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Case Report/Case Series
September 2014

Comparing Moral Judgments of Patients With Frontotemporal Dementia and Frontal Stroke

Author Affiliations
  • 1Institute of Cognitive Neurology and Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina
  • 2UDP-INECO Foundation Core on Neuroscience, Diego Portales University, Santiago, Chile
  • 3National Scientific and Technical Research Council, Buenos Aires, Argentina
  • 4Pontifical Catholic University of Argentina, Buenos Aires, Argentina
  • 5Department of Clinical Neurological Sciences, Western University, London, Canada
  • 6Laboratory of Cognitive and Social Neuroscience, Universidad Diego Portales, Santiago, Chile
  • 7Universidad Javeriana, Facultad de Medicina, Instituto de Envejecimiento, Departamento de Psiquiatría y Salud Mental, Centro de Memoria y Cognición, Hospital San Ignacio, Bogota, Colombia
  • 8Universidad Nacional de Colombia, Bogota, Colombia
  • 9Instituto de Humanidades de la Facultad de Filosofía y Humanidades, Universidad Nacional de Córdoba, Córdoba, Argentina
  • 10Unidad de Neurología Cognitiva y Demencias, Servicio de Neurología, Hospital del Salvador, Santiago, Chile
  • 11Facultad de Medicina y Centro de Investigación Avanzada en Educación, Universidad de Chile, Santiago, Chile
  • 12Departamento de Neurología, Clínica Alemana, Santiago, Chile
  • 13Australian Research Council Centre of Excellence in Cognition and Disorders, New South Wales, Australia
  • 14Universidad Autonoma del Caribe, Barraquilla, Colombia
JAMA Neurol. 2014;71(9):1172-1176. doi:10.1001/jamaneurol.2014.347

Importance  Several clinical reports have stated that patients with prefrontal lesions or patients with the behavioral variant of frontotemporal dementia share social cognition impairments. Moral reasoning is impaired in both conditions but there have been few investigations that directly compare this domain in the 2 groups.

Observations  This work compared the moral judgments of these patient groups using a task designed to disentangle the contributions of intentions and outcomes in moral judgment. For both disorders, patients judged scenarios where the protagonists believed that they would cause harm but did not as being more permissible than the control group. Moreover, patients with frontotemporal dementia judged harmful outcomes in the absence of harmful intentions as less permissible than the control participants. There were no differences between the 2 conditions.

Conclusions and Relevance  Both disorders involved impairments in integrating intention and outcome information for moral judgment. This study was the first, to our knowledge, to directly compare a social cognition domain in 2 frontal pathologies with different etiology. Our results highlighted the importance of comparing patients with vascular lesions and patients with neurodegenerative diseases.