Eddy Clare M, Sira Mahalingappa Sridevi, Rickards Hugh E
Department of Neuropsychiatry, BSMHFT, The Barberry National Centre for Mental Health, Edgbaston, Birmingham, UK,
Eur Arch Psychiatry Clin Neurosci. 2014 Dec;264(8):697-705. doi: 10.1007/s00406-014-0498-4. Epub 2014 Mar 20.
In Huntington's disease (HD), frontostriatal dysfunction may lead to deficits in theory of mind (ToM), in addition to broader cognitive impairment. We investigated relationships between patients' spatial and social perspective taking performance and executive deficits, self-reported everyday perspective taking, motor symptoms, functional capacity and quality of life. Thirty patients with symptomatic HD and twenty-three healthy controls of similar age and education completed two ToM tasks, a scale assessing everyday interpersonal perspective taking, a novel object-based spatial perspective taking task (SPT) and executive measures. Ratings of quality of life, psychiatric symptoms, motor symptom severity and functional capacity were also taken for patients. When compared to controls, patients exhibited significant deficits in ToM and spatial perspective taking and lower everyday perspective taking scores. Executive deficits were linked to poor understanding of socially inappropriate remarks and errors in mental state attribution. This may be the first study to show that aspects of ToM performance are linked to spatial perspective taking, motor symptom severity and functional capacity in HD. Our findings indicate that patients with HD exhibit evidence of reduced perspective taking in everyday life in addition to poor performance on social and SPTs. They also emphasise the need to better specify the precise cognitive and neural bases for ToM deficits in neurodegenerative conditions. Further research exploring the impact of striatal degeneration on perspective taking abilities will make a valuable contribution to the continued development of functional models of frontostriatal circuitry.
在亨廷顿舞蹈症（HD）中，除了更广泛的认知障碍外，额颞叶功能障碍可能导致心理理论（ToM）缺陷。我们研究了患者的空间和社会视角采择表现与执行功能缺陷、自我报告的日常视角采择、运动症状、功能能力和生活质量之间的关系。30例有症状的HD患者和23名年龄及教育程度相近的健康对照者完成了两项ToM任务、一项评估日常人际视角采择的量表、一项基于物体的新型空间视角采择任务（SPT）以及执行功能测量。还对患者的生活质量、精神症状、运动症状严重程度和功能能力进行了评分。与对照组相比，患者在ToM和空间视角采择方面存在显著缺陷，日常视角采择得分较低。执行功能缺陷与对社交不当言论的理解不足以及心理状态归因错误有关。这可能是第一项表明HD中ToM表现的各个方面与空间视角采择、运动症状严重程度和功能能力相关的研究。我们的研究结果表明，HD患者除了在社交和SPT任务中表现不佳外，在日常生活中也表现出视角采择能力下降的迹象。它们还强调需要更好地明确神经退行性疾病中ToM缺陷的确切认知和神经基础。进一步研究纹状体退化对视角采择能力的影响将为额颞叶回路功能模型的持续发展做出宝贵贡献。
