Social Mind and Long-Lasting Disease: Focus on Affective and Cognitive Theory of Mind in Multiple Sclerosis.

Sara Isernia,Elisabetta Groppo,Alessia D’Arma,Francesca Baglio,Antonella Marchetti,Davide Massaro

doi:10.3389/fpsyg.2019.00218

Sara Isernia, Elisabetta Groppo + Show 4 more

Open Access

https://doi.org/10.3389/fpsyg.2019.00218

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Abstract

The role of social cognition, including theory of mind (ToM), in affecting quality of life (QoL) along the course of diseases has been reported. This is a considerable aspect in chronic pathologies, such as multiple sclerosis (MS), in which supporting and maintaining QoL is of crucial importance. We aimed to investigate the relation between ToM, clinical variables and neuropsychological profile in a cohort of adults with long lasting disease, such as different clinical MS phenotypes (Relapsing Remitting -RR- versus Progressive -Pr). In particular, our study focuses on (1) how (affective and cognitive) ToM impairment occurs in different phenotypes, (2) whether MS ToM impairment is secondary to or independent from cognitive deficit and (3) whether ToM deficit impacts QoL. 42 adults with MS (18 M: 24 F, 52.38 ± 10.31 mean age, 21.24 ± 10.94 mean disease duration, 26 RR and 16 Pr) and 26 matched healthy controls (HC) (7 M: 19 F, 51.35 ± 12.42 mean age) were screened with a neuropsychological and ToM battery, assessing both affective and cognitive components. We found statistically significant groups differences in cognitive but not affective ToM, with a lower performance in PrMS than those with a RRMS disease course. Also, significant predictive effects of neuropsychological tests on ToM were identified in MS group. Finally, MS people with different level of affective ToM differed significantly in QoL. ToM deficit in moderately disabled people with MS involves cognitive but not affective ToM components with implications on QoL. It also appears to be related to cognitive performance. As neurological and neurocognitive profiles influence mentalizing in MS, ToM evaluation should be considered for inclusion in clinical screening.

Highlights

Social cognition is the life-long evolving neurocognitive capacity needed to process social information
The course of the disease could be subjected to variation over time or remain stable from the onset of the pathology: patients can experience crisis which follow fully disability recovery for all their life, it is the case of relapsing remitting multiple sclerosis (MS) (RRMS), or they can initiate to do not completely remit after relapses in a secondary phase of the illness, the case of secondary progressive MS, or even they can present a constant progression of the pathology from the onset of the disease, such as in primary progressive MS
We found a statistically significant difference between healthy controls and MS groups in Physical Health Composite Score (PHCS)

Summary

Introduction

Social cognition is the life-long evolving neurocognitive capacity needed to process social information. Recent studies have highlighted the role of social cognition in affecting QoL along the course of diseases (Maat et al, 2012), especially in chronic pathologies (e.g., Bodden et al, 2010a; Phillips et al, 2011) such as multiple sclerosis (MS). Progressive phenotypes show increased pathological alterations in brain than remitting MS (Lassmann et al, 2012). In these conditions, social cognition abilities are crucial to hold relationships (Carotenuto et al, 2017) and to preserve social support network (Wineman, 1990), significant resource for a patient’s QoL

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