Moral Judgment Impairment Can Be Seen With Both Dementia and Stroke

MedicalResearch.com Interview with:
Agustin Ibanez, PhD
Laboratory of Experimental Psychology and Neuroscience
Institute of Cognitive Neurology and the National Scientific
and Technical Research Council and

Sandra Baez, MS;
Institute of Cognitive
Neurology and Institute of Neuroscience,
Favaloro University, Buenos Aires, Argentina

Medical Research: What are the main findings of the study?

Answer: Both patients with the behavioral variant of frontotemporal dementia (bvFTD) and patients with frontal strokes presented moral judgment abnormalities. Their deficits were related to impairments in the integration of intentions and outcomes. Specifically, both patient groups judged moral scenarios by focusing on the actions’ outcomes instead of the protagonists’ intentions.

Medical Research: Were any of the findings unexpected?

Answer: Previous studies have suggested a specific role of the ventromedial prefrontal cortex (VMPFC) in moral judgment. However, in our study, frontal-stroke patients exhibited similar impairments despite the presence or absence of VMPFC damage. This preliminary result indicates that specific moral judgment impairments can be triggered not only by VMPFC lesions, but also by unilateral damage to other prefrontal regions. Similarly, bvFTD patients with diffuse atrophy of fronto-temporo-insular regions (not restricted to VMPFC) presented the same impairment.

Medical Research: What should clinicians and patients take away from your report?

Answer: Moral judgment abnormalities may be present in patients with bvFTD and patients with prefrontal stroke. Since moral judgment is an important aspect of social functioning, these impairments should be considered in clinical assessment and, potentially, in the non-pharmacological treatment of these patients.

Medical Research: What recommendations do you have for future research as a result of this study?

Answer: Our findings highlight the importance of comparing social cognition domains in patients with vascular lesions and patients with neurodegenerative diseases. Future studies should establish the specific neural networks beyond the VMPFC involved in the processing of intentions and outcomes in moral judgment.

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