2023 American Academy of Neurology Abstract Website

Giulia Giacomucci¹, Cristina Polito², Valentina Berti³, Sonia Padiglioni⁴, Giulia Galdo¹, Salvatore Mazzeo¹, Enrico Bergamin⁵, Valentina Moschini⁶, Carmen Morinelli⁶, Claudia Nuti⁵, Maria Teresa De Cristofaro⁷, Silvia Bagnoli¹, Benedetta Nacmias¹, Sandro Sorbi¹, Valentina Bessi¹
¹Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, ²IRCCS Fondazione Don Carlo Gnocchi, ³Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, ⁴Research and Innovation Centre for Dementia-CRIDEM, AOU Careggi, ⁵University of Florence, ⁶SOD Neurologia I, Dipartmento Neuromuscolo-Scheletrico e degli Organi di Senso, AOU Careggi, ⁷Azienda Ospedaliero-Universitaria Careggi

Objective:

The aim of this study is to assess possible empathy deficits and their neural basis in lv-PPA compared to amnesic AD.

Background:

Empathy is the ability to understand (cognitive empathy) and to feel (affective empathy) what others feel. Evidence about empathy in logopenic variant of Primary Progressive Aphasia (lv-PPA) are rare and not conclusive.

Design/Methods:

We included 18 lv-PPA and 38 amnesic AD patients. Informer-rated Interpersonal Reactivity Index (IRI) was used to explore cognitive (Perspective Taking-PT and Fantasy-F subscales) and affective (Empathic Concern-EC and Personal Distress-PD subscales) empathy, before (T0) and after (T1) cognitive symptoms’ onset. Emotion recognition was tested through Ekman-60 Faces Test. Eighteen lv-PPA and 30 amnesic AD patients underwent Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) and amyloid biomarker analysis. SPM analysis on FDG-PET was performed in 16 lv-PPA and 26 amnesic AD patients.

Results:

From T0 to T1, PT scores decreased, and PD scores increased in both lv-PPA (PT z=-3.43, p=0.001; PD z=-3.62, p<0.001) and in amnesic AD (PT z=-4.57, p<0.001; PD z=-5.20, p<0.001). Lv-PPA performed poorer than amnesic AD in happiness recognition (7.54±2.18 vs 8.94±1.04, p=0.001). Delta-PT(T0-T1) negatively correlated with metabolic disfunction of left superior and middle frontal gyri, inferior parietal lobule and insula in lv-PPA, and of right superior temporal gyrus and middle frontal gyrus in amnesic AD (p<0.005). Delta-PD(T0-T1) positively correlated with metabolic disfunction of left insula, inferior parietal lobule and superior frontal gyrus in lv-PPA (p<0.005) and of right inferior frontal gyrus in amnesic AD (p<0.001).

Conclusions:

Beyond language impairment, lv-PPA patients seems to present empathy changes and difficulties in emotion recognition. Lv-PPA and amnesic AD share the same empathic changes, with a damage of cognitive empathy and a heightening of person distress along time. Differences of neural correlates of empathy impairment might be due to the different vulnerability of specific brain regions in the two AD phenotypes.