Although ageing is naturally associated with cognitive decline, some lifestyle factors, such as formal education and occupational complexity, were shown to promote the preservation of cognitive functions such as memory. Genetic factors, such as the Complement Receptor 1 (CR1) gene, were also identified to have an impact on cognition. This cross-sectional study aimed to assess the associations of education, occupational complexity, and CR1 polymorphisms (rs6656401) with cognitive functions in a sample of autonomous, healthy older adults. A final sample of 102 participants was tested for executive functions, episodic memory, non-verbal memory, and reaction speed, while the final sample for the genetic assessment was 48. The mPACC scores were calculated in order to classify the participants into standard or High-Performing Older Adults. The lifelong occupations were classified according to the International Standard Classification of Occupations-08 criteria. The results revealed that education was more strongly associated with cognitive performance than occupational complexity. However, occupational complexity was independently associated with mental state among the highest education group. Furthermore, normative scores for older adults over 75 are provided. The CR1 AG/AA genotypes were associated with poorer memory performance among older participants, although these exploratory findings should be interpreted with caution due to the limited genetic sample size. The findings are consistent with the hypothesis that both education and occupation are associated with higher cognitive performance in older adults. The findings also suggest distinct cognitive effects of CR1 polymorphisms regarding ageing, although these results should be considered hypothesis-generating rather than confirmatory.
Perseveration (PE) and learned irrelevance (LI) are two distinct processes that shape attentional set-shifting in Parkinson's disease (PD). Whether LI and PE are dopamine-dependent remains unclear. We investigated whether PE and LI may be dissociated in early PD and whether these switch conditions are associated with an individual motor response to levodopa. Fifty patients with early idiopathic PD (Hoehn-Yahr I-II) were assessed OFF and ON levodopa in a counterbalanced crossover design, and 50 age- and sex-matched controls completed the same computerized LI/PE explicit-rule task twice. Log-transformed reaction time (RT) and accuracy were modelled using linear mixed effect models adjusted for global cognition, verbal fluency, and executive function, with within-PD models additionally testing period-adjusted. We also explored the addition of patients' motor response OFF versus ON levodopa, quantified as change in UPDRS-III, as a moderator variable. Overall, LI incurred the largest RT cost in both PD and controls, whereas PE was tied to a smaller but reliable cost. Levodopa status did not affect switching costs at the PD group level, whereas OFF medication patients did not differ from controls after adjustment for cognitive covariates. In exploratory analyses, a larger motor response to levodopa was associated with greater overall ON-state slowing (PE, p = .031; LI, p = .027). However, the effect size was small and only partly robust in sensitivity analyses, which requires further validation. Taken together, in early, cognitively preserved PD, PE and LI are characterized with partly separable behavioural profiles, though on average, levodopa did not alter switching costs. Individual motor improvement after dopaminergic treatment may be linked to shifting performance variability, but this requires further study and clarification.
Network psychometrics has emerged as a promising framework for modelling the structure of neuropsychological data, offering a complementary perspective to traditional latent variable approaches or single test approaches. In neuropsychology, test performance is rarely interpreted in isolation, but rather as reflecting interacting cognitive processes. Network models provide a formal framework to represent these interdependencies by estimating conditional associations among observed variables. The present article provides a comprehensive tutorial on the estimation and interpretation of psychometric networks in neuropsychology. First, we offer a step-by-step guide to estimating a cross-sectional Gaussian Graphical Model (GGM), including data preparation, model selection, regularization, visualization and stability assessment, using a neuropsychological dataset from patients with Alzheimer's disease. Particular emphasis is placed on best practices for ensuring reproducibility and robustness, including the use of bootstrap procedures and reporting standards. Second, we outline key methodological extensions, including Exploratory Graph Analysis for dimensionality assessment, joint graphical models and Network Comparison Test for group comparisons, mixed graphical models for heterogeneous data and longitudinal network approaches. These methods are presented conceptually to illustrate how network analysis can be extended beyond basic cross-sectional applications. Finally, we discuss the strengths and limitations of network psychometrics in neuropsychology. We emphasize that network models represent statistical associations among observed test scores rather than direct representations of cognitive architecture and that their interpretation requires theoretical caution. When applied with methodological rigour and conceptual restraint, network analysis provides a flexible and integrative framework for investigating the structure of cognitive systems.
Autism spectrum disorder (ASD) is characterized by persistent deficits in social communication, and conventional therapies often struggle to facilitate the generalization of these skills to real-world settings. This study aimed to determine the effectiveness of a virtual reality (VR)-based communication rehabilitation intervention as a supplement to conventional treatment for improving the linguistic and social communication skills of Arabic-speaking Egyptian children with ASD. A clinical trial with a pretest-posttest control group design was employed, wherein 60 children aged 4-6 years with mild to moderate ASD were assigned to either VR plus conventional therapy (Group I, n = 30) or conventional therapy alone (Group II, n = 30). Over 6 months, participants received 2 weekly 30-min sessions. Outcomes were measured at baseline, immediately post-intervention and at a 3-month follow-up using the Preschool Language Scale-Fourth Edition, the Childhood Autism Rating Scale-Second Edition and an ASD Social Skills Scale. Group I demonstrated statistically significant improvements in receptive and expressive language ages (p < .001) and total social skills scores (p < .001) compared to Group II. Crucially, these therapeutic gains were sustained at the 3-month follow-up with no significant deterioration (p > .05). VR-based communication rehabilitation is a highly effective and sustainable intervention for supplementing language and social skills in young children with ASD. Its integration into clinical practice provides a scalable, engaging and culturally adaptable platform for neurodevelopmental care.
Chinese characters serve as the psychological entry point for lexical recognition in reading. Over 80% of these characters are phonetic compounds containing a semantic radical. Understanding how individuals with Alzheimer's disease (AD) process these structurally distinct characters is crucial for revealing the underlying nature of their cognitive decline. This study examined 180 older adults (60 Healthy Controls, 60 Mild AD, 60 Moderate AD) in a semantic categorization task across four radical-character relationships: fully related (FR), fully unrelated (FU), radical-only related (RR) and radical-only, related (RO-R). To disentangle semantic degradation from executive control demands, this study employed signal detection theory (SDT) and mixed-effects modelling. Results demonstrated significant group-by-condition interactions for accuracy, reaction time and perceptual sensitivity (d'). AD patients exhibited globally reduced d' and prolonged reaction times. Crucially, an error pattern analysis revealed that Mild AD patients produced significantly more false alarms in the RR condition, a deficit strongly correlated with their Stroop Interference scores (r = .58), reflecting a pronounced susceptibility to semantic interference, exacerbated by atypical executive inhibitory control. Furthermore, a temporal dissociation emerged: while explicit semantic sensitivity (d') collapsed early in the disease, Mild AD patients partially preserved the automatic reaction time advantage for isolated radicals (RO-R), yet suffered an exacerbated reaction time interference effect when resolving radical-related semantic interference (RR > FU). These findings suggest that explicit semantic boundaries and executive conflict resolution abilities degrade early in AD, whereas automatic semantic spreading activation is briefly preserved but highly susceptible to multifaceted semantic interference.
Despite extensive research on HIV-associated neurocognitive disorders (HAND), interest in cognitive rehabilitation has emerged only within the past 15 years. HAND are characterised by mild-to-moderate impairments in multiple cognitive domains: attention, episodic memory and executive functions. In the context of HAND, the prevalence of episodic memory disorders is high, ranging from 40% to 65% across studies. This scoping review aims to identify available evidence of rehabilitation programmes targeting episodic memory disorders associated with HIV and to examine their characteristics and theoretical foundations. The initial search included rehabilitation programmes, but this yielded only three eligible clinical trials. Therefore, we expanded our inclusion criteria to encompass experimental studies of potential rehabilitation techniques aimed at improving episodic memory. The search results included 610 records, and 27 full-text articles were assessed for eligibility, of which 10 studies were included: 3 clinical trials and 7 experimental studies. The clinical trials all targeted multiple cognitive functions, episodic memory included. Two trials used a computer-based training approach, while one combined stimulation and compensatory techniques. Two trials demonstrated a significant effect on memory test scores post-intervention compared with the control group, but none showed an impact on quality of life, mental health or a transfer to memory functioning in daily life. The seven experimental cognitive studies demonstrated benefits for episodic memory (retrospective and prospective) using various memory techniques: retrieval practice, self-generated encoding and external aids. This scoping review underscores the need to advance clinical research and rehabilitation practices targeting episodic memory impairment in HAND.
Neuropsychiatric presentations are common across neurological and mental health services but they are often inadequately covered by core clinical psychology and clinical neuropsychology training. Consequently, we aimed to identify components for a neuropsychiatry curriculum for clinical psychologists using a Delphi process. We completed a three-round e-Delphi study with 19 experts (clinical psychologists, neuropsychologists, psychiatrists, neurologists, individuals with lived experience of neuropsychiatric disorders). Round 1 collected ratings on 80 syllabus items derived from textbook reviews, conference topics and a scoping review of neuropsychiatry syllabuses. Items failing to reach consensus were refined, and new topics added via free-text suggestions. Rounds 2 and 3 repeated rating and thematic analysis, culminating in a consensus meeting where items were classified as core or supplementary. Consensus thresholds were set at mean ≥2.0, mean distance from the mean ≤0.2 and ≥75% agreement for final decisions. The process yielded 40 core and 38 supplementary syllabus items. Core topics include autoimmune and neuroinflammatory disorders, delirium, functional neurological disorders, neuropsychiatric sequelae of epilepsy, stroke, traumatic brain injury, dementia and multidisciplinary working, among others. Supplementary items covered background knowledge of less frequent but still prevalent disorders as well as competencies in interpreting clinical data alongside conceptual and historical issues. The final component list reflects both clinical competencies and emerging areas of practice, emphasising assessment, formulation, psychological interventions, cultural considerations and medicolegal aspects. The e-Delphi-derived curriculum provides a framework for neuropsychiatric competencies for postgraduate psychology training with modification needed for application in diverse health care settings.
Transcranial electric stimulation represents a promising non-invasive neuromodulatory technique targeting maladaptive nociplastic changes in chronic pain (CP) with analgesic effects. However, its impact beyond pain reduction on broader outcomes such as quality of life (QoL) and physical function remains unclear. This study aimed to evaluate the impact of two home-based transcranial electric stimulation modalities, using direct (tDCS) or alternating current (tACS), on improving QoL, addressing comorbid symptoms and enhancing physical function and engagement in physical activity in individuals with CP. In a double-blind randomized controlled trial, 120 CP participants (97 females, 49.5 ± 8.7 years) received 15 sessions of home-based tDCS over the primary motor cortex (M1), tACS over the dorsolateral prefrontal cortex (DLPFC), or sham stimulation. A multidimensional assessment was used before, during and after the treatment, combining subjective measures (QoL, mood, fatigue, sleep quality, perceived physical fitness) and objective metrics (field-based physical fitness tests, accelerometry). Compared with the sham group, both active tES modalities significantly improved QoL, with no differences between M1-tDCS (MD=-7.7; p < .001) and DLPFC-tACS (MD=-7.8; p < .001). However, symptom-specific domains showed no differential effects compared with sham (all p > .05). All groups exhibited increased physical activity during the intervention and improvements in physical function after the intervention (p < .001), suggesting the contribution of contextual factors. Our findings highlight the potential of home-based tES to enhance QoL in CP patients. The lack of differences between intervention groups in domain-specific outcomes (mood, fatigue, sleep) and physical activity underscores the complexity of the therapeutic response, likely influenced by neurophysiological, behavioural, and contextual mechanisms.
Neurocognitive impairments are common in paediatric central nervous system (CNS) tumours and can relate to clinical and demographic factors. The impact of social or environmental factors, such as family psychosocial risk, is less well understood. We examined neurocognitive functioning in children with CNS tumours shortly after diagnosis and associations with psychosocial risk. This cohort study included children who underwent neuropsychological assessments within three months of diagnosis. Proportion, chi-square and t-tests were used to compare neurocognitive outcomes to norms and evaluate prevalence of neurocognitive impairment (International Cognition and Cancer Task Force criteria: two scores at z ≤ -1.5, one score at z ≤ -2 or both). Regression analyses examined associations between psychosocial risk, age at diagnosis and neurocognitive outcomes, controlling for medical factors. We included 125 children (47 females; mean age at diagnosis = 9.7 years) assessed at an average of 2.08 months after diagnosis. A larger proportion of patients demonstrated neurocognitive impairments than normative expectations (p = .002), with a greater likelihood for children from increased psychosocial risk groups (p = .014). Increased psychosocial risk was associated with lower parent-reported executive functioning (p = .028), but not with other neurocognitive outcomes. Midline tumour location was related to better working memory; history of obstructive hydrocephalus was related to poorer verbal memory and chemo/radiotherapy initiation was related to poorer processing speed (p's < .05). A sub-group of children with CNS tumours show neurocognitive impairments shortly after diagnosis. Children with increased family psychosocial risk were at higher risk of impairment. Psychosocial risk can help identify neurocognitively vulnerable children, highlighting the importance of both neuropsychological and psychosocial screening.
Executive functions (EF) are vulnerable in preterm children. Owing to methodological issues, inconsistent findings have left some questions unresolved. This study implemented a theory-guided, integrative EF assessment in preterm children. We also examined the impact of perinatal and sociodemographic features on EF disorder. A quasi-experimental sample of 56 preterm children (28-34 weeks' gestation) aged 7-9 underwent a multidimensional EF assessment, combining performance-based (Child Executive Functions Battery-CEF-B) and daily life measures (Behavior Rating Inventory of Executive Functions-BRIEF, parent and teacher versions). EF disorder were defined as congruent impairments in both the CEF-B Impairment index and the BRIEF Global Executive Composite index (parent or teacher), relative to French norms (scores ≥90th percentile). EF disorder were identified in 30.4% of preterm children, despite an above-average mean intellectual quotient (107 ± 12.5). CEF-B revealed a high prevalence of EF difficulties (19.6% to 51.8% depending on component: inhibition, working memory, flexibility or planning). In everyday life, difficulties are reported overall by parents (23.2%) and teachers (16.4%). CEF-B and BRIEF scores showed low-to-moderate correlations and poor-to-fair congruence. Higher paternal education (OR: 6.73, p = .049) and higher education in both parents (OR: 8.22, p = .033) were protective against EF disorder. Perinatal variables (sex, gestational age, birth weight) and family income showed no significant impact. Findings confirm the high risk of EF difficulties in preterm children. Further work should identify high-risk children for follow-up and support, while raising EF awareness.
Chronic pain involves maladaptive plasticity of the insular cortex, a key hub for both pain and affective touch. While C-tactile (CT) afferent stimulation shows analgesic potential, its efficacy is limited by altered touch processing in chronic pain populations. This review integrates neuroimaging and behavioural evidence to propose a novel, stratified therapeutic framework targeting the insula. A narrative review of PubMed and Scopus was performed. Two literature streams were synthesized: (1) neuroimaging studies characterizing structural and functional insular abnormalities in chronic pain and (2) studies examining behavioural and neural responses to affective touch in chronic pain populations. The synthesis identifies a core 'dysfunctional insula' phenotype marked by structural atrophy, persistent hyperactivity and reorganized network connectivity (e.g. salience, default mode). This is paralleled by altered affective touch processing, often manifesting as anhedonia. Neuroimaging supports a 'neural hijacking' model, where insular activity during gentle touch decouples from pleasantness and instead correlates with pain-related metrics. Critically, findings are heterogeneous: some cohorts retain hedonic discrimination, suggesting the underlying neural circuits are suppressed rather than permanently damaged. We propose a stratified model where CT-based interventions are personalized to a patient's neurofunctional phenotype: either by normalizing 'hijacked' pain-related circuits or by strengthening intact hedonic pathways. This approach moves beyond a one-size-fits-all strategy, establishing the insula as a nuanced target for personalized, non-pharmacological pain therapies.
Hospital-to-school transition following moderate-to-severe acquired brain injury (ABI) is a complex, cross-sectoral process, requiring timely and coordinated information sharing between health professionals, parents and educators. Despite its importance, families and educators often feel underprepared to support the child's return to school following ABI. This study aimed to develop and describe a participatory process mapping (PM) methodology to visualise and understand information sharing processes during hospital-to-school transition for primary school-aged children with ABI. This novel, cross-sector, two-staged PM approach involved co-developing seven child case maps through triangulation of semi-structured interviews with parents, health professionals and educators (n = 23) and medical records reviews (Stage 1). Stage 2 comprised participatory workshops with 16 stakeholders across health, community and educator sectors to synthesise case maps into an overall hospital-to-school transition process map. The final map depicted non-linear, iterative pathways of information transfer across inpatient, outpatient and school settings. Findings revealed variability in communication channels, a lack of standardised protocols and reliance on parents as primary mediators for transferring information between hospital and schools with limited resources available to support them to advocate effectively. Schools received tailored recommendations after the child had returned to school and limited provision of ABI-related resources. PM provided a pragmatic, collaborative research tool to visualise complex, cross-sector processes and identify gaps in information delivery. This method offers a foundation for driving improvements and developing targeted interventions to improve hospital-to-school transitions in paediatric rehabilitation for children with ABI.
Apathy is a common behavioural impairment in neurodegenerative conditions and is conceptualized within the Dimensional Apathy Framework as comprising Executive, Emotional and Initiation subtypes. The Dimensional Apathy Scale (DAS) is widely used to assess these domains, yet no validated German version has been available. This study aimed to translate and validate the German DAS (G-DAS) in control participants (HC) and to characterize apathy profiles in German-speaking people with amyotrophic lateral sclerosis (pwALS). Seventy-seven HC and 32 pwALS completed self-rated and caregiver-rated measures of apathy, depression, disinhibition and executive dysfunction. The G-DAS was translated using a multi-round back-translation procedure. Psychometric validation was undertaken in the HC cohort. A subsample of HC matched to pwALS on age and sex was used for between-group comparisons and for deriving exploratory reference thresholds. The G-DAS demonstrated good to high internal consistency across subscales (α = .76-.85) and total scores (self-rated: α = .88; caregiver-rated: α = .86). Convergent validity was supported by significant correlations with the Apathy Evaluation Scale and Frontal Systems Behavior subscales, particularly for the Initiation and Executive subscales. Divergent validity was evidenced by the absence of associations with anxiety and depression. PwALS showed significantly higher Executive and Initiation apathy compared with matched HC, whereas Emotional apathy did not differ. Exploratory threshold scores derived from matched HC indicated that up to 47% of pwALS exhibited clinically elevated Initiation apathy. The G-DAS is a reliable and valid German-language measure of multidimensional apathy. It effectively captures the characteristic Executive and Initiation apathy profile in ALS, supporting its clinical and research utility.
Many children experience agitation and altered consciousness during early acquired brain injury (ABI) recovery, requiring multidisciplinary collaboration across the care pathway. However, limited research evidence and variability in management approaches compromise the provision of standardised, best practice care. This study aimed to co-design and pilot a targeted, evidence-informed implementation intervention to improve inpatient care for children with ABI experiencing altered consciousness and agitation. An Advisory Group was established, comprising 10 clinicians and one parent with lived experience of paediatric ABI (pABI). An evidence-informed, experience-based co-design (E2CD) process was followed and involved 'understanding' current evidence, clinical practice and lived experience perspectives using a scoping review, clinician survey, audit and qualitative interviews (Phase 1); 'refining' this understanding in the local context (Phase 2); 'prioritising' evidence-practice gaps (Phase 3); 'co-designing' resources (Phase 4); and 'implementing and evaluating' the resources through pilot testing (Phase 5). The 'In This Together' micro-learning videos were developed, comprising five 'bite-sized' videos that provide trauma-informed information and tips on managing agitation, uncertainty and transitions in care. The videos aim to support a shared understanding of these topics among clinicians and families and seek to provide families with knowledge and strategies to empower them during their child's care. Pilot testing with clinicians in the local setting indicated that the videos are acceptable, appropriate and feasible. This study highlights the value of partnership with key stakeholders throughout the research process and resulted in the development of micro-learning videos that meaningfully address their needs and have a greater chance of clinical implementation and sustainability.
Executive function (EF) is associated with higher cognitive functions in the prefrontal cortex, and its assessment may support daily life activities. The reliability and validity of the Japanese Behavior Rating Inventory of Executive Function-Adult Version (J-BRIEF-A) were evaluated in this study. Gender and age differences in EF among adults were explored as a secondary objective. This cross-sectional study involved an online survey among 1378 adults (age: 18-89 years; 689 men) across Japan. Confirmatory factor analysis supported the nine subscales and three-factor model of the J-BRIEF-A (comparative fit index = .98, root mean square error of approximation = .094). Internal consistency and high test-retest stability were also confirmed. Construct validity was confirmed using the Dysexecutive Questionnaire as an external criterion. Younger age groups tended to have higher scores for each item. This study confirmed the reliability of the J-BRIEF-A and provided partial evidence for its validity. The factor analysis supported the theoretical structure of the scale, suggesting factorial validity. The significant correlation between the J-BRIEF-A and Dysexecutive Questionnaire partially supports the J-BRIEF-A's construct validity. Despite relying on self-reported data and there being no direct comparisons with performance-based EF tests, the J-BRIEF-A remains valuable for assessing EF in daily life.
The aim of the present review will consist of discussing the different forms of familiar people recognition disorders observed in the right and left variants of semantic dementia. The review will start with a summary of the main cognitive models of familiar people recognition and of the neuroanatomical correlates of the processing stages proposed by these models. In this section, the role played by 'familiarity feelings' and by the properly 'semantic' aspects of familiar people recognition in the recognition of familiar people will be taken separately into account. The different roles played by the right and left anterior temporal lobes in each of these components of the system will also be stressed. In the second part of the review, I will discuss results obtained by patients with right and left variants of semantic dementia on tasks assessing 'familiarity feelings' and the distinction between general and social knowledge, reaching the following conclusions: (a) recognition disorders shown by patients with a right variant of semantic dementia are due to more to the disruption of pre-semantic mechanisms allowing the automatic generation of familiarity feelings than to properly semantic defects; (b) the right anterior temporal lobe (ATL) supports more the concrete than the abstract components of 'social knowledge'; (c) the right ATL can store only information that can be represented in a concrete pictorial format whereas the left ATL mainly stores information that can be represented only through abstract linguistic propositions (240).
Cognitive reserve (CR) and motor reserve (MR) are constructs that can explain why some people are more resilient than others to neurodegenerative diseases such as Parkinson's disease (PD). However, it is unclear whether these reserves exert domain-specific or cross-domain influences. This study investigated the predictive role of CR and MR on cognition and motor function, as well as possible cross-domain interactions. Fifty individuals with PD underwent neuropsychological and motor assessments and completed questionnaires measuring CR (Cognitive Reserve Index questionnaire, CRIq), MR (Motor Reserve Index questionnaire, MRIq), and current physical activity (Current Physical Activity questionnaire, CPAq). Multiple regression models were computed to assess the predictive value of total reserve indices on cognition, executive functions, and clinical motor outcomes. Correlation analyses were conducted between reserve sub-indices and cognitive and clinical motor variables. Total CRIq scores predicted global cognitive functioning and executive abilities, as well as age of onset and disease duration. However, total MRIq scores did not demonstrate any predictive value. The CPAq total score predicted executive functions and disease stage. Some CRIq and MRIq sub-indices were found to correlate with both cognitive and motor measures. CR influences multiple domains in PD, supporting cognition and counteracting clinical decline. The MRIq total score did not demonstrate any predictive value, but some correlations emerged between MRIq sub-indices and cognitive and motor measures. The CPAq revealed effects that crossed domains, indicating that ongoing physical activity may confer immediate protective effects. This highlights the importance of promoting cognitive and physical stimulating lifestyles to enhance resilience in PD.
The Ekman 60-Faces Test is widely used to assess facial emotion recognition, but information on its validity and reliability is scarce. This systematic review evaluated the reporting of psychometric properties across clinical populations. A total of 159 studies (n = 5978) were included: case-control (n = 109), single cohort (n = 37) and review/norm studies (n = 13). Data were extracted on the reporting of structural validity, internal consistency, measurement invariance, test-retest reliability, criterion validity and construct validity. A meta-analysis was performed, assessing effect sizes (Hedges' d) to summarize differences in performance on the Ekman 60-Faces Test in different categories of clinical groups compared with control participants. Results showed that the majority of studies used the validated version by Young et al. (2002; 42%). Fewer than 10% of the studies addressed criterion validity, internal consistency, measurement invariance, structural validity or test-retest reliability. Associations with demographic variables were reported in 23% of studies. Meta-analysis revealed significantly larger effects in neurodegenerative populations (d = -1.09) than in psychiatric (d = -.70, Qm = 5.06, p < .05) and acquired brain injury (d = -.78, Qm = 5.45, p < .05) populations.
Autistic individuals experience challenges in social functioning and have demonstrated atypical patterns of social cognition. However, limitations exist regarding the ecological validity of measures used to assess social cognition in autism, and the relationships between socio-cognitive processes are unclear. The current study aimed to investigate social cognition in autistic children using a novel assessment tool, comparing their social interpretation, perspective-taking abilities (i.e. cognitive empathy) and moral reasoning to that of neurotypical controls. The relationships between these socio-cognitive processes were explored in the context of socio-moral processing. Thirty-six participants were included in the autism group (86% male, aged 8-17 years-old) and 36 participants formed an age- and sex-matched neurotypical control group (86% male, aged 8-15 years-old). The autism group scored significantly lower than the neurotypical group in cognitive empathy only, t(69.37) = 5.95, p < .001. Higher levels of cognitive empathy, but not social interpretation, were significantly positively associated with moral responding, only in the autism group, R2 = .11, F(1, 32) = 5.24, p = .029. Findings indicate the importance of perspective-taking abilities to social cognition difficulties in autism.
More precise subtyping within dementia syndromes leads to better prediction of pathology, supporting individualized, disease-specific treatments, and measuring emotion recognition abilities is particularly important for disorders like semantic behavioural variant frontotemporal dementia (sbvFTD). To evaluate current tools' effectiveness, we compared two dynamic video-based affect labelling tests-the Dynamic Affect Recognition Test (DART), The Awareness of Social Inference Test-Emotion Evaluation Test (TASIT-EET)-and a static image-based Comprehensive Affect Testing System-Name Affect (CATS-NA) test. A total of 555 persons with dementia (PwD), diagnosed with Alzheimer's disease (n = 154), progressive supranuclear palsy syndrome (n = 88), non-fluent variant primary progressive aphasia (nfvPPA) (n = 77), semantic variant PPA (svPPA) (n = 53), bvFTD (n = 124), sbvFTD (n = 65) and 133 healthy participants underwent emotion testing and MRI. All emotion labelling tests differentiated PwD from healthy controls, and FTD with social cognition deficits (sbvFTD, bvFTD and svPPA) from other PwDs. DART outperformed TASIT-EET and CATS-NA in differentiating sbvFTD from bvFTD and svPPA. Beyond emotion reading, TASIT-EET performance was also mediated by verbal memory and semantics, and CATS-NA was predicted by visuospatial and executive functions, while DART required only semantic knowledge. DART corresponded to expected structural anatomy of emotion, including predominantly right insula, anterior temporal and orbitofrontal lobes. While both TASIT-EET and CATS-NA shared that pattern, TASIT-EET additionally correlated with left temporal structures and CATS-NA associated with more dorsal frontoparietal regions. Careful selection of tests that utilize dynamic stimuli, reflect key neural circuits related to emotion and minimize demands from other cognitive domains may yield more accurate diagnoses.
