Decision-making in frontotemporal dementia: Clinical, theoretical and legal implications

Autores
Manes, Facundo Francisco; Torralva, Teresa; Ibañez, Agustin Mariano; Roca, María; Bekinschtein, Tristán Andrés; Gleichgerrcht, Ezequiel
Año de publicación
2011
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: The behavioral variant of frontotemporal dementia (bvFTD) is characterized by progressive changes in personality and social interaction, loss of empathy, disinhibition and impulsivity, most of which generally precede the onset of cognitive deficits. In this study, we investigated decision-making cognition in a group of patients with an early bvFTD diagnosis whose standard neuropsychological performance was within normal range for all variables. Methods: The Iowa Gambling Task was administered to this group of early bvFTD patients, to a group of early bvFTD patients who had shown impaired performance on the classical neuropsychological battery and to healthy controls. Results: Decision-making was impaired in both bvFTD patient groups, whether they had shown impaired or normal performance in the classical neuropsychological evaluation. Conclusions: Patients with early bvFTD may perform normally on standard cognitive tests, and yet develop severe deficits in judgment and decision-making. In many current legal systems, early bvFTD patients showing preserved cognitive functioning who commit unlawful acts run the risk of not being able to plead insane or not guilty on the grounds of diminished responsibility beyond reasonable doubt. This represents a unique legal and ethical dilemma. Our findings have important implications for medicolegal decisions relating to capacity and culpability, and regarding the philosophical concept of 'free will'.
Fil: Manes, Facundo Francisco. Instituto de Neurología Cognitiva; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Favaloro; Argentina
Fil: Torralva, Teresa. Instituto de Neurología Cognitiva; Argentina. Universidad Favaloro; Argentina
Fil: Ibañez, Agustin Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Diego Portales; Chile. Instituto de Neurología Cognitiva; Argentina. Universidad Favaloro; Argentina
Fil: Roca, María. Instituto de Neurología Cognitiva; Argentina. Universidad Favaloro; Argentina
Fil: Bekinschtein, Tristán Andrés. Instituto de Neurología Cognitiva; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Gleichgerrcht, Ezequiel. Instituto de Neurología Cognitiva; Argentina. Universidad Favaloro; Argentina
Materia
DECISION-MAKING
FREE WILL
FRONTOTEMPORAL DEMENTIA
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/193136
Acceder
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network_name_str CONICET Digital (CONICET)
spelling Decision-making in frontotemporal dementia: Clinical, theoretical and legal implicationsManes, Facundo FranciscoTorralva, TeresaIbañez, Agustin MarianoRoca, MaríaBekinschtein, Tristán AndrésGleichgerrcht, EzequielDECISION-MAKINGFREE WILLFRONTOTEMPORAL DEMENTIAhttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Background: The behavioral variant of frontotemporal dementia (bvFTD) is characterized by progressive changes in personality and social interaction, loss of empathy, disinhibition and impulsivity, most of which generally precede the onset of cognitive deficits. In this study, we investigated decision-making cognition in a group of patients with an early bvFTD diagnosis whose standard neuropsychological performance was within normal range for all variables. Methods: The Iowa Gambling Task was administered to this group of early bvFTD patients, to a group of early bvFTD patients who had shown impaired performance on the classical neuropsychological battery and to healthy controls. Results: Decision-making was impaired in both bvFTD patient groups, whether they had shown impaired or normal performance in the classical neuropsychological evaluation. Conclusions: Patients with early bvFTD may perform normally on standard cognitive tests, and yet develop severe deficits in judgment and decision-making. In many current legal systems, early bvFTD patients showing preserved cognitive functioning who commit unlawful acts run the risk of not being able to plead insane or not guilty on the grounds of diminished responsibility beyond reasonable doubt. This represents a unique legal and ethical dilemma. Our findings have important implications for medicolegal decisions relating to capacity and culpability, and regarding the philosophical concept of 'free will'.Fil: Manes, Facundo Francisco. Instituto de Neurología Cognitiva; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Favaloro; ArgentinaFil: Torralva, Teresa. Instituto de Neurología Cognitiva; Argentina. Universidad Favaloro; ArgentinaFil: Ibañez, Agustin Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Diego Portales; Chile. Instituto de Neurología Cognitiva; Argentina. Universidad Favaloro; ArgentinaFil: Roca, María. Instituto de Neurología Cognitiva; Argentina. Universidad Favaloro; ArgentinaFil: Bekinschtein, Tristán Andrés. Instituto de Neurología Cognitiva; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Gleichgerrcht, Ezequiel. Instituto de Neurología Cognitiva; Argentina. Universidad Favaloro; ArgentinaKarger2011-08info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/193136Manes, Facundo Francisco; Torralva, Teresa; Ibañez, Agustin Mariano; Roca, María; Bekinschtein, Tristán Andrés; et al.; Decision-making in frontotemporal dementia: Clinical, theoretical and legal implications; Karger; Dimentia And Geriatric Congnitive Disorders; 32; 1; 8-2011; 11-171420-8008CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://www.karger.com/Article/Abstract/329912info:eu-repo/semantics/altIdentifier/doi/10.1159/000329912info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T09:47:18Zoai:ri.conicet.gov.ar:11336/193136instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 09:47:18.558CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Decision-making in frontotemporal dementia: Clinical, theoretical and legal implications
title Decision-making in frontotemporal dementia: Clinical, theoretical and legal implications
spellingShingle Decision-making in frontotemporal dementia: Clinical, theoretical and legal implications
Manes, Facundo Francisco
DECISION-MAKING
FREE WILL
FRONTOTEMPORAL DEMENTIA
title_short Decision-making in frontotemporal dementia: Clinical, theoretical and legal implications
title_full Decision-making in frontotemporal dementia: Clinical, theoretical and legal implications
title_fullStr Decision-making in frontotemporal dementia: Clinical, theoretical and legal implications
title_full_unstemmed Decision-making in frontotemporal dementia: Clinical, theoretical and legal implications
title_sort Decision-making in frontotemporal dementia: Clinical, theoretical and legal implications
dc.creator.none.fl_str_mv Manes, Facundo Francisco
Torralva, Teresa
Ibañez, Agustin Mariano
Roca, María
Bekinschtein, Tristán Andrés
Gleichgerrcht, Ezequiel
author Manes, Facundo Francisco
author_facet Manes, Facundo Francisco
Torralva, Teresa
Ibañez, Agustin Mariano
Roca, María
Bekinschtein, Tristán Andrés
Gleichgerrcht, Ezequiel
author_role author
author2 Torralva, Teresa
Ibañez, Agustin Mariano
Roca, María
Bekinschtein, Tristán Andrés
Gleichgerrcht, Ezequiel
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv DECISION-MAKING
FREE WILL
FRONTOTEMPORAL DEMENTIA
topic DECISION-MAKING
FREE WILL
FRONTOTEMPORAL DEMENTIA
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background: The behavioral variant of frontotemporal dementia (bvFTD) is characterized by progressive changes in personality and social interaction, loss of empathy, disinhibition and impulsivity, most of which generally precede the onset of cognitive deficits. In this study, we investigated decision-making cognition in a group of patients with an early bvFTD diagnosis whose standard neuropsychological performance was within normal range for all variables. Methods: The Iowa Gambling Task was administered to this group of early bvFTD patients, to a group of early bvFTD patients who had shown impaired performance on the classical neuropsychological battery and to healthy controls. Results: Decision-making was impaired in both bvFTD patient groups, whether they had shown impaired or normal performance in the classical neuropsychological evaluation. Conclusions: Patients with early bvFTD may perform normally on standard cognitive tests, and yet develop severe deficits in judgment and decision-making. In many current legal systems, early bvFTD patients showing preserved cognitive functioning who commit unlawful acts run the risk of not being able to plead insane or not guilty on the grounds of diminished responsibility beyond reasonable doubt. This represents a unique legal and ethical dilemma. Our findings have important implications for medicolegal decisions relating to capacity and culpability, and regarding the philosophical concept of 'free will'.
Fil: Manes, Facundo Francisco. Instituto de Neurología Cognitiva; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Favaloro; Argentina
Fil: Torralva, Teresa. Instituto de Neurología Cognitiva; Argentina. Universidad Favaloro; Argentina
Fil: Ibañez, Agustin Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Diego Portales; Chile. Instituto de Neurología Cognitiva; Argentina. Universidad Favaloro; Argentina
Fil: Roca, María. Instituto de Neurología Cognitiva; Argentina. Universidad Favaloro; Argentina
Fil: Bekinschtein, Tristán Andrés. Instituto de Neurología Cognitiva; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Gleichgerrcht, Ezequiel. Instituto de Neurología Cognitiva; Argentina. Universidad Favaloro; Argentina
description Background: The behavioral variant of frontotemporal dementia (bvFTD) is characterized by progressive changes in personality and social interaction, loss of empathy, disinhibition and impulsivity, most of which generally precede the onset of cognitive deficits. In this study, we investigated decision-making cognition in a group of patients with an early bvFTD diagnosis whose standard neuropsychological performance was within normal range for all variables. Methods: The Iowa Gambling Task was administered to this group of early bvFTD patients, to a group of early bvFTD patients who had shown impaired performance on the classical neuropsychological battery and to healthy controls. Results: Decision-making was impaired in both bvFTD patient groups, whether they had shown impaired or normal performance in the classical neuropsychological evaluation. Conclusions: Patients with early bvFTD may perform normally on standard cognitive tests, and yet develop severe deficits in judgment and decision-making. In many current legal systems, early bvFTD patients showing preserved cognitive functioning who commit unlawful acts run the risk of not being able to plead insane or not guilty on the grounds of diminished responsibility beyond reasonable doubt. This represents a unique legal and ethical dilemma. Our findings have important implications for medicolegal decisions relating to capacity and culpability, and regarding the philosophical concept of 'free will'.
publishDate 2011
dc.date.none.fl_str_mv 2011-08
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/193136
Manes, Facundo Francisco; Torralva, Teresa; Ibañez, Agustin Mariano; Roca, María; Bekinschtein, Tristán Andrés; et al.; Decision-making in frontotemporal dementia: Clinical, theoretical and legal implications; Karger; Dimentia And Geriatric Congnitive Disorders; 32; 1; 8-2011; 11-17
1420-8008
CONICET Digital
CONICET
url http://hdl.handle.net/11336/193136
identifier_str_mv Manes, Facundo Francisco; Torralva, Teresa; Ibañez, Agustin Mariano; Roca, María; Bekinschtein, Tristán Andrés; et al.; Decision-making in frontotemporal dementia: Clinical, theoretical and legal implications; Karger; Dimentia And Geriatric Congnitive Disorders; 32; 1; 8-2011; 11-17
1420-8008
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://www.karger.com/Article/Abstract/329912
info:eu-repo/semantics/altIdentifier/doi/10.1159/000329912
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Karger
publisher.none.fl_str_mv Karger
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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