SAN2020

Metacognition (monitoring) of emotion recognition is fundamental for social interactions. Although dementia patients present deficits in emotion recognition and self-awareness, their metacognition of affective processes remains poorly understood. We recruited 18 patients with behavioral variant frontotemporal dementia (bvFTD), 27 with Alzheimer’s disease (AD), and 38 demographically-matched controls. Participants performed the Ekman’s facial emotion recognition test and, after each trial, provided a confidence judgment about their performance. A metacognitive index was calculated weighing performance against associated confidence ratings. Whole-brain grey matter (GM) volume was associated with the index via voxel-based morphometry multiple regression analyses. Both patient groups presented impairments in metacognition of negative emotions: disgust was specifically impaired in bvFTD, and sadness in AD. In bvFTD patients, reduced GM volume of limbic and subcortical regions was associated with emotion recognition deficits; while the frontal, insular, and cingulate cortices were linked to metacognitive impairments. In AD, temporal and parietal areas were associated with emotion recognition; whereas parietal and frontal regions were linked to metacognition. Recognition and metacognition of emotions shared several structural substrates. Further research in this direction can illuminate the bases of daily socio-behavioral alterations in these disorders.