Heitz C, Vogt N, Cretin B, Philippi N, Jung B, Phillipps C, Blanc F
Unité de neuropsychologie, CMRR, service de neurologie, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67000 Strasbourg, France; Équipe IMIS/Neurocrypto, fédération de médecine translationnelle de Strasbourg (FMTS), laboratoire ICube, université de Strasbourg et CNRS, 1, place de l'Hôpital, 67000 Strasbourg, France.
Unité de neuropsychologie, CMRR, service de neurologie, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67000 Strasbourg, France.
Rev Neurol (Paris). 2015 Apr;171(4):373-81. doi: 10.1016/j.neurol.2015.02.010. Epub 2015 Apr 3.
'Theory of Mind' 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 theory of mind in dementia with Lewy Bodies (DLB) have been published. The aim of our study was to search theory of mind deficits in patients with DLB.
Seven patients with DLB (DLB group), at the stage of mild dementia or mild cognitive impairments, and seven healthy elderly adults (control group) were included in the study. After a global cognitive assessment, we used the Faux Pas Recognition test to assess the cognitive component of theory of mind, and the Reading the Mind in the Eyes test for the assessment of affective component.
We found a significant difference between the two groups for the Faux Pas test with an average score of 35.6 for the DLB group and 48.3 for the control group (P=0.04). Scores were particularly low in the DLB group for the last question of the test concerning empathy (42.9% versus 85%, P=0.01). There was not a significant difference between the two groups for the Reading the Mind in the Eyes test (P=0.077).
This preliminary study showed early impairments of theory of mind in the DLB. The cognitive component seems more affected than the affective component in this pathology. This pattern is consistent with the pattern found in Parkinson's disease, but differs from other neurodegenerative diseases as Alzheimer's disease or frontotemporal lobe dementia. These patterns may help to differentiate DLB from these diseases. Further study is needed to confirm these results and to compare with other dementias.
“心理理论”是指将心理状态、思想（认知成分）或情感（情感成分）归因于他人的能力。这种功能已在许多神经退行性疾病中得到研究；然而，据我们所知，尚未有关于路易体痴呆（DLB）患者心理理论的研究发表。我们研究的目的是探寻DLB患者的心理理论缺陷。
本研究纳入了7名处于轻度痴呆或轻度认知障碍阶段的DLB患者（DLB组）和7名健康老年人（对照组）。在进行全面认知评估后，我们使用失言识别测试来评估心理理论的认知成分，并使用眼神读心测试来评估情感成分。
在失言测试中，两组之间存在显著差异，DLB组的平均得分为35.6分，对照组为48.3分（P = 0.04）。在测试中关于同理心的最后一个问题上，DLB组的得分特别低（42.9%对85%，P = 0.01）。在眼神读心测试中，两组之间没有显著差异（P = 0.077）。
这项初步研究表明DLB患者存在心理理论的早期损害。在这种病理状态下，认知成分似乎比情感成分受到的影响更大。这种模式与帕金森病中发现的模式一致，但与其他神经退行性疾病如阿尔茨海默病或额颞叶痴呆不同。这些模式可能有助于将DLB与这些疾病区分开来。需要进一步研究来证实这些结果，并与其他痴呆症进行比较。
