Journal
EUROPEAN JOURNAL OF NEUROLOGY
Volume 29, Issue 8, Pages 2211-2219Publisher
WILEY
DOI: 10.1111/ene.15388
Keywords
cognitive disorders and dementia; motor neuron disease; social cognition
Categories
Funding
- Italian Ministry of Health (Ministero della Salute, Ricerca Sanitaria Finalizzata) [RF-2016-02362405]
- Progetti di Rilevante Interesse Nazionale program of the Ministry of Education, University [2017SNW5MB]
- Horizon 2020 [RF H2020-SC1-DTH-2020-1, 101017598]
- Italian Ministry of Education, University, and Research
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This study assessed the differences in facial emotion recognition and theory of mind between ALS patients and controls, and found that ALS patients performed worse in social cognition, including facial emotion recognition and theory of mind. These findings support the importance of routinely assessing social cognition in ALS patients.
Background and purpose Social cognition (SC) deficits are included in amyotrophic lateral sclerosis (ALS)-frontotemporal spectrum disorder revised diagnostic criteria. However, SC performance among ALS patients is heterogeneous due to the phenotypic variability of the disease and the wide range of neuropsychological tools employed. The aim of the present study was to assess facial emotion recognition and theory of mind in ALS patients compared to controls and to evaluate correlations with the other cognitive domains and degree of motor impairment. Methods Eighty-three patients and 42 controls underwent a cognitive evaluation and SC assessment through the Ekman 60 Faces Test (EK-60F), the Reading the Mind in the Eyes Test-36 Faces (RMET-36), and the Story-Based Empathy Task (SET). Results ALS patients showed significantly worse performance compared to controls in EK-60F global score (p < 0.001), recognition of disgust (p = 0.032), anger (p = 0.038), fear (p < 0.001), and sadness (p < 0.001); RMET-36 (p < 0.001), and SET global score (p < 0.001). Also, cognitively normal patients (ALS-CN) showed significantly worse performance compared to controls in EK-60F global score (p < 0.001), recognition of fear (p = 0.002), sadness (p < 0.001), and SET (p < 0.001). RMET-36 showed a significant correlation with the Category Fluency Test (p = 0.041). SC tests showed no correlation with motor impairment expressed by Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised. Conclusions ALS patients, also when categorized as ALS-CN, may show impairment in SC performance. The frequent identification of early SC impairment in ALS patients supports the need to routinely assess SC for its impact on end-of-life decisions and its potential influence on patients' quality of life.
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