Emotional reactivity and emotion recognition in frontotemporal lobar degeneration

Background: Frontotemporal lobar degeneration (FTLD) is associated with a profound de- cline in social and emotional behavior; however, current understanding regarding the specific aspects of emotional functioning that are preserved and disrupted is limited. Objective: To assess preservation of function and deficits in two aspects of emotional processing (emotional reactivity and emotion recognition) in FTLD. Methods: Twenty-eight FTLD patients were compared with 16 controls in emo- tional reactivity (self-reported emotional experience, emotional facial behavior, and autonomic ner- vous system response to film stimuli) and emotion recognition (ability to identify a target emotion of fear, happy, or sad experienced by film characters). Additionally, the neural correlates of emotional reactivity and emotion recognition were investigated. Results: FTLD patients were comparable to con- trols in 1) emotional reactivity to the fear, happy, and sad film clips and 2) emotion recognition for the happy film clip. However, FTLD patients were significantly impaired compared with controls in emotion recognition for the fear and sad film clips. Volumetric analyses revealed that deficits in emo- tion recognition were associated with decreased lobar volumes in the frontal and temporal lobes. Conclusions: The socioemotional decline typically seen in frontotemporal lobar degeneration patients may result more from an inability to process certain emotions in other people than from deficits in emotional reactivity. NEUROLOGY 2007;69:148-155