Exploration Deficits Under Ecological Conditions as a Marker of Apathy in Frontotemporal Dementia
Apathy is one of the six clinical criteria for the behavioral variant of frontotemporal dementia (bvFTD), and it is almost universal in this disease. Although its consequences in everyday life are debilitating, its underlying mechanisms are poorly known, its assessment is biased by subjectivity and...
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Frontiers Media S.A.
2019-08-01
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Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2019.00941/full |
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doaj-8cc0197cde3346329c27587f9f5085ec |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Bénédicte Batrancourt Karen Lecouturier Johan Ferrand-Verdejo Vincent Guillemot Carole Azuar David Bendetowicz David Bendetowicz David Bendetowicz Raffaella Migliaccio Raffaella Migliaccio Raffaella Migliaccio Armelle Rametti-Lacroux Bruno Dubois Bruno Dubois Richard Levy Richard Levy Richard Levy |
spellingShingle |
Bénédicte Batrancourt Karen Lecouturier Johan Ferrand-Verdejo Vincent Guillemot Carole Azuar David Bendetowicz David Bendetowicz David Bendetowicz Raffaella Migliaccio Raffaella Migliaccio Raffaella Migliaccio Armelle Rametti-Lacroux Bruno Dubois Bruno Dubois Richard Levy Richard Levy Richard Levy Exploration Deficits Under Ecological Conditions as a Marker of Apathy in Frontotemporal Dementia Frontiers in Neurology apathy disinhibition motivation frontotemporal lobar degeneration behavior neurodegenerative diseases |
author_facet |
Bénédicte Batrancourt Karen Lecouturier Johan Ferrand-Verdejo Vincent Guillemot Carole Azuar David Bendetowicz David Bendetowicz David Bendetowicz Raffaella Migliaccio Raffaella Migliaccio Raffaella Migliaccio Armelle Rametti-Lacroux Bruno Dubois Bruno Dubois Richard Levy Richard Levy Richard Levy |
author_sort |
Bénédicte Batrancourt |
title |
Exploration Deficits Under Ecological Conditions as a Marker of Apathy in Frontotemporal Dementia |
title_short |
Exploration Deficits Under Ecological Conditions as a Marker of Apathy in Frontotemporal Dementia |
title_full |
Exploration Deficits Under Ecological Conditions as a Marker of Apathy in Frontotemporal Dementia |
title_fullStr |
Exploration Deficits Under Ecological Conditions as a Marker of Apathy in Frontotemporal Dementia |
title_full_unstemmed |
Exploration Deficits Under Ecological Conditions as a Marker of Apathy in Frontotemporal Dementia |
title_sort |
exploration deficits under ecological conditions as a marker of apathy in frontotemporal dementia |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2019-08-01 |
description |
Apathy is one of the six clinical criteria for the behavioral variant of frontotemporal dementia (bvFTD), and it is almost universal in this disease. Although its consequences in everyday life are debilitating, its underlying mechanisms are poorly known, its assessment is biased by subjectivity and its care management is very limited. In this context, we have developed “ECOCAPTURE,” a method aimed at providing quantifiable and objective signature(s) of apathy in order to assess it and identify its precise underlying mechanisms. ECOCAPTURE consists of the observation and recording of the patient's behavior when the participant is being submitted to a multiple-phase scenario reproducing a brief real-life situation. It is performed in a functional exploration platform transformed into a fully furnished waiting room equipped with a video and sensor-based data acquisition system. This multimodal method allowed video-based behavior analyses according to predefined behavioral categories (exploration behavior, sustained activities or inactivity) and actigraphy analyses from a 3D accelerometer. The data obtained were also correlated with behavioral/cognitive tests and scales assessing global cognitive efficiency, apathy, cognitive disinhibition, frontal syndrome, depression and anxiety. Here, bvFTD patients (n = 14) were compared to healthy participants (n = 14) during the very first minutes of the scenario, when the participants discovered the room and were encouraged to explore it. We showed that, in the context of facing a new environment, healthy participants first explored it and then engaged in sustained activities. By contrast, bvFTD patients were mostly inactive and eventually explored this new place, but in a more irregular and less efficient mode than normal subjects. This exploration deficit was correlated with apathy, disinhibition and cognitive and behavioral dysexecutive syndromes. These findings led us to discuss the presumed underlying mechanisms responsible for the exploration deficit (an inability to self-initiate actions, to integrate reward valuation and to inhibit involuntary behavior). Altogether, these results pave the way for simple and objective assessment of behavioral changes that represents a critical step for the evaluation of disease progression and efficacy of treatment in bvFTD. |
topic |
apathy disinhibition motivation frontotemporal lobar degeneration behavior neurodegenerative diseases |
url |
https://www.frontiersin.org/article/10.3389/fneur.2019.00941/full |
work_keys_str_mv |
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doaj-8cc0197cde3346329c27587f9f5085ec2020-11-25T01:40:09ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-08-011010.3389/fneur.2019.00941452586Exploration Deficits Under Ecological Conditions as a Marker of Apathy in Frontotemporal DementiaBénédicte Batrancourt0Karen Lecouturier1Johan Ferrand-Verdejo2Vincent Guillemot3Carole Azuar4David Bendetowicz5David Bendetowicz6David Bendetowicz7Raffaella Migliaccio8Raffaella Migliaccio9Raffaella Migliaccio10Armelle Rametti-Lacroux11Bruno Dubois12Bruno Dubois13Richard Levy14Richard Levy15Richard Levy16Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06, Institut du Cerveau et de la Moelle épiniére (ICM), FRONTlab, Paris, FranceInserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06, Institut du Cerveau et de la Moelle épiniére (ICM), FRONTlab, Paris, FranceInserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06, Institut du Cerveau et de la Moelle épiniére (ICM), FRONTlab, Paris, FranceInstitut Pasteur, Centre de Bioinformatique, Biostatistique et Biologie Intégrative (C3BI), Paris, FranceAP-HP, Groupe Hospitalier Pitiè-Salpêtrière, Département de Neurologie, Institut de la Mèmoire et de la Maladie d'Alzheimer (IM2A), Paris, FranceInserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06, Institut du Cerveau et de la Moelle épiniére (ICM), FRONTlab, Paris, FranceAP-HP, Groupe Hospitalier Pitiè-Salpêtrière, Département de Neurologie, Institut de la Mèmoire et de la Maladie d'Alzheimer (IM2A), Paris, FranceAP-HP, Groupe Hospitalier Pitiè-Salpêtrière, Département de Neurologie, Behavioral Neuropsychiatry Unit, Paris, FranceInserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06, Institut du Cerveau et de la Moelle épiniére (ICM), FRONTlab, Paris, FranceAP-HP, Groupe Hospitalier Pitiè-Salpêtrière, Département de Neurologie, Institut de la Mèmoire et de la Maladie d'Alzheimer (IM2A), Paris, FranceAP-HP, Groupe Hospitalier Pitiè-Salpêtrière, Département de Neurologie, Behavioral Neuropsychiatry Unit, Paris, FranceInserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06, Institut du Cerveau et de la Moelle épiniére (ICM), FRONTlab, Paris, FranceInserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06, Institut du Cerveau et de la Moelle épiniére (ICM), FRONTlab, Paris, FranceAP-HP, Groupe Hospitalier Pitiè-Salpêtrière, Département de Neurologie, Institut de la Mèmoire et de la Maladie d'Alzheimer (IM2A), Paris, FranceInserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06, Institut du Cerveau et de la Moelle épiniére (ICM), FRONTlab, Paris, FranceAP-HP, Groupe Hospitalier Pitiè-Salpêtrière, Département de Neurologie, Institut de la Mèmoire et de la Maladie d'Alzheimer (IM2A), Paris, FranceAP-HP, Groupe Hospitalier Pitiè-Salpêtrière, Département de Neurologie, Behavioral Neuropsychiatry Unit, Paris, FranceApathy is one of the six clinical criteria for the behavioral variant of frontotemporal dementia (bvFTD), and it is almost universal in this disease. Although its consequences in everyday life are debilitating, its underlying mechanisms are poorly known, its assessment is biased by subjectivity and its care management is very limited. In this context, we have developed “ECOCAPTURE,” a method aimed at providing quantifiable and objective signature(s) of apathy in order to assess it and identify its precise underlying mechanisms. ECOCAPTURE consists of the observation and recording of the patient's behavior when the participant is being submitted to a multiple-phase scenario reproducing a brief real-life situation. It is performed in a functional exploration platform transformed into a fully furnished waiting room equipped with a video and sensor-based data acquisition system. This multimodal method allowed video-based behavior analyses according to predefined behavioral categories (exploration behavior, sustained activities or inactivity) and actigraphy analyses from a 3D accelerometer. The data obtained were also correlated with behavioral/cognitive tests and scales assessing global cognitive efficiency, apathy, cognitive disinhibition, frontal syndrome, depression and anxiety. Here, bvFTD patients (n = 14) were compared to healthy participants (n = 14) during the very first minutes of the scenario, when the participants discovered the room and were encouraged to explore it. We showed that, in the context of facing a new environment, healthy participants first explored it and then engaged in sustained activities. By contrast, bvFTD patients were mostly inactive and eventually explored this new place, but in a more irregular and less efficient mode than normal subjects. This exploration deficit was correlated with apathy, disinhibition and cognitive and behavioral dysexecutive syndromes. These findings led us to discuss the presumed underlying mechanisms responsible for the exploration deficit (an inability to self-initiate actions, to integrate reward valuation and to inhibit involuntary behavior). Altogether, these results pave the way for simple and objective assessment of behavioral changes that represents a critical step for the evaluation of disease progression and efficacy of treatment in bvFTD.https://www.frontiersin.org/article/10.3389/fneur.2019.00941/fullapathydisinhibitionmotivationfrontotemporal lobar degenerationbehaviorneurodegenerative diseases |