Building on evidence for cognitive-behavioural change in people with Amyotrophic Lateral Sclerosis (ALS), the current study uses a range of neuropsychological measures to delineate the nature and scope of reported deficits in emotional processing and social cognition in people with ALS.    

Compared to the healthy control group, the ALS group was impaired on composite scores indexing executive function and performance on the emotional processing and social cognition tasks. Single-case analyses revealed that ALS patients showed heterogeneous performance across the cognitive tasks

Brown, Richard G.

Goldstein, Laura H.

Watermeyer, Tamlyn

English

Northumbria Research Link

Northumbria Research LinkCitation:  Watermeyer,  Tamlyn,  Brown,  Richard  G.  and  Goldstein,  Laura  H.  (2014)  Emotional processing  and  Social  Cognition  in  Amyotrophic  Lateral  Sclerosis.  In:  The  24th  International Symposium on Amyotrophic Lateral Sclerosis and Motor Neurone Disease, 3rd - 5th Dec 2013, Milan, Italy. URL: https://f1000research.com/posters/1095065 <https://f1000research.com/posters/1095065>This  version  was  downloaded  from  Northumbria  Research  Link: http://nrl.northumbria.ac.uk/id/eprint/43330/Northumbria University has developed Northumbria Research Link (NRL) to enable users to access the University’s research output. Copyright © and moral rights for items on NRL are retained by the individual author(s) and/or other copyright owners.  Single copies of full items can be reproduced, displayed or performed, and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided the authors, title and full bibliographic details are given, as well as a hyperlink and/or URL to the original metadata page. The content must not be changed in any way. Full items must not be sold commercially in any  format or medium without formal permission of the copyright holder.  The full policy is available online: http://nrl.northumbria.ac.uk/pol  i cies.html  This  document  may differ  from the  final,  published version of  the research  and has been made available online in accordance with publisher policies. To read and/or cite from the published version of the research, please visit the publisher’s website (a subscription may be required.)                        BACKGROUND & AIMS Amyotrophic Lateral Sclerosis (ALS) has traditionally been perceived as confined to the motor system. Deficits in emotional processing,  such as emotion recognition from faces, and social cognition, such as Theory of Mind (ToM) are reported1, implicating extra-motor areas. Previous studies have mostly relied on inanimate stimuli (static faces, cartoons, etc.) to examine these deficits. The current study adopts videoed vignettes depicting dynamic emotional expressions and social interactions, alongside traditional measures to explore if reported deficits persist in more naturalistic paradigms. References 1.Abrahams (2011). Neurodegen. Dis. Manage. 1(5), 397-405. 2. Delis et al (2000). California Verbal Learning Test: Second Edition. San Antonio, TX: Psychological Corporation. 3. Abrahams et al (2000). Verbal fluency and executive dysfunction in amyotrophic lateral sclerosis (ALS). Neuropsychologia, 38(6), 734-747. 4.Burgess & Shallice (1997).The Hayling and Brixton Tests. Bury St Edmonds, UK: Thames Valley Company. 5.McDonald et al (2004). Neuropsychological Rehabilitation,14, 285-302. 6. Baron-Cohen et al (2001). J Child Psychol. Psychiatry, 42, 241-251. 7. Happe et al (1999). Cognition, 70, 211-240.  8. Crawford et al (2011) Cortex, 47(10), 1166-1178. 9. Gibbons et al (2007) Neuropsychologia, 45(6), 1196-1207. 10. Girardi et al (2011)Neuropsychology, 25(1), 53-65. 11. Lillo et al (2012) Amyotroph Lateral Scler, 13(1), 102-109.12. Savage et al (2013) Amyotroph Lateral Scler Frontotemporal Degener Posted online doi: 10.3109/21678421.2013.809763 Tamlyn Watermeyer,  Richard Brown, Laura Goldstein  Institute of Psychiatry, King’s College London   Emotional Processing and Social Cognition in Amyotrophic Lateral Sclerosis (ALS) GLOSSARY Social cognition – an umbrella term that refers to any information processing that involves social information in the environment, including other people. Theory of Mind (ToM) – the ability to attribute thoughts and feelings to oneself and others. It is fundamental to Social Cognition.  Emotional processing – information processing that involves emotive material or stimuli, such as positive or negative words, happy or sad faces.  METHODS  Participants 55 ALS patients and 49 controls, matched for age, years of education and premorbid and current IQ.  Neuropsychological tasks  Executive function: Delis–Kaplan Executive Function System (DKEFS) card sorting task2 , Verbal Fluency Index (VFI)3, Hayling Latency & Brixton tests4  (all tasks were controlled for motor slowing).   Emotion and social tasks:  see Box A. and Figure 1.   Composite scores Separate composite scores for emotional processing and social cognition (EMOSOC) and executive function (Executive) by summing standardised scores according to theorised function. Internal consistency for these composite were satisfactory (EMOSOC: α=.83; Executive: α=.78).  Further analyses • Explore if variables such personality, mood, empathy and cognitive status contribute to any changes in emotion and social cognition in ALS patients.  • Examine if performance on executive and/or social cognition tasks as well as patients’ behaviour contribute to caregivers’ outcomes (mood, strain, burden, marital satisfaction).   Fig.1 Example of social stimuli  a b c d e Box A. Emotion and Social Cognition Tasks  The Awareness of Social Inference Test (TASIT)5 - Videoed vignettes depicting emotion and exchanges involving sincerity, sarcasm and deception. Assessment comprises an emotion recognition task (ER) and two social Interaction interpretation task; one with minimal paralinguistic information (SI-M) and one with enriched paralinguistic information (SI-E) (see figure 1. a, b)  Revised Reading the Mind in the Eyes (RME)6 - A series of faces showing only the eye-region. Participants are asked to select a word which best describes the thoughts or feelings of the character (see figure 1. c).   Happé Cartoons and Scenarios7 -  Cartoons  and scenarios  tasks comprise of two types of stimuli: ‘ToM’   stimuli require ‘picking up’ on the false beliefs or ignorance of the characters in the picture or story in order to understand the humour. ‘Physical’ stimuli require no such attributions and the humour relies on physical impossibility or causality. (see figure 1. d, e) CW30   0231 Results   Group-level: MANOVA                       Single-case analyses                     Discussion • Impaired patient performance relative to controls was found for both Executive and EMOSOC composites. Within the ALS group, single-case analyses revealed heterogeneity of cognitive performance across tasks   • The results are in keeping with previous research using the Happé task which found that ALS patients showed impaired performance on this task relative to controls9    •   The results are in contrast with other findings which have       found impaired emotion recognition in ALS patients relative      to controls10,11 corroborating the suggestion that      impairments on this domain are specific to ALS-FTD      patients12 The Bayesian single-case methods8 were used to test the null hypothesis that the patient’s score on a task is an observation from the scores in the control population. The control population is defined as controls having the same value(s) as the patient on covariate(s) of age, years of education & gender. Figure 3. shows the results of these analyses.  A between-groups MANOVA on log transformed data revealed significant differences between patients and controls on a combination of the composite scores (F[2,101]=4.68, p=.011, ηρ²=.085).   Univariate contrasts revealed that patients tended to score higher (were more impaired) for the executive composite (F[1,102]=8.6, p=.004, ηρ²=.078) and the EMOSOC composite (F[1, 102]=5.53, p=.021, ηρ²=.051) (see Figure 2).   Group membership was maximally differentiated by the executive composite (standardised b=.79) Figure 2. Between-group comparisons  on Executive and EMOSOC composites  Figure 3. ALS deficits on individual tests  Acknowledgments King’s College Hospital:  Prof. Ammar Al-Chalabi;  Prof. Chris Shaw; Dr. Cathy Ellis; Dr. Rachael Burman; Catherine Knights; Andrew Dougherty; Dr. Naomi Martin.   East Kent University Hospital: Dr. Joanna Karlsson; Christine Batts; Hazel Watts Medway Community Healthcare: Dr. David Oliver Cambridge University Hospitals:  Dr. Chris Allen; Joanna Sasson; Helen Copesy, Lucy Canovas University College London Hospitals: Dr. Katie Sidle; Jan Clarke; Dr. Robin Howard 0 10 20 30 40 50 60 ER SIM SIE Happe C1 Happe C2 Scenarios RME Brixton Hayling DKEFS sorts DKEFS description VFI-S VFI-C Percentage of ALS patients  impaired relative to controls  Individual Tasks Proportions significantly different from controls      p<.05        p<.001 Executive  EMOSOC 

Emotional processing and Social Cognition in Amyotrophic Lateral Sclerosis

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Emotional processing and Social Cognition in Amyotrophic Lateral Sclerosis

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