Theory of mind impairments in patients with semantic dementia

Abstract

Semantic dementia is characterized by semantic deficits and behavioural abnormalities that occur in the wake of bilateral inferolateral and predominantly left-sided anterior temporal lobe atrophy. The temporal poles have been shown to be involved in theory of mind, namely the ability to ascribe cognitive and affective mental states to others that regulates social interactions by predicting and interpreting human behaviour. However, very few studies have examined theory of mind in semantic dementia. In this study, we investigated both cognitive and affective theory of mind in a group of patients with semantic dementia, using separate objective and subjective assessment tasks. Results provided objective evidence of an impact of semantic dementia on cognitive and affective theory of mind, consistent with the patients' atrophy in the left temporal lobe and hypometabolism in the temporal lobes and the medial frontal cortex. However, the subjective assessment of theory of mind suggested that awareness of the affective but not cognitive theory of mind deficit persists into the moderate stage of the disease.

Fig 1

Clusters of significant (p<0.01 family-wise error corrected) atrophy (A), and hypometabolism (B), in patients with SD compared to controls, as superimposed onto coronal slices of the Montreal National Institute template.

Fig 2

Example of story (first order) used in the false belief task.

Fig 3

Fig 3A. Choices of responses on the Tom’s taste. CR: correct response; C-P: response taking the context into account but not Tom’s preference; PC: response taking Tom’s preference into account but not the context; UR: unsuitable response Fig 3B. Justifications of responses on the Tom’s taste. P: justified according to Tom’s preference; C: justified according to the context; Self: justified according to participant’s own preference in the context; Other: any other justifications.