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Self-projection and the default network in frontotemporal dementia

Abstract

Converging evidence suggests that when individuals are left to think to themselves, a so-called default network of the brain is engaged, allowing the individual to daydream, reflect on their past, imagine possible future scenarios, and consider the viewpoints of others. These flexible self-relevant mental explorations enable the anticipation and evaluation of events before they occur, and are essential for successful social interactions. Such self-projective efforts are particularly vulnerable to disruption in frontotemporal dementia (FTD), a neurodegenerative disorder involving damage to the frontal and temporal lobes of the brain. In this Review, we explore how the progressive degeneration of the neural networks in two subtypes of FTD—the behavioral variant and semantic dementia—affects key structures of the default network and putative self-projective functions. We examine the available evidence from studies of autobiographical memory, episodic future thinking, theory of mind, moral reasoning, and economic decision-making in these neurodegenerative diseases. Finally, we propose that the mapping of default-network functions onto discrete subsystems of the default network may need revision in light of neuropsychological and clinical evidence from studies in patients with FTD.

Key Points

  • Self-projection is a complex cognitive function that enables an individual to remember the past, imagine the future, and consider the thoughts and perspectives of others

  • Key frontal and temporal lobe regions of the default network are implicated in self-projective functions

  • Specific key regions of the default network undergo atrophy in the behavioral variant of frontotemporal dementia (bvFTD) and in semantic dementia

  • These two forms of FTD lead to differential impairments of self-projective functions

  • Neuropsychological and clinical evidence from patients with bvFTD or semantic dementia indicates that self-projective functions might not map onto discrete subsystems of the default network

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Figure 1: The default network.
Figure 2: Characteristic patterns of atrophy in bvFTD and semantic dementia.

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Acknowledgements

This research was supported in part by the Australian Research Council (ARC) Centre of Excellence in Cognition and its Disorders. M. Irish is supported by an Australian Research Council Discovery Project grant (DP10933279). O. Piguet is supported by a National Health and Medical Research Council of Australia Clinical Career Development Fellowship (APP1022684). J. R. Hodges is supported by an ARC Federation Fellowship (FF0776229).

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M. Irish researched the data for and wrote the article. O. Piguet and J. R. Hodges provided substantial contributions to discussion of the content, and contributed to review and/or editing of the manuscript before submission.

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Correspondence to Muireann Irish.

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Irish, M., Piguet, O. & Hodges, J. Self-projection and the default network in frontotemporal dementia. Nat Rev Neurol 8, 152–161 (2012). https://doi.org/10.1038/nrneurol.2012.11

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