Abstract
Introduction: Recent studies of patients with multiple sclerosis (MS) have revealed disturbances in distinct components of social cognition, such as impaired mentalizing and empathy. The present study investigated this socio-cognitive profile in MS patients in more detail, by examining their performance on tasks measuring more fundamental components of social cognition and any associated disruptions to gray-matter volume (GMV).Methods: We compared 43 patients with relapse-remitting MS with 43 age- and sex-matched healthy controls (HCs) on clinical characteristics (depression, fatigue), cognitive processing speed, and three aspects of low-level social cognition; specifically, imitative tendencies, visual perspective taking, and emotion recognition. Using voxel-based morphometry, we then explored relationships between GMV and these clinical and behavioral measures.Results: Patients exhibited significantly slower processing speed, poorer perspective taking, and less imitation compared with HCs. These impairments were related to reduced GMV throughout the putamen, thalami, and anterior insula, predominantly in the left hemisphere. Surprisingly, differences between the groups in emotion recognition were not significant.Conclusion: Less imitation and poorer perspective taking indicate a cognitive self-bias when faced with conflicting self- and other-representations. This suggests that impaired self-other distinction, and an associated subcortical pattern of GM atrophy, might underlie the socio-cognitive disturbances observed in MS.
Highlights
Recent studies of patients with multiple sclerosis (MS) have revealed disturbances in distinct components of social cognition, such as impaired mentalizing and empathy
Patients reporting mild to moderate depressive symptoms were included in the study, but the extent of symptoms reported by the two groups were not statistically different
The Multiple sclerosis (MS) patients performed worse than the healthy controls (HCs) on the SDMT (56.42 [±9.26] vs. 69.21 [±10.00]; t(84) = 6.154; p < 0.001, d = 1.33), and reported greater fatigue on the MFIS (29.65 [±12.99] vs. 18.72 [±13.59]; U = 518.00; p < 0.001; r = 0.38)
Summary
Recent studies of patients with multiple sclerosis (MS) have revealed disturbances in distinct components of social cognition, such as impaired mentalizing and empathy. Unlike the long history of research into general cognitive impairments in MS, only recently have studies begun to unveil the nuanced nature of disturbances in social cognitive abilities exhibited by these patients The findings of these studies often converge to reveal difficulties in lower-level capacities, in the recognition of negatively valenced facial emotions [e.g., sadness, anger, fear; [7]]. Investigations of other higher-level components of social cognition provide less consistent insights; while some report that patients are impaired in their ability to attribute mental (“mentalizing”) and affective states to others [“empathy”; [8, 9]], other studies have observed disturbances only in cognitive mentalizing [10, 11]. It remains to be seen whether impairments in these high-level facets of social cognition result from disruptions to more fundamental components
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