Moral Emotions and Their Brain Structural Correlates Across Neurodegenerative Disorders

Article type: Research Article

Authors: Baez, Sandra^{a; *} | Trujillo-Llano, Catalina^{b; c} | de Souza, Leonardo Cruz^d | Lillo, Patricia^{e; f} | Forno, Gonzalo^{g; t} | Santamaría-García, Hernando^{h; i; j} | Okuma, Cecilia^{k; l} | Alegria, Patricio^m | Huepe, Davidⁿ | Ibáñez, Agustín^{n; o; p; q; r} | Decety, Jean^s | Slachevsky, Andrea^{e; t; u; v; *}

Affiliations: [a] Universidad de los Andes, Bogotá, Colombia | [b] Facultad de Psicología, Universidad del Valle, Cali, Colombia | [c] Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany | [d] Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil | [e] Geroscience Center for Brain Health and Metabolism, Santiago, Chile | [f] Departamento de Neurologia Sur, Facultad de Medicina, Universidad de Chile, Santiago, Chile | [g] Universidad de los Andes, Santiago, Chile | [h] Centro de Memoria y Cognición Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia | [i] Global Brain Health Institute, University of California, San Francisco, CA, USA | [j] Universidad Javeriana, PhD Program of Neuroscience, Bogotá, Colombia | [k] Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile | [l] Servicio de Neurorradiología, Instituto de Neurocirugía Dr. Asenjo, Servicio de Salud Metropolitano Oriente, Santiago, Chile | [m] Servicio de Radiología, Hospital Barros Luco Trudeau, San Miguel, Chile | [n] Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile | [o] Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland | [p] Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile | [q] Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina | [r] National Scientific and Technical Research Council, Buenos Aires, Argentina | [s] University of Chicago, Chicago, IL, USA | [t] Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department - ICBM, Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile | [u] Memory and Neuropsychiatric Center, Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile | [v] Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile

Correspondence: [*] Correspondence to: Andrea Slachevsky, Av Salvador 486 Providencia, University of Chile, Santiago, Chile. E-mail: [email protected] and Sandra Baez, MS, PhD, Universidad de los Andes, Cra. 1 #18a-12, Bogotá, Colombia. Tel.: +57 1 3394999/Ext.: 5560; Fax: +57 1 3324539; E-mail: [email protected].

Abstract: Background:Although social cognition is compromised in patients with neurodegenerative disorders such as behavioral variant frontotemporal dementia (bvFTD) and Alzheimer’s disease (AD), research on moral emotions and their neural correlates in these populations is scarce. No previous study has explored the utility of moral emotions, compared to and in combination with classical general cognitive state tools, to discriminate bvFTD from AD patients. Objective:To examine self-conscious (guilt and embarrassment) and other-oriented (pity and indignation) moral emotions, their subjective experience, and their structural brain underpinnings in bvFTD (n = 31) and AD (n = 30) patients, compared to healthy controls (n = 37). We also explored the potential utility of moral emotions measures to discriminate bvFTD from AD. Methods:We used a modified version of the Moral Sentiment Task measuring the participants’ accuracy scores and their emotional subjective experiences. Results:bvFTD patients exhibited greater impairments in self-conscious and other-oriented moral emotions as compared with AD patients and healthy controls. Moral emotions combined with general cognitive state tools emerged as useful measures to discriminate bvFTD from AD patients. In bvFTD patients, lower moral emotions scores were associated with lower gray matter volumes in caudate nucleus and inferior and middle temporal gyri. In AD, these scores were associated with lower gray matter volumes in superior and middle frontal gyri, middle temporal gyrus, inferior parietal lobule and supramarginal gyrus. Conclusion:These findings contribute to a better understanding of moral emotion deficits across neurodegenerative disorders, highlighting the potential benefits of integrating this domain into the clinical assessment.

Keywords: Alzheimer’s disease, behavioral variant frontotemporal dementia, moral emotions, neural correlates, social cognition

DOI: 10.3233/JAD-221131

Journal: Journal of Alzheimer's Disease, vol. 92, no. 1, pp. 153-169, 2023