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. 2023 Jan 25;13(2):208.
doi: 10.3390/jpm13020208.

Differences and Similarities in Empathy Deficit and Its Neural Basis between Logopenic and Amnesic Alzheimer's Disease

Giulia Giacomucci  1 , Cristina Polito  2 , Valentina Berti  3   4 , Sonia Padiglioni  5   6 , Giulia Galdo  1 , Salvatore Mazzeo  1   2 , Enrico Bergamin  7 , Valentina Moschini  8 , Carmen Morinelli  8 , Claudia Nuti  7 , Maria Teresa De Cristofaro  4 , Assunta Ingannato  1 , Silvia Bagnoli  1 , Benedetta Nacmias  1   2 , Sandro Sorbi  1   2 , Valentina Bessi  1
Affiliations

Differences and Similarities in Empathy Deficit and Its Neural Basis between Logopenic and Amnesic Alzheimer's Disease

Giulia Giacomucci et al. J Pers Med. .

Abstract

The aims of the study were to assess empathy deficit and neuronal correlates in logopenic primary progressive aphasia (lv-PPA) and compare these data with those deriving from amnesic Alzheimer's disease (AD). Eighteen lv-PPA and thirty-eight amnesic AD patients were included. Empathy in both cognitive and affective domains was assessed by Informer-rated Interpersonal Reactivity Index (perspective taking, PT, and fantasy, FT, for cognitive empathy; empathic concern, EC, and personal distress, PD, for affective empathy) before (T0) and after (T1) cognitive symptoms' onset. Emotion recognition was explored through the Ekman 60 Faces Test. Cerebral FDG-PET was used to explore neural correlates underlying empathy deficits. 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). Delta PT (T0-T1) negatively correlated with metabolic disfunction of the right superior temporal gyrus, fusiform gyrus, and middle frontal gyrus (MFG) in amnesic AD and of the left inferior parietal lobule (IPL), insula, MFG, and bilateral superior frontal gyrus (SFG) in lv-PPA (p < 0.005). Delta PD (T0-T1) positively correlated with metabolic disfunction of the right inferior frontal gyrus in amnesic AD (p < 0.001) and of the left IPL, insula, and bilateral SFG in lv-PPA (p < 0.005). Lv-PPA and amnesic AD share the same empathic changes, with a damage of cognitive empathy and a heightening of personal distress over time. The differences in metabolic disfunctions correlated with empathy deficits might be due to a different vulnerability of specific brain regions in the two AD clinical presentations.

Keywords: Alzheimer’s disease; empathy; logopenic variant primary progressive aphasia.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Empathy assessed by Interpersonal Reactivity Index (IRI) in subjective cognitive decline (SCD), Alzheimer’s disease (AD) and logopenic variant primary progressive aphasia (lv-PPA). * p < 0.05, ** p < 0.005, *** p < 0.001.
Figure 2
Figure 2
Emotional recognition ability as assessed by Ekman 60 Faces Test in subjective cognitive decline (SCD), Alzheimer’s disease (AD), and logopenic variant primary progressive aphasia (lv-PPA). * p < 0.05, ** p < 0.005, *** p < 0.001.
Figure 3
Figure 3
Negative correlation between changes in perspective taking ability over time assessed by ∆PT (PT-T0 - PT-T1) and brain metabolism in logopenic primary progressive aphasia and amnesic Alzheimer’s disease patients at 18F-FDG-PET SPM analysis. Significant clusters projected on the standardized Montreal Neurological Institute (MNI) magnetic resonance imaging (MRI) render surface. Color grading: cyan, lv-PPA; violet, amnesic AD.
Figure 4
Figure 4
Positive correlation between changes in emotional contagion over time assessed by ∆PD (PD-T0 - PD-T1) and brain metabolism in logopenic primary progressive aphasia and amnesic Alzheimer’s disease patients at 18F-FDG-PET SPM analysis. Significant clusters projected on the standardized Montreal Neurological Institute (MNI) magnetic resonance imaging (MRI) render surface. Color grading: cyan, lv-PPA; violet, amnesic AD.
See this image and copyright information in PMC

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