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A tale of two hemispheres: Contrasting socioemotional dysfunction in right- versus left-lateralised semantic dementia

Um conto sobre dois hemisférios: contrastando a disfunção socioemocional na demência semântica com atrofia lateralizada à direita versus esquerda

ABSTRACT

Objective:

Semantic dementia, a subtype of frontotemporal lobar degeneration, is characterised by cross-modal loss of conceptual knowledge attributable to progressive degeneration of the left anterior temporal lobe. Much less is known regarding the clinical presentation of SD patients with predominantly right-lateralised atrophy. Recent reports emphasise marked socioemotional and behavioural disturbances in such cases. Given the importance of the right anterior temporal lobes in social cognition, we hypothesised that socioemotional functioning would be disproportionately affected in right versus left-lateralised SD cases.

Methods:

We assessed well-characterised cases of predominantly right (n=10) and left (n=12) SD and 20 matched healthy controls on tests of emotion processing and interpersonal functioning.

Results:

Right SD cases showed disproportionate difficulties in the recognition of positive and negative facial emotions, specifically happiness and anger, compared with left SD cases. Deficits in anger recognition persisted in right SD despite covarying for facial and semantic processing. On a contextually rich task of emotion recognition using multimodal videos, no subgroup differences were evident. Finally, empathic concern was rated as significantly lower by caregivers of right versus left SD cases. Overall, the extent of socioemotional disturbance was associated with the degree of behavioural changes in SD.

Conclusion:

Our results reveal considerable overlap in the extent to which socioemotional processes are disrupted in left and right-lateralised cases of SD. Notably, however, right SD cases show disproportionate deficits for recognition of facial emotions and the capacity for empathic concern, supporting a specialised role for the right anterior temporal lobes in mediating these cognitive functions.

Key words:
semantic dementia; emotion processing; frontotemporal dementia; hemispheric lateralisation

RESUMO

Objetivo:

A demência semântica (DS), um subtipo de degeneração lobar frontotemporal, é caracterizada por perda multimodal do conhecimento conceitual atribuída à degeneração progressiva do região anterior do lobo temporal esquerdo. Sabe-se menos sobre o quadro clínico de pacientes com DS em que a atrofia é localizada predominantemente à direita. Relatos recentes têm enfatizado marcantes distúrbios socioemocionais e comportamentais em tais casos. Dada a importância da região anterior do lobo temporal direito na cognição social, aventamos a hipótese de que o funcionamento socioemocional seria desproporcionalmente afetado nos casos de DS com atrofia lateralizada à direita.

Métodos:

Foram avaliados os desempenhos de casos bem caracterizados de DS com atrofia do lobo temporal predominantemente à direita (n=10) e à esquerda (n=12) e 20 controles saudáveis em testes de processamento de emoções e funcionamento interpessoal.

Resultados:

Casos de DS com atrofia predominante à direita apresentaram dificuldades desproporcionadas no reconhecimento de emoções faciais positivas e negativas, especificamente expressões de felicidade e raiva, em comparação com os casos de atrofia à esquerda. Os déficits no reconhecimento de raiva persistiram depois de excluídas as covariações com processamento facial e semântico. Em uma tarefa contextualmente rica de reconhecimento de emoções através de vídeos multimodais, não houve diferenças entre os subgrupos. Por fim, preocupação empática foi classificada por cuidadores como significativamente menor nos casos com atrofia à direita. Em geral, o grau de perturbação socioemocional foi associado com o grau de alterações comportamentais na DS.

Conclusão:

Nossos resultados revelam uma considerável sobreposição na medida em que os processos socioemocionais são rompidos tanto em casos com atrofia predominante à direita como à esquerda. Notavelmente, entretanto, os casos com DS com atrofia predominante à direita apresentam déficits desproporcionais no reconhecimento de emoções faciais e na capacidade de preocupação empática, dando suporte à hipótese de um papel especializado das regiões anteriores do lobo temporal direito na mediação dessas funções cognitivas.

Palavras-chave:
demência semântica; processamento de emoção; demência frontotemporal; lateralização hemisférica

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Publication Dates

  • Publication in this collection
    Jan-Mar 2013

History

  • Received
    25 Nov 2012
  • Accepted
    02 Feb 2013
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