Introduction
We aimed to investigate phenotypic heterogeneity in the behavioral variant of frontotemporal dementia (bvFTD) through assessment of inhibition deficits.
Methods
We assessed occurrences ...of 16 behavioral inhibition deficits from video recordings of 15 bvFTD patients (early stage) and 15 healthy controls (HC) in an ecological setting. We extracted dimensions of inhibition deficit and analyzed their correlations with cognitive and clinical measures. Using these dimensions, we isolated patient clusters whose atrophy patterns were explored.
Results
After identifying two patterns of inhibition deficit (compulsive automatic behaviors and socially unconventional behaviors), we isolated three behavioral clusters with distinct atrophy patterns. BvFTD‐G0 (N = 3), an outlier group, showed severe behavioral disturbances and more severe ventromedial prefrontal cortex/orbitofrontal cortex atrophy. Compared to bvFTD‐G1 (N = 6), bvFTD‐G2 (N = 6) presented higher anxiety and depression along with less diffuse atrophy especially in midline regions.
Discussion
Identifying clinico‐anatomical profiles through behavior observation could help to stratify bvFTD patients for adapted treatments.
"Social facilitation" refers to the enhancement or impairment of performance engendered by the mere presence of others. It has been demonstrated for a diversity of behaviors. This study assessed ...whether it also concerns attention and eye movements and if yes, which decision-making mechanisms it affects. Human volunteers were tested in three different tasks (saccades, visual search, and continuous performance) either alone or in the presence of a familiar peer. The results failed to reveal any significant peer influence on the visual search and continuous performance tasks. For saccades, by contrast, they showed a negative or positive peer influence depending on the complexity of the testing protocol. Pro-and anti-saccades were both inhibited when pseudorandomly mixed, and both facilitated when performed separately. Peer presence impaired or improved reaction times, i.e., the speed to initiate the saccade, as well as peak velocity, i.e., the driving force moving the eye toward the target. Effect sizes were large, with Cohen's
-values ranging for reaction times (RTs) from 0.50 to 0.95. Analyzing RT distributions using the LATER (Linear Approach to Threshold with Ergodic Rate) model revealed that social inhibition of pro- and anti-saccades in the complex protocol was associated with a significant increase in the rate of rise. The present demonstration that the simple presence of a familiar peer can inhibit or facilitate saccades depending on task difficulty strengthens a growing body of evidence showing social modulations of eye movements and attention processes. The present lack of effect on visual search and continuous performance tasks contrasts with peer presence effects reported earlier using similar tasks, and future studies are needed to determine whether it is due to an intermediate level of difficulty maximizing individual variability. Together with an earlier study of the social inhibition of anti-saccades also using the LATER model, which showed an increase of the threshold, the present increase of the rate of rise suggests that peer presence can influence both the top-down and bottom-up attention-related processes guiding the decision to move the eyes.
Apathy is one of the six clinical criteria for the behavioral variant of frontotemporal dementia (bvFTD), and it is almost universal in this disease. Although its consequences in everyday life are ...debilitating, its underlying mechanisms are poorly known, its assessment is biased by subjectivity and its care management is very limited. In this context, we have developed “ECOCAPTURE,” a method aimed at providing quantifiable and objective signature(s) of apathy in order to assess it and identify its precise underlying mechanisms. ECOCAPTURE consists of the observation and recording of the patient's behavior when the participant is being submitted to a multiple-phase scenario reproducing a brief real-life situation. It is performed in a functional exploration platform transformed into a fully furnished waiting room equipped with a video and sensor-based data acquisition system. This multimodal method allowed video-based behavior analyses according to predefined behavioral categories (exploration behavior, sustained activities or inactivity) and actigraphy analyses from a 3D accelerometer. The data obtained were also correlated with behavioral/cognitive tests and scales assessing global cognitive efficiency, apathy, cognitive disinhibition, frontal syndrome, depression and anxiety. Here, bvFTD patients (n = 14) were compared to healthy participants (n = 14) during the very first minutes of the scenario, when the participants discovered the room and were encouraged to explore it. We showed that, in the context of facing a new environment, healthy participants first explored it and then engaged in sustained activities. By contrast, bvFTD patients were mostly inactive and eventually explored this new place, but in a more irregular and less efficient mode than normal subjects. This exploration deficit was correlated with apathy, disinhibition and cognitive and behavioral dysexecutive syndromes. These findings led us to discuss the presumed underlying mechanisms responsible for the exploration deficit (an inability to self-initiate actions, to integrate reward valuation and to inhibit involuntary behavior). Altogether, these results pave the way for simple and objective assessment of behavioral changes that represents a critical step for the evaluation of disease progression and efficacy of treatment in bvFTD.
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