Cognitive and Affective Empathy in Huntington’s Disease

Article type: Research Article

Authors: Puig-Davi, Arnau^{a; b; d; e; 1} | Martinez-Horta, Saul^{a; b; c; d; e; 1; *} | Sampedro, Frederic^{a; b; c; d} | Horta-Barba, Andrea^{a; b; c; d; e} | Perez-Perez, Jesus^{a; b; c; d; e} | Campolongo, Antonia^{a; b; d} | Izquierdo-Barrionuevo, Cristina^{a; b} | Pagonabarraga, Javier^{a; b; c; d} | Gomez-Anson, Beatriz^f | Kulisevsky, Jaime^{a; b; c; d; e; *}

Affiliations: [a] Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain | [b] Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain | [c] Centro de InvestigaciónBiomédica en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain | [d] Autonomous University of Barcelona, Barcelona, Spain | [e] European Huntington’s DiseaseNetwork (EHDN) | [f] Neuroradiology, Radiology Department, Hospital de la Santa Creu i Sant Pau, AutonomousUniversity of Barcelona, Barcelona, Spain

Correspondence: [*] Correspondence to: Jaime Kulisevsky, MD, PhD, Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas 90 - 08041 Barcelona, Spain. Tel.: +34 93 5565986; Fax: +34 93 5565748; E-mail: jkulisevsky@santpau.cat. Saul Martinez-Horta, PhD, Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas 90 - 08041 Barcelona, Spain. Tel.: +34 93 5565518; Fax: +34 93 5565748; E-mail: smartinezho@santpau.cat.

Note: [1] These authors contributed equally to this work.

Abstract: Background:Empathy is a multidimensional construct and a key component of social cognition. In Huntington’s disease (HD), little is known regarding the phenomenology and the neural correlates of cognitive and affective empathy, and regarding how empathic deficits interact with other behavioral and cognitive manifestations. Objective:To explore the cognitive and affective empathy disturbances and related behavioral and neural correlates in HD. Methods:Clinical and sociodemographic data were obtained from 36 healthy controls (HC) and 54 gene-mutation carriers (17 premanifest and 37 early-manifest HD). The Test of Cognitive and Affective Empathy (TECA) was used to characterize cognitive (CE) and affective empathy (AE), and to explore their associations with grey matter volume (GMV) and cortical thickness (Cth). Results:Compared to HC, premanifest participants performed significantly worse in perspective taking (CE) and empathic distress (AE). In symptomatic participants, scores were significantly lower in almost all the TECA subscales. Several empathy subscales were associated with the severity of apathy, irritability, and cognitive deficits. CE was associated with GMV in thalamic, temporal, and occipital regions, and with Cth in parietal and temporal areas. AE was associated with GMV in the basal ganglia, limbic, occipital, and medial orbitofrontal regions, and with Cth in parieto-occipital areas. Conclusion:Cognitive and affective empathy deficits are detectable early, are more severe in symptomatic participants, and involve the disruption of several fronto-temporal, parieto-occipital, basal ganglia, and limbic regions. These deficits are associated with disease severity and contribute to several behavioral symptoms, facilitating the presentation of maladaptive patterns of social interaction.

Keywords: Huntington’s disease, social cognition, empathy, magnetic resonance imaging, voxel-based morphometry

DOI: 10.3233/JHD-210469

Journal: Journal of Huntington's Disease, vol. 10, no. 3, pp. 323-334, 2021