OBJECTIVE Impaired empathy is a diagnostic feature of behavioral variant frontotemporal dementia (bvFTD), but it is not clear whether it is caused by a primary impairment in empathy or by general emotional blunting. METHODS Patients with bvFTD who met criteria for loss of empathy (N=10) and patients with Alzheimer's disease (N=15) were assessed with a measure for empathy (Socioemotional Dysfunction Scale [SDS]) and a measure for general emotion (Scale for Emotional Blunting [SEB]). All patients underwent neuroimaging. Both patient groups and a healthy control group (N=18) were evaluated by using autonomic responses (skin conductance responses [SCR]) to pictures from the Internal Affective Picture System (IAPS) (presence or absence of empathy stimuli and high versus low emotion). RESULTS All participants reported understanding the content and others' perspectives on the empathy pictures; however, only patients with bvFTD showed impaired empathic behavior on the SDS, which persisted after adjusting for measures from the emotion scale (SEB). Patients with bvFTD had significantly lower SCR for all the IAPS stimuli, including for empathy pictures, which also persisted after adjusting for emotional content. On MRI analysis, SCR across groups significantly correlated with the volume of the dorsal anterior cingulate gyrus (dACC). CONCLUSIONS These results indicate that patients with bvFTD have decreased empathic behavior with or without emotional blunting, and they exhibit decreased psychophysiological responses to empathy stimuli, independent of general emotion. These preliminary findings suggest a specific impairment in emotional empathy, possibly related to impairment of the emotional appraisal role of the dACC.

中文翻译：

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额颞叶痴呆中的同理心受损与一般情绪低落。

目标移情障碍是行为变异性额颞叶痴呆 (bvFTD) 的诊断特征，但尚不清楚它是由原发性移情障碍还是由一般情绪迟钝引起的。方情绪迟钝 [SEB])。所有患者均接受了神经影像学检查。患者组和健康对照组 (N=18) 均通过对来自内部情感图像系统 (IAPS) 的图像的自主反应（皮肤电导反应 [SCR]）进行评估（是否存在移情刺激以及高低情绪） ）。结果 所有参与者都报告理解了移情图片的内容和其他人的观点；然而，只有 bvFTD 患者在 SDS 上表现出共情行为受损，在调整情绪量表 (SEB) 的测量后仍然存在。bvFTD 患者对所有 IAPS 刺激（包括移情图片）的 SCR 显着降低，在调整情绪内容后也持续存在。在 MRI 分析中，各组之间的 SCR 与背侧前扣带回 (dACC) 的体积显着相关。结论 这些结果表明，bvFTD 患者的移情行为降低，有或没有情绪迟钝，他们表现出对移情刺激的心理生理反应降低，与一般情绪无关。