The diagnosis of “Alzheimer's” disease (AD) relies on neuropsychological tests demonstrating massive memory decline, which is mainly associated with hippocampus lesions. In parallel, several neuroimaging studies have suggested that amygdala volume loss could be a neuroanatomical marker of AD. However, previous works dealing with behavioural indices of amygdala activity in AD have been unable to provide a converging profile of emotional impairments. The goal of this work was to corroborate data provided from various methods to demonstrate that amygdala lesions in relation to emotional disorders could be an interesting track to refine the current diagnosis of AD. In a first structural neuroimaging study, we have demonstrated that the amygdala undergoes massive atrophy in the early stage of the disease, and that volume loss predicts memory decline. In the following studies, we have shown that these lesions lead to impairments in a various set of emotional tests. Based on a meta-analytic approach, we demonstrated that emotional decoding abilities are impaired in AD, beginning in the early stage, and partly explained by the cognitive deficits characterizing the AD population. In a last set of studies we demonstrated that these emotional decoding difficulties rely on specific amygdala dysfunctions, by showing that the mechanisms behind the spontaneous extraction of emotional salience are impaired in AD. All our data converge on the idea that the amygdala damage and alteration of emotional mechanisms from the early phase of AD are a promising approach to clarify the current diagnosis of AD.
