Department of Psychology.
Department of Psychiatry and Clinical Psychology.
Neuropsychology. 2022 Sep;36(6):483-504. doi: 10.1037/neu0000807. Epub 2022 Apr 7.
Theory of mind (ToM) is the ability to infer others' mental (Cognitive) and emotional (Affective) states, both being impaired in Parkinson's disease (PD). However, the clinical, neuropsychological, and neuropsychiatric features underlying Affective and Cognitive ToM deficits in PD are unclear. Therefore, we performed a meta-analytic study to test whether PD demographical, clinical, neuropsychological, or neuropsychiatric changes related differently to both ToM processes.
A systematic literature search was performed up to January 2022, including a total of 31 studies following our search terms. Data from each study were obtained from demographic (age, education), clinical (disease duration, Hoehn & Yahr staging system, Unified Parkinson's Disease Rating Scale-III, levodopa equivalent daily dose), neuropsychological (global cognitive functioning, memory subdomains, executive functions subdomains, processing speed/complex attention/working memory, visuospatial and constructional abilities, and language), and neuropsychiatric (depression, apathy, anxiety) variables.
Affective ToM impairment in PD was related to lower educational level and global cognition, deficits of generativity, decision making, attention/working memory, and language. Conversely, Cognitive ToM deficits were associated with advanced age, poorer global cognition, executive dysfunctions, and language impairments. Medication moderated the relationship between attention/working memory and Cognitive ToM, whereas age moderated the association of Affective ToM with language. No significant associations were found between ToM deficits and patients' neuropsychiatric or clinical states.
These findings clarify the neuropsychological and clinical features that explain ToM deficits in PD. Possibly, our results suggest the need to explore the complex neural networks involving frontostriatal and temporoparietal circuits behind changes in social cognition in PD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
心理理论（ToM）是推断他人心理（认知）和情感（情感）状态的能力，这两种能力在帕金森病（PD）中都受到损害。然而，PD 中情感和认知 ToM 缺陷的临床、神经心理学和神经精神学特征尚不清楚。因此，我们进行了一项荟萃分析研究，以测试 PD 人口统计学、临床、神经心理学或神经精神学变化是否与这两个 ToM 过程有不同的关系。
我们进行了系统的文献检索，截至 2022 年 1 月，共纳入了 31 项符合我们检索词的研究。从每个研究中获取数据来自人口统计学（年龄、教育）、临床（疾病持续时间、Hoehn & Yahr 分期系统、统一帕金森病评定量表-III、左旋多巴等效日剂量）、神经心理学（整体认知功能、记忆子域、执行功能子域、处理速度/复杂注意力/工作记忆、视空间和结构能力、语言）和神经精神学（抑郁、淡漠、焦虑）变量。
PD 患者的情感 ToM 损伤与较低的教育水平和整体认知有关，与生育力、决策、注意力/工作记忆和语言的缺陷有关。相反，认知 ToM 缺陷与年龄较大、整体认知较差、执行功能障碍和语言障碍有关。注意力/工作记忆与认知 ToM 的关系受药物调节，而年龄调节情感 ToM 与语言的关系。ToM 缺陷与患者的神经精神或临床状态之间没有显著的相关性。
这些发现阐明了解释 PD 中 ToM 缺陷的神经心理学和临床特征。可能，我们的结果表明需要探索涉及额-纹状体和颞-顶叶回路的复杂神经网络，以解释 PD 中社会认知的变化。（PsycInfo 数据库记录（c）2022 APA，保留所有权利）。
