increased impulsivity was associated with reduced integrity of bilateral amygdala in AD but not in bvFTD. Altogether, our results indicate that decision-making and emotion interact at the level of the amygdala supporting findings from animal studies.


2020 ◽  
Vol 33 (2) ◽  
pp. 68-72
Author(s):  
Oleg Yerstein ◽  
Andrew R. Carr ◽  
Elvira Jimenez ◽  
Mario F. Mendez

Background: Neuropsychiatric symptoms can impact decision-making in patients with Alzheimer disease (AD). Methods: Using a simple decision-making task, a variant of the ultimatum game (UG) modified to control feelings of unfairness, this study investigated rejection responses among responders to unfair offers. The UG was administered to 11 patients with AD, 10 comparably demented patients with behavioral variant frontotemporal dementia (bvFTD), and 9 healthy controls (HC). The results were further compared with differences on the caregiver Neuropsychiatric Inventory (NPI). Results: Overall, patients with AD significantly rejected more total offers than did the patients with bvFTD and the HC ( P < .01). On the NPI, the only domain that was significantly worse among the patients with AD compared to the other groups was dysphoria/depression. Conclusions: These results suggest that early AD can be distinguished based on increased rejections of offers in decision-making, possibly consequent to a heightened sense of unfairness from dysphoria/depression.


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