左右为难：执行功能与行为变异额颞叶痴呆的心智理论。
In two minds: executive functioning versus theory of mind in behavioural variant frontotemporal dementia.
机构信息
Department of Clinical Neurosciences, University of Cambridge, UK Institut de la Mémoire et de la Maladie d'Alzheimer, Hôpital de la Pitié-Salpêtrière, Université Paris VI, Paris, France.
Behavioural and Clinical Neuroscience Unit, University of Cambridge, UK.
出版信息
J Neurol Neurosurg Psychiatry. 2016 Mar;87(3):231-4. doi: 10.1136/jnnp-2015-311643. Epub 2015 Oct 22.
BACKGROUND
The relationship of executive function (EF) and theory of mind (ToM) deficits in neurodegeneration is still debated. There is contradicting evidence as to whether these cognitive processes are overlapping or distinct, which has clear clinical relevance for the evaluation of their associated clinical symptoms.
AIM
To investigate the relationship of EF and ToM deficits via a data-driven approach in a large sample of patients with behavioural variant frontotemporal dementia (bvFTD).
METHODS
Data of 46 patients with bvFTD were employed in a hierarchical cluster analysis to determine the similarity of variance between different EF measures (verbal abstraction, verbal initiation, motor programming, sensitivity to interference, inhibitory control, visual abstraction, flexibility, working memory/attention) and ToM (faux pas).
RESULTS
Overall results showed that EF measures were clustered separately from the ToM measure. A post hoc analysis revealed a more complex picture where selected ToM subcomponents (empathy; intention) showed a relationship to specific EF measures (verbal abstraction; working memory/attention), whereas the remaining EF and ToM subcomponents were separate.
CONCLUSIONS
Taken together, these findings suggest that EF and ToM are distinct components; however, ToM empathy and intention subcomponents might share some functions with specific EF processes. This has important implications for guiding diagnostic assessment of these deficits in clinical conditions.
背景
在神经退行性疾病中，执行功能（EF）和心理理论（ToM）缺陷的关系仍存在争议。这些认知过程是否重叠或不同，存在相互矛盾的证据，这对评估它们相关的临床症状具有明确的临床意义。
目的
通过对大量行为变异额颞叶痴呆（bvFTD）患者进行数据驱动的方法，研究 EF 和 ToM 缺陷之间的关系。
方法
使用 46 名 bvFTD 患者的数据进行层次聚类分析，以确定不同 EF 测量（言语抽象、言语启动、运动编程、对干扰的敏感性、抑制控制、视觉抽象、灵活性、工作记忆/注意力）和 ToM（失礼）之间方差的相似性。
结果
总体结果表明，EF 测量与 ToM 测量分开聚类。事后分析显示出更复杂的情况，其中选定的 ToM 子成分（同理心；意图）与特定的 EF 测量（言语抽象；工作记忆/注意力）相关，而其余的 EF 和 ToM 子成分是分开的。
结论
综上所述，这些发现表明 EF 和 ToM 是不同的成分；然而，ToM 同理心和意图子成分可能与特定的 EF 过程具有一些共同功能。这对指导这些缺陷在临床情况下的诊断评估具有重要意义。
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