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Affective theory of mind in Parkinson’s disease: the effect of cognitive performance

Authors Romosan AM, Dehelean L, Romosan RS, Andor M, Bredicean AC, Simu MA

Received 12 June 2019

Accepted for publication 15 August 2019

Published 30 August 2019 Volume 2019:15 Pages 2521—2535


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Roger Pinder

Ana-Maria Romosan,1,* Liana Dehelean,1,* Radu-Stefan Romosan,1,* Minodora Andor,2 Ana Cristina Bredicean,1 Mihaela Adriana Simu3

1Department of Neurosciences, Discipline of Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 2Department of Internal Medicine, Discipline of Medical Semiology II, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 3Department of Neurosciences, Discipline of Neurology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania

Correspondence: Liana Dehelean
Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square
, Timisoara 300041, Romania
Tel +40 72 498 1888
Fax +40 25 649 0626

*These authors contributed equally to this work

Purpose: Among other non-motor symptoms, theory of mind (ToM), the ability to recognize, understand and infer others’ mental states, beliefs, intents and wishes, has been shown to deteriorate during the course of Parkinson’s disease (PD). It has been speculated that ToM impairments could be related to cognitive deficits in PD. However, the current state of literature suggests that there is heterogeneity regarding the involvement of cognitive functioning in the relationship of PD and ToM. The study aimed to measure affective ToM abilities and cognitive performance in a sample of PD patients, to explore the link between affective ToM abilities and cognitive status, and to examine the impact of PD on affective ToM through the mediator effect of cognitive performance.
Patients and methods: Sixty-five patients diagnosed with idiopathic PD and 51 healthy controls matched for age, gender and educational level completed a visual affective ToM task (Reading the Mind in the Eyes – RMET), cognitive performance was evaluated with Montreal Cognitive Assessment, and psychiatric symptoms were measured with BPRS-E (Brief Psychiatric Rating Scale).
Results: Affective ToM abilities were preserved in early PD patients, declining as the disease progressed. Deficits in cognitive functioning predicted deficiencies in affective ToM. Although attention (AT), executive functions (EF) and visuospatial abilities (VSA) together mediated the relationship between PD and affective ToM, only VSA impairment had a specific negative impact on affective ToM. Moreover, 41% of the total effect of attention and executive functions on affective ToM was mediated by visuospatial skills.
Conclusion: Cognitive performance may have an impact on the relationship between PD and affective ToM through the involvement of VSA. The influence of AT and EF in this relationship appears to be also exerted by PD patients’ VSA.

Keywords: Parkinson’s disease, cognitive functions, social cognition, visuospatial abilities, executive functions

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