Hamilton Jackie, Radlak Bogna, Morris Paul G, Phillips Louise H
Department of Clinical Neuropsychology, Aberdeen Royal Infirmary, Ashgrove House,UK.
Royal Cornhill Hospital, Aberdeen,UK.
Arch Clin Neuropsychol. 2017 Aug 1;32(5):507-518. doi: 10.1093/arclin/acx035.
Cognitive deficits following stroke are well documented, but less is known about problems with social skills such as understanding others' thoughts and feelings. This study investigated the effect of stroke on a visual-affective measure of social understanding: the Reading the Mind in the Eyes test (RMET). The aims were to investigate whether right hemisphere stroke was particularly detrimental to this aspect of Theory of Mind (ToM), and investigate the relationship between ToM ability and executive function following stroke.
Performance of stroke patients (right hemisphere stroke, n = 15; left hemisphere stroke, n = 15) was compared to that of controls (n = 40) matched for age, years of education, and IQ on tasks measuring ToM and executive functioning.
Right hemisphere stroke was associated with impaired ToM ability, but left hemisphere stroke was not. There was no effect of stroke on a matched non-ToM control task. High correlations were found between performance on the RMET and some measures of executive functioning in participants with right hemisphere stroke only. Further analyses suggested that deficits in executive functioning could not statistically explain all of the difficulties shown by stroke participants on the RMET.
A reduction in the ability to attribute mental states to others following right hemisphere stroke may adversely affect psychosocial functioning, disrupt interpersonal relationships, and lead to reduced quality of life. The clinical importance of these findings, implications for clinical practice and future research are discussed.
中风后的认知缺陷已有充分记录，但对于诸如理解他人想法和感受等社交技能方面的问题了解较少。本研究调查了中风对社交理解的视觉情感测量指标——“眼神读心测试”（RMET）的影响。目的是研究右半球中风是否对心理理论（ToM）的这一方面特别有害，并研究中风后ToM能力与执行功能之间的关系。
将中风患者（右半球中风，n = 15；左半球中风，n = 15）的表现与在测量ToM和执行功能的任务上年龄、受教育年限和智商相匹配的对照组（n = 40）的表现进行比较。
右半球中风与ToM能力受损有关，但左半球中风则不然。中风对一项匹配的非ToM对照任务没有影响。仅在右半球中风的参与者中，发现RMET表现与一些执行功能测量指标之间存在高度相关性。进一步分析表明，执行功能缺陷在统计学上不能解释中风参与者在RMET上表现出的所有困难。
右半球中风后将心理状态归因于他人的能力下降可能会对心理社会功能产生不利影响，破坏人际关系，并导致生活质量下降。讨论了这些发现的临床重要性、对临床实践的意义以及未来研究方向。
