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Impairments in Social Cognition in Early Medicated and Unmedicated Parkinson Disease

Roca, María PsyD* † ‡; Torralva, Teresa PsyD* † ‡; Gleichgerrcht, Ezequiel BSc§; Chade, Anabel MD∥ ¶; Arévalo, Gonzalo Gómez MD∥ ¶; Gershanik, Oscar MD∥ ¶; Manes, Facundo MD♯ **

Cognitive and Behavioral Neurology: September 2010 - Volume 23 - Issue 3 - p 152-158
doi: 10.1097/WNN.0b013e3181e078de
Original Studies

Background Theory of mind (ToM) refers to the ability to infer others' mental states, including intentions and feelings, and is considered to be a critical part of social cognition. Earlier studies in individuals with Parkinson disease (PD) have shown ToM deficits in the more advanced stages of the disease. There is currently no evidence of social cognition deficits in patients in the early stages of PD.

Methods In this study, we compared patients with early PD (n=36) and a control group of healthy subjects (n=36). Patients were assessed with 2 ToM tasks designed to differentially detect subtle deficits in the affective and cognitive aspects of ToM. Patients were also assessed with a complete neuropsychologic battery which included classic executive tests aimed at investigating the relationship between ToM and executive functions. Performance of medicated (n=16) and unmedicated (n=20) patients was also compared.

Results Our results are the first to indicate that ToM is affected in the early stages of PD. As has already been reported in more advanced stages of PD, such deficits seem to be related to the cognitive aspects of this domain. In our study, these deficits were not related with performance on executive functioning, depression, or medication usage.

Conclusions These results provide evidence for ToM impairments early in the course of PD. Recognition of ToM impairments in early PD is important, as these deficits may impact patients' social interactions and quality of life.

*Department of Neuropsychology

§Congnitive Neuroscience Laboratory

Department of Neurology

Congnitive Neurology Department, Institute of Cognitive Neurology (INECO)

Department of Neuropsychology

Department of Neurology

**Cognitive Neurology Department, Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina

Laboratory of Neuroscience, Universidad Diego Portales, Chile

Supported by a FINECO grant and a Fundación LyD grant. This study is part of María Roca's work toward her doctoral thesis.

Reprints: Facundo Manes, MD, Instituto de Neurología Cognitiva (INECO), Castex 3293 (1425), Buenos Aires, Argentina (e-mail:

Received for publication November 1, 2009; accepted March 28, 2010

Search terms: [165] Parkinson disease/Parkinsonism, [205] Neuropsychological assessment, [206] Executive function, Social Cognition.

María Roca, Teresa Torralva, Ezequiel Gleichgerrcht, Anabel Chade, Gonzalo Gómez Arévalo, Oscar Gershanik, and Facundo Manes reports no disclosures.

© 2010 Lippincott Williams & Wilkins, Inc.