Institute of Neuroscience, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China.
University of Chinese Academy of Sciences, Beijing, China.
Mov Disord. 2024 Jul;39(7):1154-1165. doi: 10.1002/mds.29830. Epub 2024 May 2.
Theory of mind (ToM), the ability to infer others' mental state, is essential for social interaction among human beings. It has been widely reported that both cognitive (inference of knowledge) and affective (inference of emotion) components of ToM are disrupted in Parkinson's disease (PD). Previous studies usually focused on the involvement of the prefrontal cortex.
This study investigated the causal role of the subthalamic nucleus (STN), a key hub of the fronto-basal ganglia loops, in ToM.
Thirty-four patients with idiopathic PD (15 women, aged 62.2 ± 8.3 years) completed a Yoni task with deep brain stimulation (DBS) ON and OFF. The Yoni task was designed to separate the cognitive and affective components of ToM. Volumes of tissue activated (VTA) were computed for three subregions of the STN.
DBS showed insignificant effects on ToM inference costs at the group level, which may be due to the large interindividual variability. The associative VTA correlated with the cognitive inference cost change but not the affective inference cost change. Patients with greater associative STN stimulation infer more slowly on cognitive ToM. Stimulating associative STN can adversely affect cognitive ToM in PD patients, especially in patients with a wide range of stimulation (≥0.157) or cognitive decline (Montreal Cognitive Assessment < 26).
The associative STN plays a causal role in cognitive ToM in patients with PD. However, stimulating the associative STN likely impairs cognitive ToM and potentially leads to social interaction deficits in PD. © 2024 International Parkinson and Movement Disorder Society.
心理理论（Theory of mind，ToM）是推断他人心理状态的能力，是人类社会互动的基础。已有大量研究报道帕金森病（Parkinson's disease，PD）患者的 ToM 存在认知（知识推断）和情感（情感推断）成分的损伤，且这种损伤与前额叶皮层有关。
本研究旨在探讨基底神经节环路的关键枢纽——丘脑底核（subthalamic nucleus，STN）在 ToM 中的因果作用。
34 例特发性 PD 患者（女性 15 例，年龄 62.2±8.3 岁）在深部脑刺激（deep brain stimulation，DBS）开启和关闭状态下完成了 Yoni 任务，该任务用于分离 ToM 的认知和情感成分。计算了 STN 三个亚区的组织激活体积（volume of tissue activated，VTA）。
DBS 对整体患者的 ToM 推断成本无显著影响，可能是由于个体间的变异性较大。关联 VTA 与认知推断成本变化相关，但与情感推断成本变化无关。关联 STN 刺激量较大的患者在认知 ToM 上的推断速度较慢。刺激关联 STN 可能会对 PD 患者的认知 ToM 产生不利影响，特别是在刺激范围较大（≥0.157）或认知能力下降（蒙特利尔认知评估量表<26）的患者中。
关联 STN 在 PD 患者的认知 ToM 中起因果作用。然而，刺激关联 STN 可能会损害认知 ToM，并可能导致 PD 患者的社交互动缺陷。
