[S36.003] Sarcasm Appreciation: A Test of Lateral Orbitofrontal Cortex Functioning in Frontotemporal Dementia

Christopher Kipps, Peter J. Nestor, Arnold J. Robert, J. J. Acosta-Cabronero, John Hodges, Cambridge, United Kingdom

OBJECTIVE: We aimed to test whether understanding of sarcasm in behavioural variant frontotemporal dementia could be quantified using the Test of Social Inference (TASIT), and whether atrophy within particular frontotemporal regions predicted performance. We hypothesised a disproportionate influence of medial and orbital frontal, compared with dorsolateral prefrontal and parietal brain regions, in the performance of this task. We also predicted that bvFTD patients would perform much worse on this test than age-matched controls. BACKGROUND: Degeneration of the frontal lobes is thought to play a dominant role in the genesis of the behavioural syndrome in frontotemporal dementia (bvFTD), yet the precise neural correlates remain unclear. There are also few objective clinical tests which can quantify aspects of the behavioural disturbance. DESIGN/METHODS: 21 bvFTD patients and 12 controls were tested using the TASIT. Magnetic resonance images were pre-processed using SPM5, and voxel values representing regional volumes were extracted from these images; global grey matter volume was also calculated. Multivariate analysis was used to model the differential contribution of regional atrophy to performance on the TASIT. RESULTS: Patients with FTD were particularly bad at detecting sarcastic compared to sincere statements (P<0.001). Atrophy within the lateral orbitofrontal region extending towards the inferior frontal gyrus, insula and into the temporal lobes and amygdala on the right was particularly associated this deficit (P<0.01). There was little or no contribution to sarcasm interpretation from dorsolateral or medial prefrontal cortex. In contrast, performance on the Addenbrookes Cognitive Examination, a global measure of cognitive functioning was associated with all frontal lobe regions. CONCLUSIONS/RELEVANCE: Tests of social cognition can help quantify the social deficit that is seen in patients with FTD, and here, appear to predict sub-regional atrophy within the frontal and temporal lobes. Supported by: Wellcome Trust.
Category - Behavioral Neurology
SubCategory - Neuropsychiatry/Emotion

Wednesday, April 16, 2008 4:15 PM

Scientific Sessions: Behavioral Neurology: Language and Memory (3:45 PM-5:00 PM)

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