Mini social cognition and emotional assessment: Diagnostic performance and neural correlates in behavioural-variant frontotemporal dementia

Abstract

We aimed at validating the Mini Social Cognition and Emotional Assessment (Mini-SEA) in a German cohort of mildly impaired behavioural-variant frontotemporal dementia (bvFTD) patients and healthy controls. The Mini-SEA comprises the Facial Emotion Recognition Test (FERT) and the Faux Pas Test (FPT) measuring Theory of Mind (ToM) abilities in social norm-related real-life stories. We examined the diagnostic performance of the Mini-SEA alongside other neuropsychological assessments and investigated its structural neural correlates. We included 32 bvFTD patients and 54 controls in logistic regression models with forward-stepwise selection containing demographics, standard neuropsychological battery (CERAD-NAB+) and the Mini-SEA scores to identify the most relevant variables. Demographic, neuropsychological and daily-life activity associations were explored. Voxel-based morphometry analysis was conducted in a subsample (14 bvFTD and 14 controls) on regions previously linked to emotion processing and ToM functions. The Mini-SEA yielded a very good performance, being in the best-fitting model with a high odds ratio alongside the executive-language and memory measures. Specifically, the FERT indicated the strongest effect in the group differentiation. Mini-SEA showed significant associations with executive-language tests and daily-life activities. In canonical emotion processing brain regions, we found associations of the Mini-SEA composite and the FERT with grey matter volumes in the left insula and lentiform nucleus of putamen. Within ToM regions, associations were found for the Mini-SEA composite and the FPT in cerebellar regions. The German Mini-SEA discriminates well between mildly impaired bvFTD patients and controls. We also demonstrated its significant value for neuropsychological assessment and neuro-behavioural associations in regions underlying emotion processing and ToM.