Jan Van den Stock

BackgroundVery-late-onset schizophrenia-like psychosis (VLOSLP) is associated with significant burden. Its clinical importance is increasing as the global population of older adults rises, yet owing to limited research in this population, the neurobiological underpinnings of VLOSP remain insufficiently clarified. Here we address this knowledge gap using novel morphometry techniques to investigate grey matter volume (GMV) differences between VLOSLP and healthy older adults, and their correlations with neuropsychological scores.MethodsIn this cross-sectional study, we investigated whole-brain GMV differences between 35 individuals with VLOSLP (mean age 76.7, 26 female) and 36 healthy controls (mean age 75.7, 27 female) using whole-brain voxel-based morphometry (VBM) and supplementary source-based morphometry (SBM) on high resolution 3D T1-weighted MRI images. Additionally, we investigated …

Clinical staging could be an actionable concept for behavioral and psychological symptoms of dementia (BPSD), providing clinicians with tools to navigate choices of treatment, acceptability of side effects and suitable care settings. This would pave the way for more research into tailored interventions that are much needed in high-stage BPSD.

Electroconvulsive therapy (ECT) is an effective treatment for late-life depression (LLD), but its exact mechanism is not fully understood. The neuroplasticity hypothesis suggests that ECT works by inducing seizures that lead to neurotrophic effects crucial for its success (

Late-life depression has been consistently associated with lower gray matter volume, the origin of which remains largely unexplained. Recent in-vivo PET findings in early-onset depression and Alzheimer’s Disease suggest that synaptic deficits contribute to the pathophysiology of these disorders and may therefore contribute to lower gray matter volume in late-life depression. Here, we investigate synaptic density in vivo for the first time in late-life depression using the synaptic vesicle glycoprotein 2A receptor radioligand 11C-UCB-J. We included 24 currently depressed adults with late-life depression (73.0 ± 6.2 years, 16 female, geriatric depression scale = 19.5 ± 6.8) and 36 age- and gender-matched healthy controls (70.4 ± 6.2 years, 21 female, geriatric depression scale = 2.7 ± 2.9) that underwent simultaneous 11C-UCB-J positron emission tomography (PET) and 3D T1- and T2-FLAIR weighted …

Over the last decades, theoretical perspectives in the interdisciplinary field of the affective sciences have proliferated rather than converged due to differing assumptions about what human affective phenomena are and how they work. These metaphysical and mechanistic assumptions, shaped by academic context and values, have dictated affective constructs and operationalizations. However, an assumption about the purpose of affective phenomena can guide us to a common set of metaphysical and mechanistic assumptions. In this capstone paper, we home in on a nested teleological principle for human affective phenomena in order to synthesize metaphysical and mechanistic assumptions. Under this framework, human affective phenomena can collectively be considered algorithms that either adjust based on the human comfort zone (affective concerns) or monitor those adaptive processes (affective features …

Understanding facial emotions is fundamental to interact in social environments and modify behavior accordingly. Neurodegenerative processes can progressively transform affective responses and affect social competence. This exploratory study examined the neurocognitive correlates of face recognition, in individuals with two mild cognitive impairment (MCI) etiologies (prodromal to dementia – MCI, or consequent to Parkinson’s disease – PD-MCI). Performance on the identification and memorization of neutral and emotional facial expressions was assessed in 31 individuals with MCI, 26 with PD-MCI, and 30 healthy controls (HC). Individuals with MCI exhibited selective impairment in recognizing faces expressing fear, along with difficulties in remembering both neutral and emotional faces. Conversely, individuals with PD-MCI showed no differences compared with the HC in either emotion recognition or memory …

ObjectivesIn psychogeriatric units for patients with dementia and behavioral problems, aggression is prevalent. Predictions and timely interventions of aggression are essential to create a safe environment and prevent adverse outcomes. Our study aimed to determine whether aggression severity early during admission to these units could be used as an indicator of adverse outcomes.DesignDuring one year, all aggressive incidents on a psychogeriatric unit were systematically recorded using the Revised Staff Observation of Aggression Scale (SOAS-R). The study investigated the link between the severity of incidents within the first 48 hours of admission and adverse outcomes.Setting and ParticipantsAll patients included in the study were admitted to a psychogeriatric unit for dementia and behavioral problems between November 2020 and October 2021.MethodsThe study population was categorized into groups …

BackgroundLate life depression has been consistently associated with lower grey matter volume, the cause of which remains largely unexplained. We hypothesized that lower grey matter volume would be linked to synaptic deficits due to pathological brain ageing. Here, we investigate synaptic density for the first time in vivo in late life depression using the synaptic vesicle 2A receptor radioligand 11C-UCB-J.MethodsWe included 24 depressed individuals (age 73.0±6.2, 16 female, Geriatric Depression Scale: 19.5±6.9) and 36 healthy controls (age 70.4±6.2, 21 female, Geriatric Depression Scale: 2.8±3.9). Participants underwent 11C-UCB-J PET and 3D T1 MR imaging on a 3T Signa PET-MR scanner. Standardized uptake value ratios were calculated relative to the centrum semiovale for following regions (CAT12) after partial volume correction: hippocampus, mesial temporal, lateral temporal, prefrontal, anterior …

Objective To investigate whether mild motor signs (MMS) in old age correlate with synaptic density in the brain. Background Normal aging is associated with a decline in movement quality and quantity, commonly termed “mild parkinsonian signs” or more recently MMS. Whether MMS stem from global brain aging or pathology within motor circuits remains unresolved. The synaptic vesicle glycoprotein 2A positron emission tomography (PET) ligand 11C‐UCB‐J allows the investigation of brain‐motor associations at the synaptic level in vivo. Method Fifty‐eight healthy older adults (≥50 years) were included from two monocentric control cohorts. Brain magnetic resonance imaging and 11C‐UCB‐J PET data were available in 54 participants. 11C‐UCB‐J PET binding was quantified by standardized uptake value ratio (SUVR) values in grey matter (GM) volumes of interest (VOIs): caudate, putamen, globus pallidus …

The social brain hypothesis posits that a disproportionate encephalization in primates enabled to adapt behavior to a social context. Also, it has been proposed that phylogenetically recent brain areas are disproportionally affected by neurodegeneration. Using structural and functional magnetic resonance imaging, the present study investigates brain–behavior associations and neural integrity of hyperspecialized and domain-general cortical social brain areas in behavioral variant frontotemporal dementia (bvFTD). The results revealed that both structure and function of hyperspecialized social areas in the middle portion of the superior temporal sulcus (STS) are compromised in bvFTD, while no deterioration was observed in domain general social areas in the posterior STS. While the structural findings adhered to an anterior–posterior gradient, the functional group differences only occurred in the …

The ImageNet-1k dataset has been a major contributor to the development of novel CNN-based image classification architectures over the past 10 years. This has led to the advent of a number of models, pre-trained on this dataset, that form a popular basis for creating custom image classifiers by means of transfer learning. A corollary of this process is that whatever weaknesses and biases the original model possesses, the derived model will also have. Some of these have already been extensively covered, but color sensitivity has so far been understudied. This paper explores the prediction stability of several popular CNN architectures when input images are subjected to hue or saturation shifts. We show that even small shifts in image hue can alter a model’s initial prediction, with larger shifts introducing changes up to 60% and 40% of the time for AlexNet and VGG16 respectively. For all models considered …

Deficits in social cognition may be present in frontotemporal dementia (FTD) and Alzheimer’s disease (AD). Here, we conduct a qualitative synthesis and meta-analysis of facial expression recognition studies in which we compare the deficits between both disorders. Furthermore, we investigate the specificity of the deficit regarding phenotypic variant, domain-specificity, emotion category, task modality, and geographical region. The results reveal that both FTD and AD are associated with facial expression recognition deficits, that this deficit is more pronounced in FTD compared to AD and that this applies for the behavioral as well as for language FTD-variants, with no difference between the latter two. In both disorders, overall emotion recognition was most frequently impaired, followed by recognition of anger in FTD and by fear in AD. Verbal categorization was the most frequently used task, although matching or …

BackgroundIt has been argued that symptom onset in neurodegeneration reflects the overload of compensatory mechanisms. The present study aimed to investigate whether neural functional compensation can be observed in the manifest neurodegenerative disease stage, by focusing on a core deficit in frontotemporal dementia, i.e. social cognition, and by combining psychophysical assessment, structural MRI and functional MRI with multidimensional neural markers that allow quantification of neural computations.MethodsNineteen patients with clinically manifest behavioral variant frontotemporal dementia (bvFTD) and 20 controls performed facial expression recognition tasks in the MRI-scanner and offline. Group differences in grey matter volume, neural response amplitude and neural patterns were assessed via a combination of voxel-wise whole-brain, searchlight, and ROI-analyses and these measures were …

Artificiële Intelligentie (AI) evolueerde enorm tijdens het voorbije decennium en kent steeds meer toepassingsgebieden, inclusief psychiatrie. AI omvat verschillende modaliteiten, waaronder Artificiële Neurale Netwerken (ANNs), verwijzend naar computermodellen die gebaseerd zijn op de werking van het brein. Hoewel ANNs sinds de jaren'50 beschreven zijn, werden ze pas" mainstream" sinds een tiental jaren. Momenteel worden ANNs als een van de meest efficiënte en bruikbare AI modaliteiten beschouwd. Het feit dat ANNs inspiratie halen uit de werking van het brein doet de vraag rijzen of ze gebruikt kunnen worden om het (dys) functioneren van het brein en bijgevolg cognitie en gedrag te simuleren. Deze vraag heeft geleid tot de opkomst van het domein" Computationele Psychiatrie".

Study Objectives Sleep disturbances are common in people with Alzheimer’s disease (AD), and a reduction in slow-wave activity is the most striking underlying change. Acoustic stimulation has emerged as a promising approach to enhance slow-wave activity in healthy adults and people with amnestic mild cognitive impairment. In this phase 1 study we investigated, for the first time, the feasibility of acoustic stimulation in AD and piloted the effect on slow-wave sleep (SWS). Methods Eleven adults with mild to moderate AD first wore the DREEM 2 headband for 2 nights to establish a baseline registration. Using machine learning, the DREEM 2 headband automatically scores sleep stages in real time. Subsequently, the participants wore the headband for 14 consecutive “stimulation nights” at home. During these nights, the device applied phase-locked acoustic stimulation of 40-dB pink noise delivered over 2 bone …

Social cognitive symptoms characterize multiple neurological disorders, including brain tumours and neurodegeneration. Recently, Campanella and colleagues 1 investigated deficits in cognitive and affective theory of mind (TOM) in 105 tumour patients using a non-verbal task of 18 stimuli that required patients to select one out of three possible endings of a cartoon story, ie the Story-based Empathy Task (SET). 2 The SET includes three conditions [Causal Inference (CI), Intention Attribution (IA) and Emotion Attribution (EA)], reflecting the type of inference the items tap into: inference of physical properties, intentions, or characters’ emotional state, respectively. The behavioural results of Campanella’s study revealed specific EA deficits in patients with temporal lobe tumours. Furthermore, the authors used parcel-based lesion-symptom mapping (PLSM) and reported an association between a right anterior temporal …

Achtergrond Artificiële intelligentie (AI) evolueerde enorm het voorbije decennium en kent steeds meer toepassingsgebieden, ook in de psychiatrie. AI omvat verschillende modaliteiten, waaronder artificiële neurale netwerken (ANN’s), verwijzend naar computermodellen die gebaseerd zijn op de werking van het brein. Hoewel ANN’s sinds de jaren 50 beschreven zijn, werden ze pas ‘mainstream’sinds een tiental jaren. Het feit dat ANN’s inspiratie halen uit de werking van het brein doet de vraag rijzen of ze gebruikt kunnen worden om het (dis) functioneren van het brein te simuleren. Deze vraag heeft geleid tot de opkomst van het domein ‘computationele psychiatrie’.

Dodich and colleagues recently reviewed the evidence supporting clinical use of social cognition assessment in behavioral variant frontotemporal dementia (Dodich et al., ). Here, we comment on their methods and present an initiative to address some of the limitations that emerged from their study. In particular, we established the social cognition workgroup within the Neuropsychiatric International Consortium Frontotemporal dementia (scNIC-FTD), aiming to validate social cognition assessment for diagnostic purposes and tracking of change across clinical situations.

Amyloid positron emission tomography (PET) and hippocampal volume derived from magnetic resonance imaging may be useful clinical biomarkers for differentiating between geriatric depression and Alzheimer's disease (AD). Here we investigated the incremental value of using hippocampal volume and 18F-flutemetmol amyloid PET measures in tandem and sequentially to improve discrimination in unclassified participants. Two approaches were compared in 41 participants with geriatric depression and 27 participants with probable AD: (1) amyloid and hippocampal volume combined in one model and (2) classification based on hippocampal volume first and then subsequent stratification using standardized uptake value ratio (SUVR)-determined amyloid positivity. Hippocampal volume and amyloid SUVR were significant diagnostic predictors of depression (sensitivity: 95%, specificity: 89%). 51% of participants …

Prosopagnosia or loss of face perception and recognition is still poorly understood and rare single cases of acquired prosopagnosia can provide a unique window on the behavioural and brain basis of normal face perception. The present study of a new case of acquired prosopagnosia with bilateral occipito-temporal lesions but a structurally intact FFA and OFA investigated whether the lesion overlapped with the face network and whether the structurally intact FFA showed a face selective response. We also investigated the behavioral correlates of the neural findings and assessed configural processing in the context of facial and non-facial identity recognition, expression recognition and memory, also focusing on the face-selectivity of each specific deficit. The findings reveal a face-selective response in the FFA, despite lesions in the face perception network. At the behavioural level, the results showed …

Bewertung der sozialen Kognition bei leichter neurokognitiver Störung: eine gemeinsame Arbeit des internationalen SIGNATURE-Konsortiums IRIS IRIS Home Sfoglia Macrotipologie & tipologie Autore Titolo Riviste Serie IT Italiano Italiano English English LOGIN 1.IRIS 2.Catalogo Ricerca 3.4 Contributo in Atti di Convegno (Proceeding) 4.4.3 Poster Bewertung der sozialen Kognition bei leichter neurokognitiver Störung: eine gemeinsame Arbeit des internationalen SIGNATURE-Konsortiums Andrea Panzavolta; Chiara Cerami; 2022-01-01 Scheda breve Scheda completa Scheda completa (DC) Anno 2022 Appare nelle tipologie: 4.3 Poster File in questo prodotto: Non ci sono file associati a questo prodotto. I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione. Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12076/…

Background and Objectives Agitation, a critical behavioral and psychological symptom in dementia, has a profound impact on a patients’ quality of life as well as their caregivers’. Autonomous and objective characterization of agitation with multimodal systems has the potential to capture key patient responses or agitation triggers. Research Design and Methods In this article, we describe our multimodal system design that encompasses contextual parameters, physiological parameters, and psychological parameters. This design is the first to include all three of these facets in an n > 1 study. Using a combination of fixed and wearable sensors and a custom-made app for psychological annotation, we aim to identify physiological markers and contextual triggers of agitation. Results A discussion of both the clinical as well as the technical implementation of the to …

Background: Widespread gray matter volume (GMV) increase associated with electroconvulsive therapy (ECT) has been widely reported [1-5] and is considered a robust phenomenon. It has been suggested that the reported GMV increase is an indirect manifestation of neuroplasticity [3], which could explain the antidepressant effect of ECT. Most studies report a short-term volume increase in the first days and weeks after ECT [1-3], with a limited number of studies also reporting a subsequent decrease in GMV in the months following the increase [4, 5]. This increase-and-decrease pattern of GMV has not been investigated to the same extent as the initial increase phase, likely due to a large drop-out ratio at the third imaging time-point and the limited number of studies that have included longitudinal follow up, which limits the power to conduct statistical analyses. A larger sample is needed to confirm the reliability of …

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The clinical phenotype of behavioural variant frontotemporal dementia (bvFTD) is characterised by neuropsychiatric symptoms, including loss of empathy, compulsive behaviour, behavioural disinhibition and apathy. An expansion of a hexanucleotide (GGGGCC) repeat in the chromosome 9 open reading frame 72 gene (c9orf72RE) is the most common genetic cause of bvFTD. Neurobiological and behavioural changes have been evidenced in carriers of c9orf72RE, decades before the estimated onset of symptoms. Recently, Gossink and colleagues investigated the hypothesis that the c9orf72RE genotype phenotypically could encompass a neuropsychiatric hypervulnerability, emerging during early childhood. They used clinical case-record data and performed semistructured biographical interviews with spouses, first-degree relatives and patients with bvFTD with (N= 20) and without (N= 23) c9orf72RE. The …

Mnemonic enhanced memory has been observed for negative events. Here, we investigate its association with spatiotemporal attention, consolidation, and age. An ingenious method to study visual attention for emotional stimuli is eye tracking. Twenty young adults and twenty-one older adults encoded stimuli depicting neutral faces, angry faces, and houses while eye movements were recorded. The encoding phase was followed by an immediate and delayed (48 h) recognition assessment. Linear mixed model analyses of recognition performance with group, emotion, and their interaction as fixed effects revealed increased performance for angry compared to neutral faces in the young adults group only. Furthermore, young adults showed enhanced memory for angry faces compared to older adults. This effect was associated with a shorter fixation duration for angry faces compared to neutral faces in the older adults group. Furthermore, the results revealed that total fixation duration was a strong predictor for face memory performance.

Facial expressions are important for nonverbal communication and can display personal emotions and indicate an individual's intention within a social situation. The expression of emotion is known to enhance retention of facial identity. Relative little is known about the underlying neuropsychology and the link between emotional and social memory, an interaction known to be of pivotal importance for an individual's social interactions. The human brain has been found to possess multiple neuronal networks involved in managing the complex process of social interaction. This doctoral thesis includes a literature study and five research studies that are conducted in order to investigate the neural basis of social cognition. The first objective was to provide a better understanding of both facial and emotion recognition in subjects with different neurodegenerative disorders. The second objective was to explore the neural substrate of social and emotional memory. The third objective was to investigate the link between neurobiology and personality (brain-trait association). In addition, the role of the amygdala as possible key structure relevant for social cognition was studied and discussed. Chapter one is dedicated to a general introduction. In chapter two, the results are discussed of a systematic literature review to obtain a comprehensive overview of the current knowledge and the impact of neurodegeneration in the form of Frontotemporal Dementia (FTD) and Alzheimer's disease (AD) on facial expression recognition and the differential impact of FTD versus AD. The qualitative syntheses revealed that in both FTD and AD overall emotion recognition was …

Affective experience colours everyday perception and cognition, yet its fundamental and neurobiological basis is poorly understood. The current debate essentially centers around the communalities and specificities across individuals, events, and emotional categories like anger, sadness, and happiness. Using fMRI during the experience of these emotions, we critically compare the two dominant conflicting theories on human affect. Basic emotion theory posits emotions as discrete universal entities generated by dedicated emotion category-specific neural circuits, while psychological construction theory claims emotional events as unique, idiosyncratic, and constructed by psychological primitives like core affect and conceptualization, which underlie each emotional event and operate in a predictive framework. Based on the findings of 8 a priori-defined model-specific prediction tests on the neural response …

Dear Sir. The contribution of gray matter volume increase to the antidepressant effect of electroconvulsive therapy (ECT) is currently an area of debate in the field. In a recent Letter to the Editor of the Journal of ECT, Takamiya and colleagues1 report replication of findings from an earlier study2 in Molecular Psychiatry which reported a negative correlation between volume change in the right dentate gyrus (DG) of the hippocampus and change in Hamilton Depression Rating Scale (HAM-D) scores in ECT using the repeated measures correlation (rmcorr). 3 Interestingly, this finding—a statistically significant negative correlation between HAM-D score and the right DG volume—was not detected using simple linear correlation between difference scores in a pre-ECT post-ECT design, but only emerged when the original data were reanalyzed using rmcorr. 3 Based on these results, the authors conclude that rmcorr …

Late-life depression (LLD) is associated with a risk of developing Alzheimer’s disease (AD). However, the role of AD-pathophysiology in LLD, and its association with clinical symptoms and cognitive function are elusive. In this study, one hundred subjects underwent amyloid positron emission tomography (PET) imaging with [18F]-flutemetamol and structural MRI: 48 severely depressed elderly subjects (age 74.1 ± 7.5 years, 33 female) and 52 age-/gender-matched healthy controls (72.4 ± 6.4 years, 37 female). The Geriatric Depression Scale (GDS) and Rey Auditory Verbal Learning Test (RAVLT) were used to assess the severity of depressive symptoms and episodic memory function respectively. Amyloid deposition was quantified using the standardized uptake value ratio. Whole-brain voxel-wise comparisons of amyloid deposition and gray matter volume (GMV) between LLD and controls were performed …

We first investigated the specificity of the emotional conflict index in the FTD sample and calculated the correlation with disease duration, executive processing speed as measured with the Trail Making Test part B and with the reaction time of the only other moral condition containing a direct active involvement of the agent (ie personal dilemmas), yet with only a slightly instead of a highly aversive emotional act, ie the low-conflict moral dilemmas. None of these analyses revealed a significant result (all q’s< 0.518; all P’s> 0.102), indicating it does not largely reflect overall disease progression, nor a domaingeneral executive or personal moral effect. Furthermore, while there was no significant difference between the control (N¼19) and FTD (N¼12) group on this measure (U¼165, P ¼ 0.117), it was significantly increased compared to the low-conflict equivalent in the FTD sample (W¼ 11, P ¼ 0.016; Fig. 1A), as …

BackgroundElectroconvulsive therapy (ECT) applies electric currents to the brain to induce seizures for therapeutic purposes. ECT increases gray matter (GM) volume, predominantly in the medial temporal lobe (MTL). The contribution of induced seizures to this volume change remains unclear.MethodsT1-weighted structural MRI was acquired from thirty patients with late-life depression (mean age 72.5 ± 7.9 years, 19 female), before and one week after one course of right unilateral ECT. Whole brain voxel-/deformation-/surface-based morphometry analyses were conducted to identify tissue-specific (GM, white matter: WM), and cerebrospinal fluid (CSF) and cerebral morphometry changes following ECT. Whole-brain voxel-wise electric field (EF) strength was estimated to investigate the association of EF distribution and regional brain volume change. The association between percentage volume change in the right …

Repetition suppression (RS) reflects a neural attenuation during repeated stimulation. We used fMRI and the subsequent memory paradigm to test the predictive coding hypothesis for RS during visual memory processing by investigating the interaction between RS and differences due to memory in category-selective cortex (FFA, pSTS, PPA, and RSC). Fifty-six participants encoded face and house stimuli twice, followed by an immediate and delayed (48 h) recognition memory assessment. Linear Mixed Model analyses with repetition, subsequent recognition performance, and their interaction as fixed effects revealed that absolute RS during encoding interacts with probability of future remembrance in face-selective cortex. This effect was not observed for relative RS, i.e. when controlled for adapter-response. The findings also reveal an association between adapter response and RS, both for short and long term …

Psychomotor dysfunction (PMD) is a core element and key contributor to disability in late life depression (LLD), which responds well to electroconvulsive therapy (ECT). The neurobiology of PMD and its response to ECT are not well understood. We hypothesized that PMD in LLD is associated with lower striatal volume, and that striatal volume increase following ECT explains PMD improvement. We analyzed data from a two-center prospective cohort study of 110 LLD subjects (>55 years) receiving ECT. Brain MRI and assessment of mood, cognition, and PMD was performed 1 week before, 1 week after, and 6 months after ECT. Volumetry of the caudate nucleus, putamen, globus pallidus, and nucleus accumbens was derived from automatically segmented brain MRIs using Freesurfer®. Linear multiple regression analyses were used to study associations between basal ganglia volume and PMD. Brain MRI was …

Background Major depressive disorders rank in the top ten causes of ill health in all but four countries worldwide and are the leading cause of years lived with disability in Europe (WHO). Recent research suggests that neurodegenerative pathology may contribute to the development of late-life depression (LLD) in a sub-group of patients and represent a target for prevention and early diagnosis. In parallel, electroconvulsive therapy (ECT), which is the most effective treatment for severe LLD, has been associated with significant brain structural changes. In both LLD and ECT hippocampal volume change plays a central role; however, the neurobiological mechanism underlying it and its relevance for clinical outcomes remain unresolved. Methods This is a monocentric, clinical cohort study with a cross-sectional arm evaluating PET-MR imaging and …

To the Editor: Refractory epilepsy is a condition where patients continue to have seizures despite adequate trials of 2 antiepileptic drugs (AEDs), alone or in combination. It occurs in 30% to 40% of patients with epilepsy leading to a poor quality of life, increasing the health care burden. 1 Psychosis is a common comorbidity in epilepsy with a prevalence of 5.6%. 2 It can occur independently or may be inversely related to the seizure episodes by forced normalization (alternating psychosis). The later can present in the ictal, postictal, or interictal state, which can cause diagnostic and therapeutic dilemma. 3 Here, we report a case of refractory epilepsy with intermittent psychotic behavior, which was atypical in its presentation, leading to difficulty in its diagnosis and subsequent management. There are anecdotal reports of electroconvulsive therapy (ECT) being effective in treatment-resistant epilepsy and status epilepticus …

A recent article in this journal by Cohen et al., 1 ‘Looking beyond the face area: lesion network mapping of prosopagnosia’, concluded that prosopagnosia was caused not only by lesions to core face processing areas—such as the face fusiform area (FFA)—but also observed when other nodes within a distributed brain network were damaged. They sought to identify these nodes using ‘lesion network mapping’, which indirectly estimates functional connections that would be ‘lost’due to localized brain lesions. The locations of lesions were used as seeds for resting state functional connectivity analysis with data from healthy participants. Cohen et al. 1 report that in 44 cases with acquired prosopagnosia, all the lesion locations outside the right FFA were functionally connected in healthy controls to this region and were also functionally connected (albeit through negative correlation) with regions in the left frontal cortex …

Reports an error in" Recommendations to distinguish behavioural variant frontotemporal dementia from psychiatric disorders" by Simon Ducharme, Annemiek Dols, Robert Laforce, Emma Devenney, Fiona Kumfor, Jan van den Stock, Caroline Dallaire-Théroux, Harro Seelaar, Flora Gossink, Everard Vijverberg, Edward Huey, Mathieu Vandenbulcke, Mario Masellis, Calvin Trieu, Chiadi Onyike, Paulo Caramelli, Leonardo Cruz de Souza, Alexander Santillo, Maria Landqvist Waldö, Ramon Landin-Romero, Olivier Piguet, Wendy Kelso, Dhamidhu Eratne, Dennis Velakoulis, Manabu Ikeda, David Perry, Peter Pressman, Bradley Boeve, Rik Vandenberghe, Mario Mendez, Carole Azuar, Richard Levy, Isabelle Le Ber, Sandra Baez, Alan Lerner, Ratnavalli Ellajosyula, Florence Pasquier, Daniela Galimberti, Elio Scarpini, John van Swieten, Michael Hornberger, Howard Rosen, John Hodges, Janine Diehl-Schmid and …

In a considerable amount of individuals the onset of psychosis is delayed until later in life, even after the age of 60 years. This condition is referred to as very-late-onset schizophrenia-like psychosis (VLOSLP) and it is characterized by paranoid or partition delusions, as well as multimodal hallucinations (Howard et al., 2000). Although a delayed manifestation of psychotic symptoms appears counterintuitive, the life-cycle model of stress provides a well-established theoretical framework to understand associations between early adversity and late-onset psychopathology, suggesting that severe childhood distress causes the hyperactivation and sensitization of the hypothalamus-pituitary-adrenal (HPA) axis stimulating the production of glucocorticoids that exert lasting harmful effects on brain structures regulating stress such as the hippocampus, and hence leading to a lifelong increased vulnerability to the development of psychopathology (Lupien et al., 2009).

The authors apologize for misspelling the last name of the author Ratnavalli Ellajosyula. This has now been corrected.

Due to their ability to capture attention, emotional stimuli tend to benefit from enhanced perceptual processing, which can be helpful when such stimuli are task-relevant but hindering when they are task-irrelevant. Altered emotion-attention interactions have been associated with symptoms of affective disturbances, and emerging research focuses on improving emotion-attention interactions to prevent or treat affective disorders. In line with the Human Affectome Project’s emphasis on linguistic components, we also analyzed the language used to describe attention-related aspects of emotion, and highlighted terms related to domains such as conscious awareness, motivational effects of attention, social attention, and emotion regulation. These terms were discussed within a broader review of available evidence regarding the neural correlates of (1) Emotion-Attention Interactions in Perception, (2) Emotion-Attention …

The behavioural variant of frontotemporal dementia (bvFTD) is a frequent cause of early-onset dementia. The diagnosis of bvFTD remains challenging because of the limited accuracy of neuroimaging in the early disease stages and the absence of molecular biomarkers, and therefore relies predominantly on clinical assessment. BvFTD shows significant symptomatic overlap with non-degenerative primary psychiatric disorders including major depressive disorder, bipolar disorder, schizophrenia, obsessive-compulsive disorder, autism spectrum disorders and even personality disorders. To date, ∼50% of patients with bvFTD receive a prior psychiatric diagnosis, and average diagnostic delay is up to 5–6 years from symptom onset. It is also not uncommon for patients with primary psychiatric disorders to be wrongly diagnosed with bvFTD. The Neuropsychiatric International Consortium for Frontotemporal …

Background Depression is associated with a risk of developing dementia and is hypothesized to enhance (pathological) brain aging. Previously we reported that amyloid burden in late‐life depression (LLD) did not differ from healthy controls in cortical regions typically associated with Alzheimer’s disease (AD) [1]. Here we extend our analysis beyond hippocampal volume and AD‐specific volumes‐of‐interest, to the whole brain. Method Forty‐eight individuals with LLD (age 74.1±7.5 years, 33 female) and 52 healthy controls (72.4±6.4 years, 37 female) underwent static amyloid PET imaging with [18]F‐flutemetamol and 3D T1‐weighted structural MRI. Amyloid deposition was quantified using the standardized uptake value ratio (SUVR) relative to the cerebellar grey matter (GM). Whole‐brain voxel‐wise comparisons of amyloid PET SUVR and GM volume (GMV) between LLD and controls were performed using …

Sir, We read the study by Marshall et al.(2019) entitled:‘The functional neuroanatomy of emotion processing in frontotemporal dementias’ with great interest. They used taskbased functional MRI to investigate the neurofunctional basis of facial expression perception in behavioural variant FTD (bvFTD). The results revealed a cross-patient correlation between behavioural emotion recognition performance and brain activation during perception of facial expressions (versus abstract mosaic stimuli) in the left caudate nucleus and anterior insula, both key regions in bvFTD progression and symptomatology (Zhou and Seeley, 2014; Landin-Romero et al., 2017; Van den Stock and Kumfor, 2019). Here, we replicate and extend their findings in an independent dataset. Despite the advantages of task-based functional MRI, its application in neurodegenerative syndromes has been limited (Dickerson et al., 2016) and based on …

The human amygdala is considered a key region for successful emotion recognition. We recently reported that temporal lobe surgery (TLS), including resection of the amygdala, does not affect emotion recognition performance (Journal of Neuroscience, 2018, 38, 9263). In the present study, we investigate the neural basis of this preserved function at the network level. We use generalized psychophysiological interaction and graph theory indices to investigate network level characteristics of the emotion recognition network in TLS patients and healthy controls. Based on conflicting emotion processing theories, we anticipated two possible outcomes: a substantial increase of the non‐amygdalar connections of the emotion recognition network to compensate functionally for the loss of the amygdala, in line with basic emotion theory versus only minor changes in network level properties as predicted by psychological …

ImportanceDuring a time with the potential for novel treatment strategies, early detection of disease manifestations at an individual level in presymptomatic carriers of a hexanucleotide repeat expansion in theC9orf72gene (preSxC9) is becoming increasingly relevant.ObjectivesTo evaluate changes in glucose metabolism before symptom onset of amyotrophic lateral sclerosis or frontotemporal dementia in preSxC9 using simultaneous fluorine 18–labeled fluorodeoxyglucose ([18F]FDG positron emission tomographic (PET) and magnetic resonance imaging as well as the mutation’s association with clinical and fluid biomarkers.Design, Setting, and ParticipantsA prospective, case-control study enrolled 46 participants from November 30, 2015, until December 11, 2018. The study was conducted at the neuromuscular reference center of the University Hospitals Leuven, Leuven, Belgium.Main Outcomes and Measures …

BackgroundFrontotemporal dementia is a heterogenous neurodegenerative disorder, with about a third of cases being genetic. Most of this genetic component is accounted for by mutations in GRN, MAPT, and C9orf72. In this study, we aimed to complement previous phenotypic studies by doing an international study of age at symptom onset, age at death, and disease duration in individuals with mutations in GRN, MAPT, and C9orf72.MethodsIn this international, retrospective cohort study, we collected data on age at symptom onset, age at death, and disease duration for patients with pathogenic mutations in the GRN and MAPT genes and pathological expansions in the C9orf72 gene through the Frontotemporal Dementia Prevention Initiative and from published papers. We used mixed effects models to explore differences in age at onset, age at death, and disease duration between genetic groups and individual …