Empathy In Neurodegenerative Diseases: A Systematic Review

Abstract

Introduction

Empathy, in its affective and cognitive components, is a crucial interpersonal ability. It is broadly studied in the field of psychopathology, whereas its study in the neurodegenerative diseases is relatively recent. Existing literature, though, focused on a reduced subset of considered diseases, which often found a compromise in empathy abilities. Organized knowledge about a more comprehensive set of diseases is lacking.

Method

The present PRISMA systematic review was aimed at collecting the current available literature concerning empathic alterations in adult patients affected by neurodegenerative diseases. It considered the different empathy components, evaluated existing patterns, the impact on patients’ lives, and treatment considerations.

Results

Overall, the 32 retrieved studies describe a spread deterioration of empathic abilities in patients, with each disease displaying its own pattern of empathy functioning. Literature in this field is fragmented and of heterogeneous quality, and further studies are warranted to increase evidence of many preliminary results.

Discussion

In conclusion, we highlight the crucial importance of acknowledging empathy deficits in these diseases, showing their repercussion on both patients’ and caregivers’ quality of life, the establishment of a functional doctor–patient relationship, and the development of efficacious psychological intervention. These clinical approaches can be enriched by the knowledge of the spared abilities of patients affected by neurodegenerative diseases.

Keywords:

• neurodegenerative diseases
• empathy
• mentalizing
• doctor-patient relationship
• psychological intervention
• quality of life

Abbreviations

aCC, anterior cingulate cortex; AD, Alzheimer's disease; ALS, amyotrophic lateral sclerosis; BEES, Balanced Emotional Empathy Scale; BES, Basic Empathy Scale; bvFTD, behavioral variant FTD; DM1, myotonic dystrophy type 1; EMG, electromyography; EPT, Empathy for Pain Task; EQ, Empathy Quotient questionnaire; fMRI, functional magnetic resonance imaging; IFG, inferior frontal gyrus; FPT, Faux-Pas Test; FTD, frontotemporal dementia; GCPT, Guilford’s Cartoon Predictions Test; GM, grea matter; HD, Huntington's disease; IRI, Interpersonal Reactivity Index; MET, Multifaceted Empathy Test; mPFC, medial prefrontal cortex; PD, Parkinson's disease; PNFA, progressive non-fluent aphasia; POFA, pictures of facial affect; RMET, Reading the Mind in the Eyes Test; SBMA, spinal and bulbar muscular atrophy; SD, semantic dementia; SET, Story-based Empathy Task; TASIT, The Awareness of Social Inference Test; TECA, The Test of Cognitive and Affective Empathy.

Data Availability

All data relevant to the study are included in the article.

Author Contributions

AP and SM conceptualized the idea. AP and EP designed the article. EP acquired and analyzed the data. EP and JRK wrote the main manuscript. AP, EP, and JRK interpreted the results. AP, JRK, and SM critically revised the manuscript for important intellectual content. All authors approved the final version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of the work are appropriately investigated and resolved.

Disclosure

The authors report no conflicts of interest in this work.