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. 2022 May;145(5):571-578.
doi: 10.1111/ane.13585. Epub 2022 Feb 2.

Theory of mind: A clue for the interpretation of functional movement disorders

Maria Caterina Silveri  1   2 , Sonia Di Tella  1 , Maria Rita Lo Monaco  2   3 , Martina Petracca  2 , Alice Tondinelli  1 , Gabriella Antonucci  4 , Gino Pozzi  2   5 , Giulia Di Lazzaro  2   6 , Paolo Calabresi  2   7 , Anna Rita Bentivoglio  2   7
Affiliations

Theory of mind: A clue for the interpretation of functional movement disorders

Maria Caterina Silveri et al. Acta Neurol Scand. 2022 May.

Abstract

Objectives: Functional movement disorders (FMD) refer to a heterogeneous group of manifestations incongruent with known neurological diseases. Functional neuroimaging studies in FMD indicate the overlap between cerebral regions in which abnormal activation occurs and those considered crucial for theory of mind (ToM), the ability to attribute mental states. The aim of this study was to explore whether FMD might be related to ToM disorders to the extent that they reduce the ability to make inferences about the mental states underlying motor behaviour during social interaction.

Materials & methods: Eighteen subjects with FMD and 28 matched healthy controls (HC) were given a ToM battery. The severity of FMD was rated by the Simplified-FMD Rating Scale (S-FMDRS). Dissociative symptoms were evaluated by the Dissociative Experiences Scale (DES-II).

Results: FMD scored worse than the HC in most ToM tasks: second-order False Beliefs (p = .005), Faux-Pas Recognition Test (p < .001) and Reading the Mind in the Eyes Test (p = .020); control questions elicited normal scores. The DES-II indicated dissociative-borderline psychopathology and negatively correlated with accuracy on the second-order False Belief (Spearman's rho = -.444; p = .032); the positive correlation between DES-II and severity of motor symptoms (S-FMDRS) approached significance (Spearman's rho test = .392; p = .054). ToM disorders were not correlated with S-FMDRS, due to the typical variability in FMD over time with regard to the severity of symptoms and the district of body involved.

Conclusions: Our results are consistent with the hypothesis that FMD are related to ToM deficits, and future studies are needed to define the specific nature of this relationship.

Keywords: dissociation; functional movement disorders; social cognition; theory of mind.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

FIGURE 1
FIGURE 1
Performance of FMD and HC on False Belief tasks (Mann‐Whitney U test). Panel A: First‐order False Beliefs; Panel B: second‐order False Beliefs. *Statistical significance at p < .05. FMD, patients with functional movement disorders; HC, healthy controls
FIGURE 2
FIGURE 2
Performance of FMD and HC on Faux‐Pas tasks (Mann‐Whitney U test). **Statistical significance at p < .001. FMD, patients with functional movement disorders; HC, healthy controls
FIGURE 3
FIGURE 3
Performance of FMD and HC on RMET (Mann‐Whitney U test). *Statistical significance at p < .05. FMD, patients with functional movement disorders; HC, healthy controls; RMET, Reading the Mind in the Eyes Test
See this image and copyright information in PMC

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