Diagnostic Accuracy of Affective Social Tasks in the Clinical Classification Between the Behavioral Variant of Frontotemporal Dementia and Other Neurodegenerative Disease

Article type: Research Article

Authors: Dodich, Alessandra^a | Crespi, Chiara^{b; c} | Santi, Gaia C.^d | Luzzi, Simona^e | Ranaldi, Valentina^e | Iannaccone, Sandro^f | Marcone, Alessandra^f | Zamboni, Michele^f | Cappa, Stefano F.^{d; g} | Cerami, Chiara^{c; d; *}

Affiliations: [a] Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto (TN), Italy | [b] Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy | [c] Cognitive Computational Neuroscience Research Unit, IRCCS Mondino Foundation, Pavia, Italy | [d] Scuola Universitaria Superiore IUSS Pavia, Pavia, Italy | [e] Department of Experimental and Clinical Medicine, Polytechnic University of Marche – Ospedali Riuniti, Ancona, Italy | [f] Department of Rehabilitation and Functional Recovery, San Raffaele Hospital, Milan, Italy | [g] Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy

Correspondence: [*] Correspondence to: Chiara Cerami, MD, Scuola Universitaria Superiore IUSS Pavia, Piazza della Vittoria 15, 27100, Pavia, Italy. E-mail: chiara.cerami@iusspavia.it.

Abstract: Background:Severe socio-emotional impairments characterize the behavioral variant of frontotemporal dementia (bvFTD). However, literature reports social cognition disorders in other dementias. Objective:In this study, we investigated the accuracy of social cognition performances in the early and differential diagnosis of bvFTD. Methods:We included 131 subjects: 32 bvFTD, 26 Alzheimer’s disease (AD), 16 primary progressive aphasia (PPA), 17 corticobasal syndrome (CBS), and 40 healthy control (HC). Each subject completed the Ekman 60 faces (Ek-60F) test assessing basic emotion recognition and the Story-based Empathy Task (SET) assessing attribution of intentions/emotions. A combined social measure (i.e., Emotion Recognition and Attribution (ERA) index) was calculated. One-way ANOVA has been used to compare performances among groups, while receiver operating characteristic (ROC) curve tested measures ability to distinguish subjects with and without bvFTD. Results:Ek-60F and ERA index scores were significantly lower in bvFTD versus HC, AD, and PPA groups. ROC analyses significantly distinguished bvFTD from HC (AUC 0.82–0.92), with the Ek-60F test showing the highest performance, followed by the ERA index. These two social measures showed the best accuracy in detecting bvFTD from AD (AUC 0.78–0.74) and PPA (AUC 0.80–0.76). Investigated measures failed in detecting bvFTD from CBS. Conclusion:Accuracy analyses support the advantage of using social cognition tests for bvFTD diagnosis. Short social battery may reduce uncertainties and improve disease identification in clinical settings. We recommend a revision of current clinical criteria considering neuropsychological deficits in emotion recognition and processing tasks as key cognitive markers of this neurodegenerative syndrome.

Keywords: Accuracy, behavioral variant of frontotemporal dementia, cognitive marker, diagnosis, emotion recognition, empathy, frontotemporal dementia, social cognition

DOI: 10.3233/JAD-201210

Journal: Journal of Alzheimer's Disease, vol. 80, no. 4, pp. 1401-1411, 2021