Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa 16100, Italy.
J Neurol Neurosurg Psychiatry. 2013 Jul;84(7):818-21. doi: 10.1136/jnnp-2012-303684. Epub 2012 Nov 1.
Recent data suggest that theory of mind (ToM) deficits represent an early symptom of the behavioural variant of frontotemporal dementia (bvFTD). However, longitudinal data on the natural history of subjects presenting with isolated ToM deficits are lacking. The aim of the study was to verify if isolated ToM deficits represent an at-risk state for prefrontal dysfunction and bvFTD.
A population of healthy subjects (n=4150, age range: 50-60 years) completed a clinical and neuropsychological evaluation including the Reading the Mind in the Eyes Test (RMET), a widely used ToM task. From this group, we recruited a low-RMET group (n=83) including subjects with RMET scores lower than 2 SDs but an otherwise normal neuropsychological evaluation and a control group. All subjects underwent evaluation at baseline and after 2 years.
Subjects in the low-RMET group showed decline in prefrontal functions at follow-up. Moreover, at follow-up 12 subjects in the low-RMET group presented with findings suggestive of bvFTD. Neuropsychological performance was stable in the control group.
Our data suggest that isolated ToM deficits could represent an at-risk situation for the development of future prefrontal dysfunction and bvFTD. ToM evaluation should be included in neuropsychological protocols aimed to evaluate the early phases of dementia.
最近的数据表明，心理理论（ToM）缺陷是额颞叶痴呆（bvFTD）行为变异型的早期症状。然而，关于表现出孤立 ToM 缺陷的受试者的自然病史的纵向数据尚缺乏。本研究旨在验证孤立的 ToM 缺陷是否代表前额叶功能障碍和 bvFTD 的高危状态。
一组健康受试者（n=4150，年龄范围：50-60 岁）完成了临床和神经心理学评估，包括使用广泛的心理理论任务“读心测试”（RMET）。从该组中，我们招募了一个低 RMET 组（n=83），包括 RMET 评分低于 2 个标准差但其他神经心理学评估正常的受试者和对照组。所有受试者均在基线和 2 年后进行评估。
低 RMET 组的受试者在随访时表现出前额叶功能下降。此外，在随访时，低 RMET 组的 12 名受试者出现了提示 bvFTD 的表现。对照组的神经心理学表现稳定。
我们的数据表明，孤立的 ToM 缺陷可能代表未来前额叶功能障碍和 bvFTD 发展的高危情况。ToM 评估应纳入旨在评估痴呆早期阶段的神经心理学方案中。
