Supplementary Material

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Supplementary Material

100

80

60

40

20

0

A

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R ot io n-

Se le ct io n

Em

Ek m an

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TA

SI

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CBS - PiB Negative

CBS - PiB Positive

CBS - no PiB

AD

Supplementary Figure 1.

Performance on the ACE-R, Emotion-Selection, Ekman 60 and

TASIT tasks according to PiB status in CBS patients compared with AD.

Note. All scores are total percent correct. Each marker represents an individual patient’s score.

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To examine any potential differences in profile according to PiB status, we reanalysed the emotion processing data excluding the 2 CBS patients with PiB positive results. The main effect of Diagnosis remained significant on each of the four tasks (Face Perception: F (2,48) =

4.167, p = .021; Face Matching: F (2,48) = 3.470, p = .039; Emotion Matching: F (2,48) =

7.942, p = .001; Emotion Selection: F (2,48) = 13.331, p < .001), with the CBS patients performing below controls on the Face-Perception, Emotion-Matching and Emotion-

Selection tasks (all p values < .05), and worse than the AD group on the Emotion Selection task ( p = .019). On the Ekman 60, the main effect of Diagnosis was significant ( F (2,51) =

11.550, p < .001), with both patient groups performing worse than controls (CBS: p < .001;

AD: p = .003), although no difference in the level of impairment was seen between patient

2 groups. The overall effect of Emotion ( F (4,200) = 37.716, p < .001) and the interaction between Emotion and Diagnosis was also significant ( F (8,200) = 3.072, p = .003). On the

TASIT similar patterns of performance were observed, with an overall effect of Diagnosis present ( F (2,49) = 17.853, p < .001). Again, both CBS and AD patients performed worse than controls (both p values < .001), with no significant difference in performance seen between groups (both p values > .05). The main effect of Emotion was also significant

( F (5,222) = 10.551, p < .001), although no interaction between Emotion and Diagnosis was observed ( F (9,222) = 1.066, p > .05).

In summary, after excluding the two PiB positive patients, the general pattern of emotion processing deficits remained the same, with the exception of performance on the Emotion-

Selection task. On this task, the trend for CBS patients to perform worse than AD patients became significant, after PiB positive CBS patients were excluded. These analyses confirm that the two PiB positive patients were not performing substantially different from the PiB negative CBS cases on the emotion processing tasks.

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Supplementary Table 1. Correlations between emotion processing and cognitive/behavioural scores in CBS and AD.

CBS

Face-Perception

Face-Matching

ACE-R Digits-F Digits-B Trails A Naming Comprehension RCF-

Copy

.349

-.152

Emotion-Matching .234

Emotion-Selection .237

Ekman 60 .498

TASIT

AD

Face-Perception

Ekman 60

TASIT

.599

.470

Face-Matching .461

Emotion-Matching .535

Emotion-Selection .479

.265

.231

.524

.487

.477

.261

.265

.393

.329

.290

.327

.585

.532

.593

.132

.330

.738

.527

.288

.601

.354

.292

.305

.370

.287

.510

Note. Correlations are Pearson two-tailed. * p ≤ .001.

-.004

-.686

-.273

-.309

-.047

-.419

-.724

.078

-.222

-.001

-.187

-.566

.004

.519

.482

.463

.266

.301

-.254

.141

.412

.628

.470

.261

.703

.247

.456

.157

.022

.512

-.143

.190

.589

.774*

.590

.387

.867*

-.188

.145

-.310

-.090

.395

.634

.597

.460

.142

-.010

-.010

.268

.198

.053

.537

.459

.476

.096

-.079

-.023

-.245

-.088

.115

RCF-

Recall

CBI

Abnormal

Behaviour

CBI

Loss of

Motivation

.205

-.415

.169

.004

-.301

-.350

-.260

-.140

-.045

.062

-.169

-.060

.231

.074

.124

-.096

-.034

.065

.297

.433

.130

-.133

-.277

-.014

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Supplementary Figure 2. Patterns of cortical thinning in corticobasal syndrome

(CBS) and Alzheimer’s disease (AD). Regions in red/yellow show where patient groups have more cortical thinning compared to controls. The Alzheimer’s Disease vs. Corticobasal syndrome analysis shows regions where AD have more cortical thinning compared to CBS. No regions were identified where cortical thinning was greater in CBS than AD. Note. L = left hemisphere; R = right hemisphere.

Comparison of surface-based thickness (20mm FWHM smoothing). Statistical significance p < .001 (uncorrected for multiple comparisons).

Patterns of Cortical Thickness According to Diagnostic Group

Patients with CBS showed significant cortical thinning in the left insula, occipito– temporal gyrus, parieto-occipital sulcus and posterior lateral fissure as well as the right pre- and post-central gyri compared to controls. In AD, extensive bilateral cortical thinning was present involving the lateral and medial parietal cortices and medial temporal regions. Compared with AD, CBS patients showed less cortical thinning of the left anterior insula, superior temporal sulcus and middle temporal gyrus. No regions showed greater cortical thinning in CBS compared to AD.

Subcortical Volumes According to Diagnostic Group

Examination of subcortical volumes revealed a main effect of Diagnosis ( F (2,53) =

13.450, p < .001), with CBS ( p = .002) and AD ( p < .001) showing smaller

5 subcortical volumes than controls, but no overall differences between patient groups

( p > .05). Importantly, the interaction between region and diagnosis was significant

( F (6,160) = 4.309, p < .001). The interaction between hemisphere and region was also significant ( F (3,150) = 12.263, p < .011), although no other main or interaction effects according to hemisphere of the region were observed (all p values > .05). Post hoc analyses revealed that averaged across left and right hemispheres, the CBS group had smaller putamen ( p = .019), hippocampus ( p = .003) and nucleus accumbens ( p =

.001) compared to controls, whereas the AD group had smaller hippocampus ( p <

.001), amygdala ( p < .001), nucleus accumbens ( p < .001) and putamen ( p = .003). In addition, AD had smaller hippocampus ( p = .029) and amygdala ( p = .006) volumes compared to CBS.

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Supplementary Table 2. Regions of cortical thickness significantly associated with emotion processing in corticobasal syndrome and

Alzheimer’s disease groups combined.

Anatomical Location Side Cluster size

(mm 2 )

Ekman 60

Anterior cingulate Left 276.8

Number of vertices

Talairach coordinates t value p value Effect size

(Cohen’s d) x y z

501 -13.5 30.6 22.2 4.5 <0.0001 1.6

Effect size

(r)

0.63

TASIT

Anterior cingulate Left 16.6 27 -10.9 27.4 28.1 3.8 0.0008 1.4 0.59

Note. Effect size was computed according to the formula by Cohen. Clusters were thresholded at p < .001 (uncorrected for multiple comparisons). Coordinates and p values refer to the maximum vertex within the cluster.

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Supplementary Figure 3. Regions of cortical thickness significantly associated with emotion processing in corticobasal syndrome and Alzheimer’s disease groups combined at p < .001 (uncorrected for multiple comparisons).

FreeSurfer analyses were conducted to examine the regions associated with emotion processing across both groups, with diagnosis included as a nuisance variable, at p <

.001 uncorrected for multiple comparisons. The left anterior cingulate was significantly associated with performance on both the Ekman 60 and TASIT

(Supplementary Figure 3, Supplementary Table 2).

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Supplementary Table 3. Correlations between face processing and emotion recognition task performance and subcortical volumes.

Thalamus Caudate Putamen Pallidum Hippocampus

Left Right Left Right Left Right Left Right Left Right

Amygdala

Left Right

Accumbens

Left Right

Ekman 60

CBS .315 .354

AD .201 .295

.380

.292

.259

.188

.372

.286

.204

.318

.055

.061

-.001

.180

.415

.447

.325

.510*

.212

.334

.186

.418

.314

.257

.306

.425

Tasit

CBS .299 .420 .538* .412 .603* .479 .183 .131 .562* .477 .399 .371 .432 .448

AD .297 .447 .220 .136 .482* .469* .011 .174 .591* .582* .443 .493* .492* .466*

Note. Values are Pearson correlation values.

* p < .003 (Bonferroni correction). CBS = CBS and controls combined; AD = AD and controls combined.

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Supplementary Figure 4. A subset of scatterplots showing correlations between subcortical region volumes and emotion processing performance according to diagnostic group.

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