Abstract
Social cognition deficits are observed both in patients with schizophrenia (SCZ) and in patients with mesial temporal lobe epilepsy (MTLE). This may be due to dysfunction of the amygdala network, which is a common feature of both diseases. In this study, SCZ (n = 48) or MTLE (n = 31) and healthy controls (HC, n = 47) completed assessments of mentalising (Reading Mind in the Eyes Test, RMET) and basic cognitive processing, e.g., working memory, executive functions and psychomotor speed (Trail-Making Test B and Digit Symbol). SCZ were also assessed with the Positive And Negative Syndrome Scale (PANSS). We found that the RMET scores of the two clinical groups were similar (p > 0.05) and lower than in the HCs (SCZ: p < 0.05; MTLE: p < 0.001). In the next step, SCZ were split into two groups with respect to the level of symptoms. Analysis of the RMET scores revealed no differences between the HC (M = 25.7 ± 4.1) and POS-LO (M = 25.3 ± 4.8); both groups outperformed the POS-HI group (M = 21.3 ± 5.2) and the MTLE group (M = 20.8 ± 4.6). No differences were found for the median-split with regard to negative symptoms. In SCZ, the mind-reading deficit appears to be associated with the level of positive symptoms. Both POS-HI and MTLE patients present significant mentalising deficits compared to healthy controls.
Highlights
During the last two decades, “Theory of Mind” (ToM) and its “mentalising/mind reading” processes, understood as the ability to attribute mental states of others[1, 2], have become some of the most studied areas in cognitive neuroscience[1, 2]
The a priori planned comparisons between the healthy controls (HC), mesial temporal lobe epilepsy (MTLE) and SZ were post hoc expanded secondary comparisons accounting for the symptom profiles in patients with schizophrenia
Post hoc tests confirmed that HCs had higher Reading Mind in the Eyes Test (RMET) scores than both patients with schizophrenia (p < 0.05) and patients with MTLE (p < 0.001), whilst the performance of the two clinical groups was similar (p > 0.05)
Summary
A series of one-way ANOVAs comparing cognitive functions of the healthy and clinical groups showed that HCs performed better than both patient groups on the Digit Symbol test (F(2,125) = 20.0, p < 0.001) and TMT-B (F(2,125) = 9.4, p < 0.001). Post hoc tests confirmed that HCs had higher RMET scores than both patients with schizophrenia (p < 0.05) and patients with MTLE (p < 0.001), whilst the performance of the two clinical groups was similar (p > 0.05). To investigate whether the POS-LO vs POS-HI differences in RMET performance can be attributed to a difference in clinical state, we carried out an analogous median-split based on PANSS Negative symptoms.
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