The Dynamic Affect Recognition Test: Construction and Validation in Neurodegenerative Syndromes

Practical, neurologically validated measures of emotion identification are still needed in the dementia field. The Dynamic Affect Recognition Test (DART) was designed to identify emotion reading deficits in persons with dementia (PWD). Participants included 257 early-stage PWD and 115 healthy controls (HC) who underwent DART and magnetic resonance imaging (MRI). DART performance was worse in PWD than in HC, with the lowest scores observed in the semantic behavioral variant of frontotemporal dementia (sbvFTD). DART showed strong diagnostic specificity (areas under the curve (AUCs) ≥82% comparing syndromes), with the highest performance distinguishing syndromes with prominent socioemotional impairment, particularly sbvFTD. DART performance was associated with other emotion identification measures and predicted real-world socioemotional sensitivity. Poorer DART performance predominantly correlated with focal atrophy in right-sided emotion processing areas, including the insula, temporal pole, and caudate head. The DART is a brief, clinically practical, video-based test of emotion identification designed for PWD that accurately reflects the neuroanatomy involved in emotion.