Cognitive and affective theory of mind in dementia with Lewy bodies and Alzheimer's disease.
Cognitive and affective theory of mind in dementia with Lewy bodies and Alzheimer's disease.
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DOI：
10.1186/s13195-016-0179-9
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发表时间：
2016-03-16
期刊：
影响因子：
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通讯作者：
Blanc F
中科院分区：
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作者：
Heitz C;Noblet V;Phillipps C;Cretin B;Vogt N;Philippi N;Kemp J;de Petigny X;Bilger M;Demuynck C;Martin-Hunyadi C;Armspach JP;Blanc F
心理理论（Theory of mind, ToM）是指将心理状态、思想（认知成分）或感觉（情感成分）归因于他人的能力。这种功能在许多神经退行性疾病中都有研究；然而，据我们所知，尚无研究ToM在路易体痴呆（DLB）中的研究发表。我们研究的目的是评估DLB患者的ToM，并寻找潜在缺陷的神经相关因素。研究纳入33例早期DLB患者（DLB组）和15例老年痴呆症患者（AD组），以及16例健康老年人对照（HC组）。在全面的认知评估后，我们使用失礼识别（FPR）测试、眼睛读心（RME）测试和Ekman面部情绪识别测试来评估ToM的认知和情感成分。患者行脑3-T磁共振成像，采用基于体素的形态学分析灰质萎缩情况。我们进行了单样本t检验来研究每个ToM评分与灰质体积之间的相关性，并进行了双样本t检验来比较每个测试中DLB受损患者与非受损患者。DLB组在FPR测试（P = 0.033）和RME测试（P = 0.015）上的表现明显低于HC组。AD组与HC组、DLB组与AD组无显著性差异。一些大脑区域与ToM损伤有关。前额叶皮层、下额叶皮层和眶额叶皮层是主要区域，但我们也发现与颞顶叶交界处、楔前叶、梭状回和脑岛相关。本研究首次揭示了DLB患者的早期ToM损伤。这两种认知和情感成分似乎都在这种疾病中受到影响。在ToM困难的患者中，我们发现与ToM相关的经典脑区萎缩，这加强了ToM的神经网络。现在需要进一步的研究来更好地了解这种损伤的神经基础。本文的在线版本（doi:10.1186/s13195-016-0179-9）包含补充材料，可供授权用户使用。
Theory of mind (ToM) refers to the ability to attribute mental states, thoughts (cognitive component) or feelings (affective component) to others. This function has been studied in many neurodegenerative diseases; however, to our knowledge, no studies investigating ToM in dementia with Lewy bodies (DLB) have been published. The aim of our study was to assess ToM in patients with DLB and to search for neural correlates of potential deficits. Thirty-three patients with DLB (DLB group) and 15 patients with Alzheimer’s disease (AD group), all in the early stage of the disease, as well as 16 healthy elderly control subjects (HC group), were included in the study. After a global cognitive assessment, we used the Faux Pas Recognition (FPR) test, the Reading the Mind in the Eyes (RME) test and Ekman’s Facial Emotion Recognition test to assess cognitive and affective components of ToM. Patients underwent cerebral 3-T magnetic resonance imaging, and atrophy of grey matter was analysed using voxel-based morphometry. We performed a one-sample t test to investigate the correlation between each ToM score and grey matter volume and a two-sample t test to compare patients with DLB impaired with those non-impaired for each test. The DLB group performed significantly worse than the HC group on the FPR test (P = 0.033) and the RME test (P = 0.015). There was no significant difference between the AD group and the HC group or between the DLB group and the AD group. Some brain regions were associated with ToM impairments. The prefrontal cortex, with the inferior frontal cortex and the orbitofrontal cortex, was the main region, but we also found correlations with the temporoparietal junction, the precuneus, the fusiform gyrus and the insula. This study is the first one to show early impairments of ToM in DLB. The two cognitive and affective components both appear to be affected in this disease. Among patients with ToM difficulties, we found atrophy in brain regions classically involved in ToM, which reinforces the neuronal network of ToM. Further studies are now needed to better understand the neural basis of such impairment. The online version of this article (doi:10.1186/s13195-016-0179-9) contains supplementary material, which is available to authorized users.