Visuospatial working memory in behavioural variant frontotemporal dementia: a comparative analysis with Alzheimer's disease using the box task.

OBJECTIVE: This study investigated the visuospatial working memory profiles of behavioural variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) using a novel computerised test of visuospatial working memory: the Box Task. METHODS: Twenty-eight bvFTD and 28 AD patients, as well as 32 age-matched control participants were recruited. All participants completed the Box Task and conventional neuropsychological tests of working memory, episodic memory, and visuospatial function. RESULTS: Both the bvFTD and AD groups exhibited significantly more Box Task between-search errors than the control group across all set sizes. Notably, the AD group demonstrated a significantly higher error rate compared to the bvFTD group. Regression analysis revealed that whilst episodic memory impairment significantly predicted Box Task error performance in AD, this was not the case for bvFTD. Additionally, a noticeable trend was observed for attention in predicting Box Task errors in both bvFTD and AD groups. The Box Task demonstrated high utility in differentiating between bvFTD and AD, with a decision tree correctly classifying 82.1% of bvFTD patients and 75% of AD patients. CONCLUSIONS: Our findings reveal significant visuospatial working memory impairments in bvFTD, albeit of lesser severity compared to disease-matched AD patients. The Box Task, a novel measure of visuospatial working memory, proved effective in differentiating between bvFTD and AD, outperforming many traditional neuropsychological measures. Overall, our findings highlight the utility of assessing visuospatial memory when differentiating between bvFTD and AD in the clinical setting.

Scene construction in healthy aging - Exploring the interplay between task complexity and oculomotor behaviour.

Mounting evidence indicates a close correspondence between episodic memory, mental imagery, and oculomotor behaviour. It remains unclear, however, how oculomotor variables support endogenously driven forms of mental imagery and how this relationship changes across the adult lifespan. In this study we investigated age-related changes in oculomotor signatures during scene construction and explored how task complexity impacts these processes. Younger and cognitively healthy older participants completed a guided scene construction paradigm where scene complexity was manipulated according to the number of elements to be sequentially integrated. We recorded participants' eye movements and collected subjective ratings regarding their phenomenological experience. Overall, older adults rated their constructions as more vivid and more spatially integrated, while also generating more fixations and saccades relative to the younger group, specifically on control trials. Analyses of participants' total scan paths revealed that, in the early stages of scene construction, oculomotor behaviour changed as a function of task complexity within each group. Following the introduction of a second stimulus, older but not younger adults showed a significant decrease in the production of eye movements. Whether this shift in oculomotor behaviour serves a compensatory function to bolster task performance represents an important question for future research.

Disrupted social perception in frontotemporal dementia and Alzheimer's disease - Associated cognitive processes and clinical implications.

BACKGROUND: Social perception refers to the ability to adapt and update one's behaviour in accordance with the current context and provides the foundation for many complex social and emotional interactions. Alterations in social cognition are a hallmark of the behavioural variant of frontotemporal dementia (bvFTD), yet the capacity for social perception in this syndrome remains unclear. METHODS: We examined social perception in 18 bvFTD and 13 Alzheimer's disease (AD) patients, in comparison with 17 healthy older controls, using a social perception task derived from the Dewey Story Test. Participants also completed a comprehensive neuropsychological battery and carers provided ratings of behavioural and neuropsychiatric changes. RESULTS: Overall, bvFTD and AD performance diverged significantly from control ratings on the social perception task, however, no significant difference was found between patient groups. Standardised values relative to the mean control rating revealed considerable variability within the patient groups in terms of the direction of deviation, i.e., over- or under-rating the vignettes relative to healthy controls (range z-scores = -1.79 to +1.63). Greater deviation from control ratings was associated with more pronounced memory (p = .007) and behavioural (p = .009) disturbances in bvFTD; whilst social perception performance correlated exclusively with verbal fluency in AD (p = .003). CONCLUSIONS: Social perception is comparably disrupted in bvFTD and AD, yet likely reflects the differential breakdown of distinct cognitive processes in each dementia syndrome. Our findings have important clinical implications for the development of targeted interventions to manage disease-specific changes in social perception in dementia.

Exploring graded profiles of hippocampal atrophy along the anterior-posterior axis in semantic dementia and Alzheimer's disease.

Mounting evidence indicates marked hippocampal degeneration in semantic dementia (SD) however, the spatial distribution of hippocampal atrophy profiles in this syndrome remains unclear. Using a recently developed parcellation approach, we extracted hippocampal volumes from four distinct subregions running from anterior to posterior along the longitudinal axis (anterior, intermediate rostral, intermediate caudal, and posterior). Volumetric differences in hippocampal subregions were compared between 21 SD, 24 matched Alzheimer's disease (AD), and 27 healthy older Control participants. Despite comparable overall hippocampal volume loss, SD and AD groups diverged in terms of the magnitude of atrophy along the anterior-posterior axis of the hippocampus. Global hippocampal atrophy was observed in AD, with no discernible gradation or lateralisation. In contrast, SD patients displayed graded bilateral hippocampal atrophy, most pronounced on the left-hand side, and concentrated in anterior relative to posterior subregions. Finally, we found preliminary evidence that disease-specific vulnerability along the anterior-posterior axis of the hippocampus was associated with canonical clinical features of these syndromes.

Establishing the link between motivational disturbances and behavioural rigidity in frontotemporal dementia.

BACKGROUND: Rigid and inflexible behaviours are common in frontotemporal dementia (FTD), manifesting in compulsive pursuit of specific interests, routines, and rituals. Paradoxically, these changes occur alongside profound motivational disturbances including apathy and anhedonia. While posited to be related, no study to date has explored the link between motivational changes and behavioural rigidity in FTD. METHODS: Carer ratings for 71 FTD participants (26 semantic dementia [SD], 45 behavioural variant [bvFTD]) were obtained on the Dimensional Apathy Scale (apathy), the Snaith-Hamilton Pleasure Scale (hedonic tone) and the Cambridge Behavioural Inventory-Revised (CBI-R; behavioural changes). A rigidity index was created from existing items on the CBI-R. Whole-brain voxel-based morphometry was used to explore associations between rigidity and grey matter intensity in the combined FTD group. RESULTS: Behavioural rigidity was significantly related to apathy severity (r = 0.57) and decreased hedonic tone (r = -0.36) in the combined FTD group. Multiple linear regression revealed a significant diagnosis × hedonic tone interaction (ß = -1.40), whereby lower hedonic tone predicted rigidity in SD (r = -0.65) but not in bvFTD (r = -0.18). In contrast, the relationship between rigidity and apathy did not differ between the groups (ß = -0.42). At the neural level, rigidity correlated with degeneration of predominantly right-sided frontostriatal structures including, notably, the nucleus accumbens. CONCLUSIONS: As the first study to demonstrate a link between motivational changes and behavioural rigidity in FTD, our findings have important clinical implications. By identifying candidate mechanisms of behavioural rigidity, our findings can inform targeted interventions to manage inflexible patterns of thought and behaviour in daily life.

Deconstructing spontaneous expressions of memory in dementia.

Dementia syndromes offer a unique opportunity to clarify some of the component processes of spontaneous expressions of memory proposed by the Barzykowski and Moulin model. By considering the model through the lens of memory disorders, I outline several important extensions to progress our understanding of these spontaneous cognitive phenomena.

Combining experience sampling with temporal network analysis to understand inertia of negative emotion in dysphoria.

BACKGROUND: Emotional inertia refers to the resistance to update or change an emotional state and is a hallmark of maladaptive emotional dynamics in psychopathology. Little is known, however, about the role of emotion regulation in negative emotional inertia in dysphoria. The current study aimed to explore the association between inertia of discrete negative emotions, and emotion-specific emotion regulation strategy selection use and efficacy in dysphoria. METHODS: The Center for Epidemiologic Studies Depression Scale (CESD) was used to divide university students into a dysphoria (N = 65) and non-dysphoria control (N = 62) group. Using an experience sampling approach delivered via a smartphone app, participants were queried semi-randomly regarding negative emotions and emotion regulation strategies 10 times a day for 7 consecutive days. Temporal network analysis was employed to estimate autoregressive connections for each discrete negative emotion (inertia of negative emotion) and the bridge connections between negative emotion and emotion regulation clusters. RESULTS: Participants with dysphoria showed stronger inertia for anger and sadness in the context of the use of emotion-specific regulation strategies. Specifically, individuals with dysphoria displaying greater inertia of anger were more likely to ruminate about the past to cope with anger, and to ruminate on the past and future when experiencing sadness. LIMITATIONS: Lack of a clinical depression patient group for comparison. CONCLUSIONS: Our findings suggest an inflexibility to adaptively shift attention from discrete negative emotions in dysphoria and provide important insights for development of interventions to support wellbeing in this population.

Reconciling profiles of reward-seeking versus reward-restricted behaviours in frontotemporal dementia.

This scientific commentary refers to 'The architecture of abnormal reward behaviour in dementia: multimodal hedonic phenotypes and brain substrate', by Chokesuwattanaskul et al. (https://doi.org/10.1093/braincomms/fcad027).

Mapping behavioural, cognitive and affective transdiagnostic dimensions in frontotemporal dementia.

Two common clinical variants of frontotemporal dementia are the behavioural variant frontotemporal dementia, presenting with behavioural and personality changes attributable to prefrontal atrophy, and semantic dementia, displaying early semantic dysfunction primarily due to anterior temporal degeneration. Despite representing independent diagnostic entities, mounting evidence indicates overlapping cognitive-behavioural profiles in these syndromes, particularly with disease progression. Why such overlap occurs remains unclear. Understanding the nature of this overlap, however, is essential to improve early diagnosis, characterization and management of those affected. Here, we explored common cognitive-behavioural and neural mechanisms contributing to heterogeneous frontotemporal dementia presentations, irrespective of clinical diagnosis. This transdiagnostic approach allowed us to ascertain whether symptoms not currently considered core to these two syndromes are present in a significant proportion of cases and to explore the neural basis of clinical heterogeneity. Sixty-two frontotemporal dementia patients (31 behavioural variant frontotemporal dementia and 31 semantic dementia) underwent comprehensive neuropsychological, behavioural and structural neuroimaging assessments. Orthogonally rotated principal component analysis of neuropsychological and behavioural data uncovered eight statistically independent factors explaining the majority of cognitive-behavioural performance variation in behavioural variant frontotemporal dementia and semantic dementia. These factors included Behavioural changes, Semantic dysfunction, General Cognition, Executive function, Initiation, Disinhibition, Visuospatial function and Affective changes. Marked individual-level overlap between behavioural variant frontotemporal dementia and semantic dementia was evident on the Behavioural changes, General Cognition, Initiation, Disinhibition and Affective changes factors. Compared to behavioural variant frontotemporal dementia, semantic dementia patients displayed disproportionate impairment on the Semantic dysfunction factor, whereas greater impairment on Executive and Visuospatial function factors was noted in behavioural variant frontotemporal dementia. Both patient groups showed comparable magnitude of atrophy to frontal regions, whereas severe temporal lobe atrophy was characteristic of semantic dementia. Whole-brain voxel-based morphometry correlations with emergent factors revealed associations between fronto-insular and striatal grey matter changes with Behavioural, Executive and Initiation factor performance, bilateral temporal atrophy with Semantic dysfunction factor scores, parietal-subcortical regions with General Cognitive performance and ventral temporal atrophy associated with Visuospatial factor scores. Together, these findings indicate that cognitive-behavioural overlap (i) occurs systematically in frontotemporal dementia; (ii) varies in a graded manner between individuals and (iii) is associated with degeneration of different neural systems. Our findings suggest that phenotypic heterogeneity in frontotemporal dementia syndromes can be captured along continuous, multidimensional spectra of cognitive-behavioural changes. This has implications for the diagnosis of both syndromes amidst overlapping features as well as the design of symptomatic treatments applicable to multiple syndromes.

Neural correlates of schizotypal traits: Findings from connectome-based predictive modelling.

Schizotypal traits can be conceptualized as a phenotype for schizophrenia spectrum disorders. As such, a better understanding of schizotypal traits could potentially improve early identification and treatment of schizophrenia. We used connectome-based predictive modelling (CPM) based on whole-brain resting-state functional connectivity to predict schizotypal traits in 82 healthy participants. Results showed that only the negative network could reliably predict an individual's schizotypal traits (r = 0.29). The 10 nodes with the highest edges in the negative network were those known to play a key role in sensation and perception, cognitive control as well as motor control. Our findings suggest that CPM might be a promising approach to improve early identification and prevention of schizophrenia from a spectrum perspective.

Altered reward processing underpins emotional apathy in dementia.

INTRODUCTION: While apathy is broadly defined as a loss of motivation, it is increasingly recognised as a multidimensional syndrome spanning executive, emotional, and initiation domains. Emotional apathy is purportedly driven by deficits in using socioemotional rewards to guide behaviour, yet the link between these symptoms and reward processing, and their common neural correlates, has not been directly examined. METHODS: Sixty-four patients (33 behavioural-variant frontotemporal dementia, 14 Alzheimer's disease, 8 semantic dementia, 6 progressive nonfluent aphasia, 3 logopenic progressive aphasia) were classified into high (HEA; n = 36) and low (LEA; n = 28) emotional apathy groups based on emotional apathy subscale scores on the Dimensional Apathy Scale. Patients and age-matched healthy controls (n = 27) performed an instrumental reward learning task where they learned to associate cues with either social or monetary outcomes. RESULTS: HEA patients showed impaired learning on both the social and monetary reward conditions, relative to LEA patients (p = 0.016) and controls (p = 0.005). Conversely, the LEA group did not differ from controls (p = 0.925). Importantly, multiple regression analyses indicated that social reward learning significantly predicted emotional apathy. Voxel-based morphometry analyses revealed that emotional apathy and social reward learning were both associated with orbitofrontal cortex, ventral striatum, and insula atrophy. DISCUSSION: Our results demonstrate a unique link between impaired social reward learning and emotional apathy in dementia and reveal a shared neurobiological basis. Greater understanding of these neurocognitive mechanisms of reward processing will help improve the identification of emotional apathy in dementia and inform the development of novel interventions to address these symptoms.

Autobiographical memory in dementia syndromes-An integrative review.

Autobiographical memory represents a defining feature of human cognition, enabling us to vividly re-experience salient events from the personal past. By mentally traversing different temporal contexts, humans can maintain an enduring sense of who we are as individuals, as well as envisaging our future goals and behaviors. The relative ease with which we engage in these endeavors, however, belies the remarkable complexity of the autobiographical memory system. Dementia syndromes offer compelling insights into the cognitive neuroarchitecture of autobiographical memory in the face of progressive neural insult to large-scale brain networks. Importantly, the atrophy profiles of many neurodegenerative disorders follow coordinated and predictable trajectories, affecting key regions implicated in episodic and semantic memory. A wealth of evidence suggests that autobiographical memory disruption is a transdiagnostic feature of dementia, yet this impairment takes many forms and arises due to differential neurocognitive disturbances. This review aims to provide a comprehensive overview of the literature on autobiographical memory in typical and atypical presentations of Alzheimer's disease, as well as younger-onset dementia syndromes such as frontotemporal dementia and primary progressive aphasia. I will demonstrate how the systematic study of autobiographical memory across dementia syndromes can constrain and inform our fundamental understanding of memory function and, in turn, stimulate new directions in how we conceptualize and assess these cognitive capacities. Consideration will further be given to clinical implications of autobiographical memory dysfunction with a view to developing targeted interventions to better support the person living with dementia. This article is categorized under: Psychology > Memory Neuroscience > Clinical Neuroscience Psychology > Brain Function and Dysfunction.

Distinct hypothalamic involvement in the amyotrophic lateral sclerosis-frontotemporal dementia spectrum.

BACKGROUND: Hypothalamic dysregulation plays an established role in eating abnormalities in behavioural variant frontotemporal dementia (bvFTD) and amyotrophic lateral sclerosis (ALS). Its contribution to cognitive and behavioural impairments, however, remains unexplored. METHODS: Correlation between hypothalamic subregion atrophy and cognitive and behavioural impairments was examined in a large sample of 211 participants (52 pure ALS, 42 mixed ALS-FTD, 59 bvFTD, and 58 age- and education- matched healthy controls). RESULTS: Graded variation in hypothalamic involvement but relative sparing of the inferior tuberal region was evident across all patient groups. Bilateral anterior inferior, anterior superior, and posterior hypothalamic subregions were selectively implicated in memory, fluency and processing speed impairments in addition to apathy and abnormal eating habits, taking into account disease duration, age, sex, total intracranial volume, and acquisition parameters (all p ≤ .001). CONCLUSIONS: These findings revealed that subdivisions of the hypothalamus are differentially affected in the ALS-FTD spectrum and contribute to canonical cognitive and behavioural disturbances beyond eating abnormalities. The anterior superior and superior tuberal subregions containing the paraventricular nucleus (housing oxytocin-producing neurons) displayed the greatest volume loss in bvFTD and ALS-FTD, and ALS, respectively. Importantly, the inferior tuberal subregion housing the arcuate nucleus (containing different groups of neuroendocrine neurons) was selectively preserved across the ALS-FTD spectrum, supporting pathophysiological findings of discrete neuropeptide expression abnormalities that may underlie the pathogenesis of autonomic and metabolic abnormalities and potentially certain cognitive and behavioural symptom manifestations, representing avenues for more refined symptomatic treatment targets.

Intertemporal choice reflects value comparison rather than self-control: insights from confidence judgements.

Intertemporal decision-making has long been assumed to measure self-control, with prominent theories treating choices of smaller, sooner rewards as failed attempts to override immediate temptation. If this view is correct, people should be more confident in their intertemporal decisions when they 'successfully' delay gratification than when they do not. In two pre-registered experiments with built-in replication, adult participants (n = 117) made monetary intertemporal choices and rated their confidence in having made the right decisions. Contrary to assumptions of the self-control account, confidence was not higher when participants chose delayed rewards. Rather, participants were more confident in their decisions when possible rewards were further apart in time-discounted subjective value, closer to the present, and larger in magnitude. Demonstrating metacognitive insight, participants were more confident in decisions that better aligned with their separate valuation of possible rewards. Decisions made with less confidence were more prone to changes-of-mind and more susceptible to a patience-enhancing manipulation. Together, our results establish that confidence in intertemporal choice tracks uncertainty in estimating and comparing the value of possible rewards-just as it does in decisions unrelated to self-control. Our findings challenge self-control views and instead cast intertemporal choice as a form of value-based decision-making about future possibilities. This article is part of the theme issue 'Thinking about possibilities: mechanisms, ontogeny, functions and phylogeny'.

Functional Coupling between the Fronto-Parietal Network and Default Mode Network Is Associated with Balanced Time Perspective.

Balanced time perspective refers to the ability to flexibly switch between different temporal foci in an adaptive manner according to the current context. Functional connectivity within the default mode network (DMN) has been suggested to support balanced time perspective. The coupling between the DMN and fronto-parietal network (FPN) may drive many important expressions of internally directed cognition. However, it remains unclear whether balanced time perspective is supported by the interaction between the FPN and DMN. To examine these issues, we recruited 91 participants (52 males with mean age of 19.6, and 39 females with mean age of 20.0) to undergo resting-state brain imaging scan and to complete a questionnaire measuring balanced time perspective. Seed-based voxel-wise functional connectivity analyses implicated midline DMN regions including the anterior medial prefrontal cortex (amPFC) and posterior cingulate cortex (PCC) along with the anterior cingulate cortex (ACC), precuneus, and cerebellum in supporting a balanced time perspective. More importantly, functional connectivity between the right amPFC and right dorsal lateral prefrontal cortex (DLPFC) in the FPN was found to associate with balanced time perspective. Our findings suggest the importance of coordinated brain activity in supporting a balanced time perspective.

Distinct disease trajectories in frontotemporal dementia-motor neuron disease and behavioural variant frontotemporal dementia: A longitudinal study.

BACKGROUND AND PURPOSE: The heterogeneity of cognitive and behavioural disturbances in frontotemporal dementia-motor neuron disease (FTD-MND), and clinical differences between FTD-MND and FTD subtypes, have been illustrated cross-sectionally. This study aimed to examine the FTD-MND disease trajectory by comparing clinical features of FTD-MND and the behavioural variant FTD (bvFTD) longitudinally. METHODS: Neuropsychological and disease severity assessments were conducted in a cohort of FTD-MND (baseline, n = 42; follow-up, n = 18) and bvFTD (baseline, n = 116; follow-up, n = 111) using a longitudinal, case-control design. Age-, sex-, and education-matched controls (n = 52) were recruited. Predictors of clinical progression were analyzed. Voxel-based morphometry analysis was undertaken to investigate the progression of brain atrophy. RESULTS: At baseline, FTD-MND was characterized by semantic and general cognition deficits, whereas bvFTD had greater behavioural disturbances. General cognition and language deteriorated in FTD-MND when followed longitudinally. Language deficits at baseline predicted cognitive deterioration and disease progression and correlated with progressive atrophy of language regions. Further deterioration in behaviour was evident in bvFTD over time. The rate of disease progression (i.e., general cognition, semantic association, and disease severity) was significantly faster in FTD-MND than in bvFTD. CONCLUSIONS: FTD-MND and bvFTD appear to have distinct disease trajectories, with more rapid progression in FTD-MND. Language impairments should be closely monitored in FTD-MND as potential predictors of cognitive deterioration and disease progression.

A shared cognitive and neural basis underpinning cognitive apathy and planning in behavioural-variant frontotemporal dementia and Alzheimer's disease.

Apathy is the most common and disabling non-cognitive feature of dementia, affecting up to 90% of individuals over the disease course. Despite its prevalence, the underlying mechanisms of apathy remain elusive. This study aimed to investigate whether cognitive apathy and executive functioning have a shared cognitive and neural basis, in behavioural-variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD). Seventy-one participants (31 bvFTD, 17 AD and 23 controls) were assessed on a neuropsychological battery of executive tasks including the Zoo Map Test, Modified Six Elements Test, Tower Test and verbal fluency. The Dimensional Apathy Scale (DAS) was used to quantify cognitive apathy. Principal components analysis identified a single component underpinning performance on the neuropsychological tests, with both bvFTD and AD showing significantly reduced "planning ability" compared to controls. On the DAS, 74% of bvFTD patients and 59% of AD patients showed clinically significant cognitive apathy. Importantly, linear regression revealed that lower planning ability significantly predicted increased cognitive apathy, even after controlling for cognitive impairment and disease duration. Voxel-based morphometry analyses revealed that planning ability and cognitive apathy were both associated with atrophy of the right frontal pole and orbitofrontal cortex, as well as the thalamus and putamen. From a theoretical perspective, our results reveal a shared mechanism underpinning both cognitive apathy and planning deficits in bvFTD and AD. Clinically, this knowledge will help to improve the identification of apathy in clinical syndromes and inform targeted interventions to improve independence and wellbeing for those living with dementia.

Understanding the multidimensional cognitive deficits of logopenic variant primary progressive aphasia.

The logopenic variant of primary progressive aphasia is characterized by early deficits in language production and phonological short-term memory, attributed to left-lateralized temporoparietal, inferior parietal and posterior temporal neurodegeneration. Despite patients primarily complaining of language difficulties, emerging evidence points to performance deficits in non-linguistic domains. Temporoparietal cortex, and functional brain networks anchored to this region, are implicated as putative neural substrates of non-linguistic cognitive deficits in logopenic variant primary progressive aphasia, suggesting that degeneration of a shared set of brain regions may result in co-occurring linguistic and non-linguistic dysfunction early in the disease course. Here, we provide a Review aimed at broadening the understanding of logopenic variant primary progressive aphasia beyond the lens of an exclusive language disorder. By considering behavioural and neuroimaging research on non-linguistic dysfunction in logopenic variant primary progressive aphasia, we propose that a significant portion of multidimensional cognitive features can be explained by degeneration of temporal/inferior parietal cortices and connected regions. Drawing on insights from normative cognitive neuroscience, we propose that these regions underpin a combination of domain-general and domain-selective cognitive processes, whose disruption results in multifaceted cognitive deficits including aphasia. This account explains the common emergence of linguistic and non-linguistic cognitive difficulties in logopenic variant primary progressive aphasia, and predicts phenotypic diversification associated with progression of pathology in posterior neocortex.

The neural substrates of sex differences in balanced time perspective: A unique role for the precuneus.

Sex differences in various aspects of behaviour and cognition have been widely observed. Few studies, however, have explored potential sex differences in maintaining a balanced time perspective or their underlying neural correlates. To address these questions, two studies were conducted. In Study 1, time perspective was assessed in 1913 college students (796 males and 1117 females), revealing that females had a significantly more balanced time perspective relative to males. In Study 2, 58 males and 47 females underwent an assessment of time perspective and structural brain imaging. Voxel-based morphometry analysis and cortical thickness analysis were conducted to explore associations between the structural imaging data and balanced time perspective. Compared with males, females demonstrated a more balanced time perspective in the context of lower grey matter volume in the bilateral precuneus, right cerebellum, right putamen and left supplementary motor area. Analysis of cortical thickness failed to reveal any significant sex differences. Furthermore, lower grey matter volume of bilateral precuneus was associated with more balanced time perspective among all participants. Our findings point to a critical role for the precuneus in modulating a balanced time perspective, and extend our understanding of sex differences in human cognition. Future studies are required to determine whether sex differences in balanced time perspective are predictive of functional outcomes in daily life.