Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-26T07:06:52.253Z Has data issue: false hasContentIssue false
  • English
  • Français

Social inappropriateness in neurodegenerative disorders

Published online by Cambridge University Press:  10 July 2017

Philippe Desmarais ,
Krista L. Lanctôt ,
Mario Masellis ,
Sandra E. Black  and
Nathan Herrmann
Philippe Desmarais*
Affiliation:
Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada Cognitive & Movement Disorders Clinic, Sunnybrook Health Sciences Centre, Toronto, Canada L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Toronto, Canada Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
Krista L. Lanctôt
Affiliation:
Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, Canada
Mario Masellis
Affiliation:
Cognitive & Movement Disorders Clinic, Sunnybrook Health Sciences Centre, Toronto, Canada L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Toronto, Canada Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada Institute of Medical Science, University of Toronto, Toronto, Canada
Sandra E. Black
Affiliation:
L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Toronto, Canada Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada Institute of Medical Science, University of Toronto, Toronto, Canada
Nathan Herrmann
Affiliation:
Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, Canada Lewar Chair in Geriatric Psychiatry, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
*
Correspondence should be addressed to: Philippe Desmarais, Cognitive & Movement Disorders Clinic, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room A4-55, Toronto, Ontario M4N 3M5, Canada. Phone: 1-416-480-4551. E-mail: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

New onset of mood and behavioral changes in middle-aged patients are frequently the first manifestations of an unrecognized neurocognitive disorder. Impairment of social cognition, the cognitive ability to process social information coming from others, such as emotions, to attribute mental states to others, and to respond appropriately to them, is often at the origin of behavioral manifestations in neurodegenerative disorders.

Methods:

This paper reviews the current literature on social cognition impairment in neurocognitive disorders, particularly in prodromal stages of behavioral-variant frontotemporal dementia (bvFTD), Alzheimer's disease (AD), idiopathic Parkinson's disease (IPD), and Lewy body dementia (LBD). The concepts of social cognition will be reviewed, including its impairment and neural basis, its clinical assessment, and the different therapeutic interventions available clinically.

Results:

Socially inappropriate behaviors, such as loss of empathy, inappropriateness of affect, and disinhibition are frequently reported in prodromal bvFTD and in prodromal AD. Lack of self-control, reduced perception of social cues, such as recognition of facial emotions and sarcastic speech, and impaired Theory of Mind all contribute to the neuropsychiatric symptoms and are secondary to neurodegeneration in specific brain regions. In contrasts to bvFTD and AD, deficits in social cognition in IPD occur later in the course of the disease and are often multifactorial in origin.

Conclusions:

Through various manifestations, social inappropriateness is frequently the first clinical sign of a neurodegenerative process, especially in AD and bvFTD, years before noticeable impairment on classical neuropsychological assessment and brain atrophy on imaging.

Keywords

cognitive disordersmild behavior impairment (MBI)Alzheimer's disease (AD)mild cognitive impairment (MCI)frontotemporal dementia (FTD)
Type
Review Article
Information
International Psychogeriatrics , Volume 30 , Special Issue 2: Mild Behavioral Impairment , February 2018 , pp. 197 - 207
Copyright
Copyright © International Psychogeriatric Association 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abu-Akel, A. (2003). The neurochemical hypothesis of “theory of mind”. Medical Hypotheses, 60, 382–386. doi: 10.1016/S0306-9877(02)00406-1.Google Scholar
Abu-Akel, A. and Shamay-Tsoory, S. (2011). Neuroanatomical and neurochemical bases of theory of mind. Neuropsychologia, 49, 2971–2984. doi: 10.1016/j.neuropsychologia.2011.07.012.CrossRefGoogle ScholarPubMed
Adolphs, R., Tranel, D. and Damasio, A. R. (2003). Dissociable neural systems for recognizing emotions. Brain and Cognition, 52, 61–69. doi: 10.1016/S0278-2626(03)00009-5.Google Scholar
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edn. Washington, DC: American Psychiatric Association.Google Scholar
Amodio, D. M. and Frith, C. D. (2006). Meeting of the minds: the medial frontal cortex and social cognition. Nature Reviews Neuroscience, 7, 268–277. doi: 10.1038/nrn1884.Google Scholar
Ariatti, A., Benuzzi, F. and Nichelli, P. (2008). Recognition of emotions from visual and prosodic cues in Parkinson's disease. Neurological Sciences, 29, 219–227. doi: 10.1007/s10072-008-0971-9.Google Scholar
Baarendse, P. J., Counotte, D. S., O'Donnell, P. and Vanderschuren, L. J. (2013). Early social experience is critical for the development of cognitive control and dopamine modulation of prefrontal cortex function. Neuropsychopharmacology, 28, 1485–1494. doi: 10.1038/npp.2013.47.Google Scholar
Barber, R., Snowden, J. S. and Craufurd, D. (1995). Frontotemporal dementia and Alzheimer's disease: retrospective differentiation using information from informants. Journal of Neurology, Neurosurgery and Psychiatry, 59, 61–70. doi: 10.1136/jnnp.59.1.61.Google Scholar
Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y. and Plumb, I. (2001). The “Reading the Mind in the Eyes” test revised version: a study with normal adults, and adults with asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry, 42, 241–251. doi: 10.1111/1469-7610.00715.Google Scholar
Beer, J. S, John, O. P., Scabini, D. and Knight, R. T. (2006). Orbitofrontal cortex and social behavior: integrating self-monitoring and emotion-cognition interactions. Journal of Cognitive Neuroscience, 16, 871–879. doi: 10.1162/jocn.2006.18.6.871.CrossRefGoogle Scholar
Bertoux, M., Volle, E., Funkiewiez, A., de Souza, L. C., Leclercq, D. and Dubois, B. (2012). Social cognition and emotional assessment (SEA) is a marker of medial and orbital frontal functions: a voxel-based morphometry study in behavioral variant of frontotemporal degeneration. Journal of the International Neuropsychological Society, 18, 972–985. doi: 10.1017/S1355617712001300.Google Scholar
Bodden, M. E., Dodel, R. and Kalbe, E. (2010). Theory of mind in Parkinson's disease and related basal ganglia disorders: a systematic review. Movement Disorders, 25, 13–27. doi: 10.1002/mds.22818.Google Scholar
Bowers, D., Blonder, L. X. and Heilman, K. M. (1999). Florida Affect Battery. Gainesville, FL: Center for Neuropsychological Studies, University of Florida.Google Scholar
Cummings, J. L., Dubois, B., Molinuevo, J. L. and Scheltens, P. (2013). International work group criteria for the diagnosis of Alzheimer disease. Medical Clinics of North America, 97, 363–368. doi: 10.1016/j.mcna.2013.01.001.CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. and Gornbein, J. (1994). The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.Google Scholar
Davis, M. H. (1980). A multidimensional approach to individual differences in empathy. Journal of Southern African Studies Catalog of Selected Documents in Psychology, 10, 1–19.Google Scholar
Dermody, N. et al. (2016). Uncovering the neural bases of cognitive and affective empathy deficits in Alzheimer's disease and the behavioral-variant of Frontotemporal dementia. Journal of Alzheimer's Disease, 53, 801–816. doi: 10.3233/JAD-160175.Google Scholar
Devinsky, O., Morrell, M. J. and Vogt, B. A. (1995). Contributions of anterior cingulate cortex to behavior. Brain, 118, 279–306.Google Scholar
Ekman, P. and Friesen, W. V. (1976). Pictures of Facial Affect. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
Farb, N. A.S. et al. (2013). Abnormal network connectivity in frontotemporal dementia: evidence for prefrontal isolation. Cortex, 49, 1856–1873. doi: 10.1016/j.cortex.2012.09.008.CrossRefGoogle ScholarPubMed
Fernandez-Duque, D. and Black, S. E. (2005). Impaired recognition of negative facial emotions in patients with frontotemporal dementia. Neuropsychologia, 43, 1673–1687. doi: 10.1016/j.neuropsychologia.2005.01.005.Google Scholar
Fernandez-Duque, D., Baird, J. A. and Black, S. E. (2009). False-belief understanding in frontotemporal dementia and Alzheimer's disease. Journal of Clinical and Experimental Neuropsychology, 31, 489–497. doi: 10.1080/13803390802282688.Google Scholar
Finger, E. C. et al. (2015). Oxytocin for frontotemporal dementia. Neurology, 84, 174–181. doi: 10.1212/WNL.0000000000001133.Google Scholar
Freedman, M., Binns, M. A., Black, S. E., Murphy, C. and Stuss, D. T. (2013). Theory of mind and recognition of facial emotion in dementia: challenge to current concepts. Alzheimer Disease & Associated Disorders, 27, 56–61. doi: 10.1097/WAD.0b013e31824ea5db.Google Scholar
Frith, C. D. (2008). Social cognition. Philosophical Transactions of the Royal Society, 363, 2033–2039. doi: 10.1098/rstb.2008.0005.CrossRefGoogle ScholarPubMed
Franceschi, M. et al. (2005). Glucose metabolism and serotonin receptors in the frontotemporal lobe degeneration. Annals of Neurology, 57, 216–225. doi: 10.1002/ana.20365.Google Scholar
Frith, C. D. and Frith, U. (2012). Mechanisms of social cognition. Annual Reviews of Psychology, 63, 287–313. doi: 10.1146/annurev-psych-120710-100449.CrossRefGoogle ScholarPubMed
Grace, J., Stout, J. and Malloy, P. (1999). Assessing frontal behavior syndromes with the Frontal Lobe Personality Scale. Assessment, 6, 269–284.CrossRefGoogle ScholarPubMed
Gregory, C. A. (1999). Frontal variant of frontotemporal dementia: a cross-sectional and longitudinal study of neuropsychiatric features. Psychological Medicine, 29, 1205–1217.Google Scholar
Gregory, C. et al. (2002). Theory of mind in patients with frontal variant frontotemporal dementia and Alzheimer's disease: theoretical and practical implications. Brain, 125, 752–764. doi: 10.1093/brain/awf079.Google Scholar
Guastella, A. J. and MacLeod, C. (2012). A critical review of the influence of oxytocin nasal spray on social cognition in humans: evidence and future directions. Hormones and Behavior, 61, 410–418. doi: 10.1016/j.yhbeh.2012.01.002.Google Scholar
Heitz, C. et al. (2015). Théorie de l'esprit cognitive et affective dans la démence à corps de Lewy: une étude préliminaire. Revue Neurologique, 171, 373–381. doi: 10.1016/j.neurol.2015.02.010.CrossRefGoogle Scholar
Henry, J. D., Von Hippel, W., Molenberghs, P., Lee, T. and Sachdev, P. S. (2016). Clinical assessment of social cognitive function in neurological disorders. Nature Reviews Neurology, 12, 28–39. doi: 10.1038/nrneurol. 2015.229.CrossRefGoogle ScholarPubMed
Herrmann, N., Black, S. E., Chow, T., Cappell, J., Tang-Wai, D. F. and Lanctôt, K. L. (2012). Serotonergic function and treatment on behavioral and psychological symptoms of frontotemporal dementia. American Journal of Geriatric Psychiatry, 20, 789–797. doi: 10.1097/JGP.0b013e31823033f3.CrossRefGoogle ScholarPubMed
Hooker, C. I. et al. (2013). The influence of combined cognitive plus social-cognitive training on amygdala response during face emotion recognition in schizophrenia. Psychiatry Research, 213, 99–107. doi: 10.1016/j.pscychresns.2013.04.001.Google Scholar
Hsiesh, S., Irish, M., Daveson, N., Hodges, J. R. and Piguet, O. (2013). When one loses empathy: its effect on carers of patients with dementia. Journal of Geriatric Psychiatry and Neurology, 26, 174–184. doi: 10.1177/0891988713495448.CrossRefGoogle Scholar
Ismail, Z. et al. (2016). Neuropsychiatric symptoms as early manifestations of emergent dementia: Provisional diagnostic criteria for mild behavioral impairment. Alzheimer's and Dementia, 12, 195–202. doi: 10.1016/j.jalz.2015.05.017.CrossRefGoogle ScholarPubMed
Ismail, Z. et al. (2017). The Mild Behavioral Impairment Checklist (MBI-C): a rating scale for neuropsychiatric symptoms in pre-dementia populations. Journal of Alzheimer's Disease, 56, 929–938. doi: 10.3233/JAD-160979.CrossRefGoogle ScholarPubMed
Jessen, F. et al. (2014). AD dementia risk in late MCI, in early MCI, and in subjective memory impairment. Alzheimer's Dementia, 10, 76–83. doi: 10.1016/j.jalz.2012.09.017.CrossRefGoogle ScholarPubMed
Jesso, S. et al. (2011). Effects of oxytocin on social cognition and behaviour in frontotemporal dementia. Brain, 134, 2493–2501. doi: 10.1093/brain/awr171.CrossRefGoogle ScholarPubMed
Kalbe, M. et al. (2010). Dissociating cognitive from affective theory of mind: a TMS study. Cortex, 46, 769–780. doi: 10.1016/j.cortex.2009.07.010.CrossRefGoogle ScholarPubMed
Kertesz, A., Davidson, W. and Fox, H. (1997). Frontal behavioral inventory: diagnostic criteria for frontal lobe dementia. Canadian Journal of Neurological Sciences, 24, 29–36. doi: 10.1017/S0317167100021053.CrossRefGoogle ScholarPubMed
Kucharska-Pietura, K. and Mortimer, A. (2013) Can antipsychotics improve social cognition in patients with schizophrenia?. CNS Drugs, 27, 335–343. doi: 10.1007/s40263-013-0047-0.CrossRefGoogle ScholarPubMed
Lanctôt, K. L., Herrmann, N., van Reekum, R., Eryavec, G. and Naranjo, C. A. (2002). Gender, aggression and serotonergic function are associated with response to sertraline for behavioral disturbances in Alzheimer's disease. International Journal of Geriatric Psychiatry, 17, 531–541. doi: 10.1002/gps.636.Google Scholar
Lee, R., Ferris, C., Van de Kar, L. D. and Coccaro, E. F. (2009). Cerebrospinal fluid oxytocin, life history of aggression, and personality disorder. Psychoneuroendocrinology, 34, 1567–1573. doi: 10.1016/j.psyneuen.2009.06.002.CrossRefGoogle ScholarPubMed
Liljegren, M. et al. (2015). Criminal behavior in frontotemporal dementia and Alzheimer disease. Journal of the American Medical Association Neurology, 72, 295–300. doi: 10.1001/jamaneurol.2014.3781.Google Scholar
Lindau, M. et al. (2000). First symptoms – frontotemporal dementia versus Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 11, 286–293. doi: 10.1159/000017251.CrossRefGoogle ScholarPubMed
Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J. and DeKosky, S. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment—results from the cardiovascular health study. Journal of the American Medical Association, 288, 1475–1483. doi: 10.1001/jama.288.12.1475.Google Scholar
Martinón-Torres, G., Fioravanti, M. and Grimley Evans, J. (2004). Trazodone for agitation in dementia. Cochrane Database of Systematic Reviews, 3. doi: 10.1002/14651858.CD004990.Google Scholar
McKeith, I. et al. (2004). Dementia with Lewy bodies. Lancet, 3, 19–28. doi: 10.1016/S1474-4422(03)00619-7.CrossRefGoogle ScholarPubMed
McKhann, G. M. et al. (2011). The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association Workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & Dementia, 7, 263–269. doi: 10.1016/j.jalz.2011.03.005.CrossRefGoogle ScholarPubMed
de Mendonca, A., Ribeiro, F., Guerreiro, M. and Garcia, C. (2004). Frontotemporal mild cognitive impairment. Journal Alzheimer's Disease, 6, 1–9.Google Scholar
Mendez, M. F. and Shapira, J. S. (2011). Loss of emotional insight in behavioral variant frontotemporal dementia or “frontal anosodiaphoria”. Consciousness and Cognition, 20, 1690–1696. doi: 10.1016/j.concog.2011.09.005.Google Scholar
Meyer-Lindenberg, A., Domes, G., Kirsch, P. and Heinrichs, M. (2011). Oxytocin and vasopressin in the human brain: social neuropeptides for translational medicine. Nature Reviews Neuroscience, 12, 524–538. doi: 10.1038/nrn3044.Google Scholar
Moreau, N. et al. (2015). Different patterns of theory of mind impairment in mild cognitive impairment. Journal of Alzheimer's Disease, 45, 581–597. doi: 10.3233/JAD-143021.Google Scholar
Moretti, R., Torre, P., Antonello, R. M., Cazzato, G. and Bava, A. (2003). Frontotemporal dementia: paroxetine as a possible treatment of behavior symptoms. A randomized, controlled, open 14-month study. European Neurology, 49, 13–19. doi: 10.1159/000067021.Google Scholar
O'Callaghan, C. et al. (2016). Fair play: social norm compliance failures in behavioural variant frontotemporal dementia. Brain, 139, 204–216. doi:10.1093/brain/awv315.Google Scholar
Pardini, M. et al. (2013). Isolated theory of mind deficits and risk for frontotemporal dementia: a longitudinal pilot study. Journal of Neurology, Neurosurgery, & Psychiatry, 84, 818–821. doi: 10.1136/jnnp-2012-303684.CrossRefGoogle ScholarPubMed
Péron, J. et al. (2009). Are dopaminergic pathways involved in theory of mind? A study in Parkinson's disease. Neuropsychologia, 47, 406–414. doi: 10.1016/j.neuropsychologia.2008.09.008.Google Scholar
Peters, F. et al. (2006). Orbitofrontal dysfunction related to both apathy and dishihibition in frontotemporal dementia. Dementia and Geriatric Cognitive Disorders, 21, 373–379. doi: 10.1159/000091898.Google Scholar
Porsteinsson, A. P. et al. (2014). Effect of citalopram on agitation in Alzheimer disease: the CitAD randomized clinical trial. Journal of the American Medical Association. 311, 682–691. doi: 10.1001/jama.2014.93.Google Scholar
Premack, D. and Woodruff, G. (1978). Does the chimpanzee have a « theory of mind »?. Behavioral and Brain Sciences, 4, 515–526. doi: 10.1017/S0140525X00076512.Google Scholar
Peters, M. E. et al. (2013). Neuropsychiatric symptoms as risk factors for progression from CIND to dementia: the cache county study. American Journal of Geriatric Psychiatry, 21, 1116–1124. doi: 10.1016/j.jagp.2013.01.049.Google Scholar
Rankin, K. P. et al. (2006). Structural anatomy of empathy in neurodegenerative disease. Brain, 129, 2945–2956. doi: 10.1093/brain/awl254.Google Scholar
Rascovsky, K. et al. (2011). Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain, 134, 2456–2477. doi: 10.1093/brain/awr179.Google Scholar
Reisberg, B. and Gauthier, S. (2008). Current evidence for subjective cognitive impairment (SCI) as the pre-mild cognitive impairment (MCI) stage of subsequently manifest Alzheimer's disease. International Psychogeriatrics, 20, 1–16. doi: 10.1017/S1041610207006412.Google Scholar
Rosenberg, P. B., Mielke, M. M., Appleby, B. S., Oh, E. S., Geda, Y. E. and Lyketsos, C. G. (2013). The association of neuropsychiatric symptoms in MCI with incident dementia and Alzheimer disease. American Journal of Geriatric Psychiatry, 21, 685–695. doi: 10.1016/j.jagp.2013.01.006.CrossRefGoogle ScholarPubMed
Saltzman, J., Strauss, E., Hunter, M. and Archibald, S. (2000). Theory of mind and executive functions in normal human aging and Parkinson's disease. Journal of international Neuropsychological Society, 6, 781–788.Google Scholar
Shany-Ur, T. et al. (2012). Comprehension of insincere communication in neurodegenerative disease: lies, sarcasms, and theory of mind. Cortex, 48, 1329–1341. doi: 10.1016/j.cortex.2011.08.003.Google Scholar
Shany-Ur, T. and Rankin, K. P. (2011). Personality and social cognition in neurodegenerative disease. Current Opinion in Neurology, 24, 550–555. doi: 10.1097%2FWCO.0b013e32834cd42a.Google Scholar
Shinagawa, S., Ikeda, M., Fukuhara, R. and Tanabe, H. (2006). Initial symptoms in frontotemporal dementia and semantic dementia compared with Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 21, 74–80. doi: 10.1159/000090139.Google Scholar
Stone, V. E., Baron-Cohen, S. and Knight, R. T. (1998). Frontal lobe contributions to theory of mind. Neurosciences, 10, 640–656. doi: 10.1162/089892998562942.Google Scholar
Swartz, J. R., Miller, B. L., Lesser, I. M. and Darby, A. L. (1997). Frontotemporal dementia: treatment response to serotonin selective reuptake inhibitors. Journal of Clinical Psychiatry, 58. 212–216. doi: 10.4088/JCP.v58n0506.CrossRefGoogle ScholarPubMed
Taragano, F. E. and Allegri, R. (2003). Mild behavioral impairment: the early diagnosis. Presented at the 11th International Congress of the International Psychogeriatric Association, Chicago, IL, August 17–22, 2003.Google Scholar
Taragano, F. E. et al. (2009). Mild behavioral impairment and risk of dementia: a prospective cohort of 358 patients. Journal of Clinical Psychiatry, 70, 584–592. doi: 10.4088/JCP.08m04181.Google Scholar
Teipel, S. J. et al. (2015). Neuropsychiatric symptoms in people screened positive for dementia in primary care. International Psychogeriatrics, 27, 39–48. doi: 10.1017/S1041610214001987.Google Scholar
Teng, E., Lu, P. H. and Cummings, J. L. (2007). Deficits in facial emotion processing in mild cognitive impairment. Dementia and Geriatric Disorders, 23, 271–279. doi: 10.1159/000100829.CrossRefGoogle ScholarPubMed
Torralva, T. et al. (2009). A neuropsychological battery to detect specific executive and social cognitive impairments in early frontotemporal dementia. Brain, 132, 1299–1309. doi: 10.1093/brain/awp041.Google Scholar
Weintraub, D. et al. (2015). Clinical spectrum of impulse control disorders in Parkinson's disease. Movement Disorders, 30, 121–127. doi: 10.1002/mds.26016.CrossRefGoogle ScholarPubMed
Weiss, E. M. et al. (2008). Impairment in emotion recognition abilities in patients with mild cognitive impairment, early and moderate Alzheimer disease compared to healthy comparison subjects. American Journal of Geriatric Psychiatry, 16, 974–980. doi: 10.1097/JGP.0b013e318186bd53.CrossRefGoogle ScholarPubMed
Wimmer, H. and Perner, (1983). Beliefs about beliefs: representation and constraining function of wrong beliefs in young children's understanding of deception. Cognition, 13, 103–128. doi: 10.1016/0010-0277(83)90004-5.Google Scholar
Woolley, J. D. et al. (2011). The diagnostic challenge of psychiatric symptoms in neurodegenerative disease; rates of and risk factors for prior psychiatric diagnosis in patients with early neurodegenerative disease. Journal of Clinical Psychiatry, 72, 126–133. doi: 10.4088/JCP.10M06382oli.Google Scholar