Impaired affective and cognitive theory of mind and behavioural change in amyotrophic lateral sclerosis.

OBJECTIVES: Executive and behavioural changes are well-recognised in classical amyotrophic lateral sclerosis (ALS), indicating a subclinical behavioural-variant frontotemporal dementia (bvFTD) in some patients. Social cognitive deficits in ALS have been recently described and an impairment was identified on a simple Theory of Mind (ToM) test, which assesses the judgement of the preference of another through direction of eye gaze. The present study further delineated this deficit, by distinguishing between Affective and Cognitive subcomponents, and determining the relationship to behavioural change, levels of empathy and self-awareness. METHODS: The Cognitive-Affective Judgement of Preference Test was administered to 33 patients with ALS and 26 controls. Furthermore, a comprehensive neuropsychological battery and detailed behavioural assessment, with measures of empathy and awareness, were included. RESULTS: Patients with ALS showed a significant impairment in Affective ToM only when compared with healthy controls, with a deficit in 36% of patients; 12% showed an isolated Affective ToM deficit while 24% showed more generic ToM dysfunction. A Cognitive ToM deficit was found in 27% of patients, with 3% showing an isolated Cognitive ToM deficit. The patients with ALS showed reduced empathy (Fantasy scale) and increased behavioural dysfunction with high levels of apathy. In addition, patients with either an Affective and/or Cognitive ToM deficit exhibited poor self-awareness of their performance and abnormalities on verbal fluency, while those with an Affective ToM deficit also displayed higher levels of apathy and a naming deficit. CONCLUSIONS: Dysfunctional ToM is a prominent feature of the cognitive profile of ALS. This specific difficulty in identifying and distinguishing the feelings and thoughts of another from a self-perspective may underpin the social behavioural abnormalities present in some patients with ALS, manifest as apathy and loss of awareness.

A neuropsychological study of personality: trait openness in relation to intelligence, fluency, and executive functioning.

Openness is a personality trait that has been linked to intelligence and divergent thinking. DeYoung, Peterson, and Higgins (2005) theorized that trait Openness depends on dopamine function, especially in the prefrontal cortex. We tested their theory in 335 healthy adults by hypothesizing that individual differences in Openness would correlate more strongly with performance on tests of executive function than on tests of intelligence and fluency. However, Openness correlated more strongly with verbal/crystallized intelligence (Gc; r = .44) than with executive functioning (r = .16) and fluency (r = .24). Further, the partial correlation between Openness and Gc increased from r = .26 among young adults to r = .53 among elderly adults. These findings suggest that Openness is more closely associated with the acquisition of broad verbal intellectual skills and knowledge than with executive abilities localized to a specific brain region or neurotransmitter system.