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Clinical Manifestations.

Jayden J Lee1, Derek B Archer1,2, Ryan Darby1

  • 1Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 26, 2025
PubMed
Summary
This summary is machine-generated.

Dementia patients with reduced white matter integrity in the uncinate fasciculus (UF) show impaired trust and cooperation. Behavioral variant frontotemporal dementia (bvFTD) patients were less cooperative than Alzheimer

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Area of Science:

  • Neuroscience
  • Neuroimaging
  • Behavioral Economics

Background:

  • Interpersonal trust and cooperation are key prosocial behaviors.
  • Dementia can alter trust and cooperation, but underlying neural mechanisms are unclear.
  • This study investigates white matter integrity's role in trust and cooperation deficits in dementia.

Purpose of the Study:

  • To examine the relationship between white matter degeneration and cooperative behavior in Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) patients.
  • To quantify trust and trustworthiness using the Trust Game (TG) and assess white matter integrity using diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI).

Main Methods:

  • Collected diffusion MRI data from 22 AD and 38 bvFTD patients.
  • Assessed white matter integrity using fractional anisotropy (FA) and intra-axonal volume fraction (ICVF) in specific white matter tracts.
  • Analyzed cooperative behavior in the Trust Game (TG) using linear regression models, controlling for age and sex.

Main Results:

  • Lower ICVF in the uncinate fasciculus (UF) correlated with reduced investment in a cooperative partner.
  • Lower FA in the UF correlated with decreased investment changes over time with a cooperative partner.
  • bvFTD patients showed significantly less investment with cooperative partners compared to AD patients.

Conclusions:

  • Reduced white matter integrity in the UF is linked to impaired trusting behaviors in dementia patients.
  • bvFTD patients exhibit lower overall cooperation than AD patients.
  • Damage to the UF may underlie impaired prosocial cooperation and trust in dementia.