Impaired facial emotion recognition in a case of right frontotemporal dementia

After the description of its involvement in amydalin lesions, there has been growing interest in the last decade on the neuropsychological examination of impaired emotional recognition in different diseases. This study aims to demonstrate the existence of emotional recognition impairment in a case of frontotemporal dementia affecting right temporal lobe structures with an experimental battery. The case of 7 year long frontotemporal dementia with right temporal predominance, clinically characterized by behavior disorders such as loss of hygiene habits, eating food in bad condition, approach to marginal groups and other psychiatric disorders (megalomanic delusional ideation) is presented. The psychiatric, neurological, neuropsychological and neuroimaging examination are described. Facial recognition impairments were assessed with a modification of Ekman and Friesen Task (1976). The results were compared with those obtained in three controls matched by age, and educational level. The case we report showed marked impairment in discrimination, matching, selection and naming of negative facial emotions (anger, fear, sadness and disgust). The impairment was more striking in the selection and naming paradigms. Anger was the most affected emotion. It was hypothesized if the impairment of emotional recognition could be in the base of certain behavior disturbances of the patient such as approach to marginal groups.