Abstract Details

Empathy is the ability to understand (cognitive empathy) and to feel (affective empathy) what others feel and it may be reduced in neurodegenerative disease.

To assess empathy deficit and possible neuronal correlates along Alzheimer’s Disease (AD) continuum: from Subjective Cognitive Decline (SCD), to Mild Cognitive Impairment (MCI) and to dementia.

We included 24 SCD, 41 MCI and 46 AD patients, who underwent neuropsychologic assessment, and APOE genotyping. Six SCD, 23 MCI and 24 AD patients underwent cerebral FDG-PET, cerebrospinal fluid (CSF) biomarkers analysis and/or amyloid-PET. Informer-rated Interpersonal Reactivity Index (IRI) was used to explore cognitive (Perspective Taking-PT and Fantasy-F subscales) and affective (Empathic Concern-EC and Personal Distress-PD subscales) empathy, before (T0) and after (T1) cognitive symptoms’ onset. Ekman-60 Faces (EK-60F) Test was administered to investigate emotional recognition ability.

F-T1 scores were lower in AD compared to SCD (13.0±8.0 vs 19.1±4,7 p=0.008), while PD-T1 score were higher in AD compared to MCI and to SCD (27.00±10.00 vs 25.3±5.9 vs 20.5±5.6, p=0.001). The difference in PD-T1 among groups was confirmed by multiple regression analysis adjusted for age and years of education.
In MCI and in AD, PT scores decreased from T0 to T1 (MCI z=-3.88, p<0.001, AD z=-5.22, p<0.001). PD scores increased from T0 to T1 in SCD (z=3.34, p=0.001), MCI (z=5.54 p<0.001) and AD (z=5.76, p<0.001).
A positive correlation was found between PT-T1 and metabolic disfunction of right precentral and frontal inferior gyrus in MCI (p<0.005) and AD (p<0001). In AD group, a positive correlation between PT-T1 and angular gyrus, superior and medium temporal region metabolism was detected. 

Impairment of cognitive empathy starts from MCI, as well as increase of personal distress start from SCD stage. Our study suggests the presence of a continuum, with a progressive involvement of structures involved in cognitive empathy starting from prodromal phases of AD.