Abstract
Affective “Theory of Mind” (ToM) is the specific ability to represent own and others’ emotional states and feelings. Previous studies examined affective ToM ability in patients with Huntington’s disease (HD), using the “Reading the Mind in the Eyes test” (RMET). Results were consistent in showing difficulties in inferring complex mental states from photographs of people even in the early stage of HD. However, there has been no agreement as to whether or not cognitive impairments in HD population might have contributed to poor performance on the RMET test. The aim of the present study was to assess whether the affective ToM ability was impaired in the mild to moderate stages of HD, and whether there was an association between compromised ToM ability and the presence of cognitive impairment. We evaluated ToM by means of RMET and global cognitive functioning by means of the MoCA questionnaire in 15 HD patients and 15 healthy subjects (HS). Both groups were matched for age and level of education. Our study showed that the ability to judge a person’s mental states from a picture of their eyes was impaired in HD patients compared to normal population. Indeed, HD subjects gave the 34% of correct responses on RMET, whereas healthy control subjects’ percentage of correct responses was 71%. Furthermore, this impairment was not correlated with global cognitive functioning except for the visuospatial task. These results show that RMET might represent a valid instrument to assess affective ToM ability in HD patients in the mild to moderate stages of the disease, independently from their cognitive status. Since it is known that HD patients, in addition to motor symptoms, suffer from cognitive deficits, including memory and executive impairments, it is important to have an instrument, which is not influenced by cognitive abilities. It is possible therefore to use RMET to assess important aspects of HD patients such as their ability to recognize others’ emotions and feelings even when patients suffer from cognitive decline.
Highlights
Huntington’s disease (HD) is a hereditary neurodegenerative disorder, caused by an expansion of CAG triplet repeats in the Huntingtin gene on chromosome 4
HD and healthy subjects (HS) groups were matched for age, gender and education levels since no significant differences emerged between groups (p always > 0.05)
Statistical analysis on the percentage of correct responses at the Reading the Mind in the Eyes test (RMET) test revealed a significant difference between HD and HS groups (U = 9.50, p = 0.000001), showing that HD subjects performed significantly worse than HS (Figure 2)
Summary
Huntington’s disease (HD) is a hereditary neurodegenerative disorder, caused by an expansion of CAG triplet repeats in the Huntingtin gene on chromosome 4. A core component of “social cognition” is the concept of Theory of Mind (ToM), which refers to the ability to infer other people’s mental states in terms of beliefs, desires or intentions (Premack and Woodruff, 1978; Baron-Cohen et al, 1985). This concept has been generally treated as a unitary process, some authors have argued for a distinction between “cognitive” and “affective” ToM (Shamay-Tsoory and Aharon-Peretz, 2007), depending on specific task demands. Fine et al (2001) reported a case study of a patient suffering from amygdala damage who showed to be severely impaired in ToM, but did not show any impairment in his EF abilities (Fine et al, 2001)
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