Mind-Reading Ability and Structural Connectivity Changes in Aging

Assessing metarepresentational abilities in adolescence: an exploratory study on relationships between definitional competence and theory of mind

Introduction

Several developmental changes occur in adolescence, particularly in the metarepresentational domain, which allows and promotes adaptive sociality. We explored the possible relationships between theory of mind (ToM) and definitional competence, both metarepresentational, beyond age and gender effects.

Methods

To reach our goals, we involved 75 adolescents (age range 14-19 years, M = 15.7, and SD = 1.36). ToM was measured through "The Reading the Mind in the Eyes Test" (RMET), and definitional competence was assessed through a new instrument, namely, the "Co.De. Scale". Attention was paid to check whether results were different when considering mental states vs. non-mental states of the scale and emotional words vs. non-emotional words.

Results

T-tests showed that older adolescents (third grade of high school) performed better than younger ones (first grade of high school) in both tasks. Only in the male group, there were no school grade differences in the ToM task. Regression analyses showed that RMET performance predicted the score of non-emotional mental states definitions and, even if marginally, of ToM word definitions. However, RMET was not a predictor of the general performance of the definitional task or emotion definitions.

Discussion

Connections with global adolescents' development and possible educational implications are discussed.

Brain structure variation and individual differences in theory of mind among older adults

The theory of mind (ToM) is not substantially influenced by aging, suggesting the emergence of various compensatory mechanisms. To identify brain regions subserving ToM in older adults, we investigated the associations of individual differences in brain structure with performance on the Reading the Mind in the Eyes Test (RMET), a widely used measure of ToM, using voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS). In contrast to findings obtained from young adults, where multiple cortical regions are implicated in ToM, VBM analysis revealed a significant positive correlation between RMET score and gray matter (GM) volume only in the right middle temporal gyrus, a region implicated in social cognition. Alternatively, TBSS revealed significant positive correlations between RMET score and the fractional anisotropy (FA) values in widespread white matter (WM) tracts, including the bilateral uncinate fasciculus, a region previously linked to RMET performance in young adults. We speculate that individual differences in WM integrity are strong influences on ToM among older adults, whereas the impact of individual differences in GM volumes is relatively limited.

Assessing social cognition in patients with schizophrenia and healthy controls using the reading the mind in the eyes test (RMET): a systematic review and meta-regression

The reading the mind in the eyes test (RMET) - which assesses the theory of mind component of social cognition - is often used to compare social cognition between patients with schizophrenia and healthy controls. There is, however, no systematic review integrating the results of these studies. We identified 198 studies published before July 2020 that administered RMET to patients with schizophrenia or healthy controls from three English-language and two Chinese-language databases. These studies included 41 separate samples of patients with schizophrenia (total n = 1836) and 197 separate samples of healthy controls (total n = 23 675). The pooled RMET score was 19.76 (95% CI 18.91-20.60) in patients and 25.53 (95% CI 25.19-25.87) in controls (z = 12.41, p < 0.001). After excluding small-sample outlier studies, this difference in RMET performance was greater in studies using non-English v. English versions of RMET (Chi [Q] = 8.54, p < 0.001). Meta-regression analyses found a negative association of age with RMET score and a positive association of years of schooling with RMET score in both patients and controls. A secondary meta-analysis using a spline construction of 180 healthy control samples identified a non-monotonic relationship between age and RMET score - RMET scores increased with age before 31 and decreased with age after 31. These results indicate that patients with schizophrenia have substantial deficits in theory of mind compared with healthy controls, supporting the construct validity of RMET as a measure of social cognition. The different results for English versus non-English versions of RMET and the non-monotonic relationship between age and RMET score highlight the importance of the language of administration of RMET and the possibility that the relationship of aging with theory of mind is different from the relationship of aging with other types of cognitive functioning.

The impact of emotional valence and stimulus habituation on fMRI signal reliability during emotion generation

BACKGROUND

The emotional domain is often impaired across many neurological diseases, for this reason it represents a relevant target of rehabilitation interventions. Functional changes in neural activity related to treatment can be assessed with functional MRI (fMRI) using emotion-generation tasks in longitudinal settings. Previous studies demonstrated that within-subject fMRI signal reliability can be affected by several factors such as repetition suppression, type of task and brain anatomy. However, the differential role of repetition suppression and emotional valence of the stimuli on the fMRI signal reliability and reproducibility during an emotion-generation task involving the vision of emotional pictures is yet to be determined.

METHODS

Sixty-two healthy subjects were enrolled and split into two groups: group A (21 subjects, test-retest reliability on same-day and with same-task-form), group B (30 subjects, test-retest reproducibility with 4-month-interval using two equivalent-parallel forms of the task). Test-retest reliability and reproducibility of fMRI responses and patterns were evaluated separately for positive and negative emotional valence conditions in both groups. The analyses were performed voxel-wise, using the general linear model (GLM), and via a region-of-interest (ROI)-based approach, by computing the intra-class correlation coefficient (ICC) on the obtained contrasts.

RESULTS

The voxel-wise GLM test yielded no significant differences for both conditions in reliability and reproducibility analyses. As to the ROI-based approach, across all areas with significant main effects of the stimuli, the reliability, as measured with ICC, was poor (<0.4) for the positive condition and ranged from poor to excellent (0.4-0.75) for the negative condition. The ICC-based reproducibility analysis, related to the comparison of two different parallel forms, yielded similar results.

DISCUSSION

The voxel-wise GLM analysis failed to capture the poor reliability of fMRI signal which was instead highlighted using the ROI-based ICC analysis. The latter showed higher signal reliability for negative valence stimuli with respect to positive ones. The implementation of two parallel forms allowed to exclude neural suppression as the predominant effect causing low signal reliability, which could be instead ascribed to the employment of different neural strategies to cope with emotional stimuli over time. This is an invaluable information for a better assessment of treatment and rehabilitation effects in longitudinal studies of emotional neural processing.

Do cognitive reserve and executive functions matter to perform the reading the mind in the eyes test in late lifespan?

Theory of Mind (ToM) is the capacity to understand the feelings and emotional states (i.e., affective ToM) or intentions, goals, and beliefs (i.e., cognitive ToM) of others. Previous evidence on the effect of executive functions and educational attainment on affective ToM is controversial. This study was conducted to investigate: (1) the nature of the associations between affective ToM and some indexes of cognitive reserve (i.e., years of education, vocabulary) in late adulthood when age was controlled; (2) whether cognitive reserve (e.g., years of education, leisure activities, vocabulary) and age predicted affective ToM in late adulthood; (3) the associations between affective ToM and some executive functions measures in late adulthood, controlling for the effect of age; (4) whether executive functioning predicted affective ToM performance; (5) whether some executive functions (i.e., cognitive flexibility and inhibition) mediated between vocabulary score (i.e., used as an index of cognitive reserve) and affective ToM score. Fifty-six 75-93-year-old community-dwellers completed a battery of tasks to assess some executive functions and affective ToM skills (i.e., through the Reading the Mind in the Eyes Test). It was found that vocabulary, age, and participation in outdoor socio-recreational leisure activities predicted 31% of the variance in the Reading the Mind in the Eyes condition. Moreover, significant relationships were found between ToM and some executive functions, that is, cognitive flexibility and inhibition predicted 34% of the ToM score. Finally, cognitive flexibility and inhibition mediate between cognitive reserve (i.e., assessed in terms of vocabulary) and Reading the Mind in the Eyes test score.

The arcuate fasciculus: Combining structure and function into surgical considerations

BACKGROUND

Two Centuries from today, Karl Friedrich Burdach attributed the nomenclature "arcuate fasciculus" to a white matter (WM) pathway connecting the frontal to the temporal cortices by arching around the Sylvian fissure. Although this label remained essentially unvaried, the concepts related to it and the characterization of the structural properties of this bundle evolved along with the methodological progress of the past years. Concurrently, the functional relevance of the arcuate fasciculus (AF) classically restricted to the linguistic domain has extended to further cognitive abilities. These features make it a relevant structure to consider in a large variety of neurosurgical procedures.

OBJECTIVE

Herein, we build on our previous review uncovering the connectivity provided by the Superior Longitudinal System, including the AF, and provide a handy representation of the structural organization of the AF by considering the frequency of defined reports in the literature. By adopting the same approach, we implement an account of which functions are mediated by this WM bundle. We highlight how this information can be transferred to the neurosurgical field by presenting four surgical cases of glioma resection requiring the evaluation of the relationship between the AF and the nearby structures, and the safest approaches to adopt.

CONCLUSIONS

Our cumulative overview reports the most common wiring patterns and functional implications to be expected when approaching the study of the AF, while still considering seldom descriptions as an account of interindividual variability. Given its extension and the variety of cortical territories it reaches, the AF is a pivotal structure for different cognitive functions, and thorough understanding of its structural wiring and the functions it mediates is necessary for preserving the patient's cognitive abilities during glioma resection.

Sex and age differences in "theory of mind" across 57 countries using the English version of the "Reading the Mind in the Eyes" Test

The "Reading the Mind in the Eyes" Test (Eyes Test) is a widely used assessment of "theory of mind." The NIMH Research Domain Criteria recommends it as one of two tests for "understanding mental states." Previous studies have demonstrated an on-average female advantage on the Eyes Test. However, it is unknown whether this female advantage exists across the lifespan and across a large number of countries. Thus, we tested sex and age differences using the English version of the Eyes Test in adolescents and adults across 57 countries. We also tested for associations with sociodemographic and cognitive/personality factors. We leveraged one discovery dataset (N = 305,726) and three validation datasets (Ns = 642; 5,284; and 1,087). The results show that: i) there is a replicable on-average female advantage in performance on the Eyes Test; ii) performance increases through adolescence and shallowly declines across adulthood; iii) the on-average female advantage is evident across the lifespan; iv) there is a significant on-average female advantage in 36 out of 57 countries; v) there is a significant on-average female advantage on translated (non-English) versions of the Eyes Test in 12 out of 16 countries, as confirmed by a systematic review; vi) D-scores, or empathizing-systemizing, predict Eyes Test performance above and beyond sex differences; and vii) the female advantage is negatively linked to "prosperity" and "autonomy," and positively linked to "collectivism," as confirmed by exploratory country-level analyses. We conclude that the on-average female advantage on the Eyes Test is observed across ages and most countries.

Affective Theory of Mind as a residual ability to preserve mentalizing in amnestic Mild Cognitive Impairment: A 12-months longitudinal study

INTRODUCTION

Theory of Mind (ToM) decline has been outlined in people with amnestic Mild Cognitive Impairment (aMCI), but evidence from longitudinal studies is lacking. This longitudinal study aims to investigate changes in cognitive and affective ToM performance in an aMCI sample (n = 28; 14 females, mean age = 76.54 ± 4.35).

METHOD

Participants underwent two steps of neurocognitive evaluation, at the baseline (T1) and 12-month follow-up (T2), to obtain their global cognitive level and both affective (Reading the Mind in the Eyes test, ET) and cognitive (Strange Stories, SS) ToM profile. Then, participants were categorized into two groups based on ToM changes: people who worsened (ETΔ < 0; SSΔ < 0) and people who did not (ETΔ≥0; SSΔ≥0) at follow-up. Differences between groups in cognitive functions and ToM profiles at baseline have been investigated.

RESULTS

Our results showed that 46% of subjects worsened in affective (ET) and 28% in cognitive (SS) ToM at follow-up. People who worsened in ET reported a statistically significantly higher performance in ET at baseline (p = 0.002) but not at follow-up than people who did not worsen. In contrast, subjects who worsened in SS showed a lower Immediate Free Recall (IFR, p = 0.026) and Delayed Free Recall (DFR, p = 0.028) score of the Free and Cued Selective Reminding test at baseline and at follow-up, a lower ET (p = 0.020) baseline score, a lower SS and MMSE level at follow-up than people who not worsened. About 71% of MCI subjects showed the same trend of evolution of the Mini-Mental State Examination and SS. Variables that significantly differed between groups have been inserted in a stepwise logistic regression to pilot explore predictors of affective and cognitive ToM evolution. Logistic regression showed ET at baseline (p = 0.015) as the only significant predictor of affective ToM evolution (R2 = 0.450), while both ET (p = 0.044) and memory performance (p = 0.045) at baseline significantly predicted cognitive ToM evolution (R2 = 0.746).

DISCUSSION

In conclusion, our results support the role of affective ToM as a residual mentalizing ability in preserving the mentalizing level in people with aMCI.

Affective cognition in eating disorders: a systematic review and meta-analysis of the performance on the "Reading the Mind in the Eyes" Test

BACKGROUND

The Reading the Mind in the Eyes Test (RMET) is listed in the National Institute of Mental Health's Research Domain Criteria as a tool apt to measure the understanding of others' mental states. People diagnosed with anorexia nervosa (AN) showed poorer performances on the RMET than healthy controls. Less data are available concerning other eating disorders.

METHODS

Systematic review of four major databases from inception to July 15, 2021 following the PRISMA guidelines. Meta-analysis of cross-sectional observational studies comparing the scores of the RMET between patients with eating disorders and age- and-gender matched control groups.

RESULTS

Out of 21 studies, we retrieved 29 independent samples of patients diagnosed with an eating disorder. Patients with active AN (n = 580) showed worse performances on the RMET than controls (n = 1019). Year of publication accounted for 61% of the (substantial: I2 = 81%) heterogeneity in the meta-analysis. Earlier studies were more likely to find worse performances on the RMET of patients with active AN than later studies. Patients with bulimia nervosa (n = 185) performed poorly as compared to controls (n = 249), but the results were not statistically significant on the random-effect model. Obese patients with binge-eating disorder (n = 54) did not differ on the RMET from obese controls (n = 52). Patients with eating disorder not otherwise specified (n = 57) showed minimal differences compared to controls (n = 96). Study quality was good in six studies only.

CONCLUSIONS

Patients with eating disorders do not suffer from an impaired understanding of others' mental states, except for a still-to-be-identified subgroup of patients with active AN.

LEVEL OF EVIDENCE

I, systematic review and meta-analysis.

Reading language of the eyes

The need for assessment of social skills in clinical and neurotypical populations has led to the widespread, and still increasing use of the 'Reading the Mind in the Eyes Test' (RMET) developed more than two decades ago by Simon Baron-Cohen and colleagues for evaluation of social cognition in autism. By analyzing most recent clinical and brain imaging data, we illuminate a set of factors decisive for using the RMET. Converging evidence indicates: (i) In neurotypical individuals, RMET scores are tightly correlated with other social skills (empathy, emotional intelligence, and body language reading); (ii) The RMET assesses recognition of facial affect, but also heavily relies on receptive language skills, semantic knowledge, and memory; (iii) RMET performance is underwritten by the large-scale ensembles of neural networks well-outside the social brain; (iv) The RMET is limited in its capacity to differentiate between neuropsychiatric conditions as well as between stages and severity of a single disorder, though it reliably distinguishes individuals with altered social cognition or elevated pathological traits from neurotypical persons; (v) Merely gender (as a social construct) rather than neurobiological sex influences performance on the RMET; (vi) RMET scores do not substantially decline in healthy aging, and they are higher with higher education level, cognitive abilities, literacy, and mental well-being; (vii) Accuracy on the RMET, and engagement of the social brain, are greater when emotions are expressed and recognized by individuals with similar cultural/ethnic background. Further research is required to better inform usage of the RMET as a tool for swift and reliable examination of social cognition. In light of comparable visual input from the RMET images and faces covered by masks due to COVID-19 regulations, the analysis is of value for keeping efficient social interaction during the current pandemic, in particular, in professional settings related to social communication.

White matter association tracts underlying language and theory of mind: An investigation of 809 brains from the Human Connectome Project

Language and theory of mind (ToM) are the cognitive capacities that allow for the successful interpretation and expression of meaning. While functional MRI investigations are able to consistently localize language and ToM to specific cortical regions, diffusion MRI investigations point to an inconsistent and sometimes overlapping set of white matter tracts associated with these two cognitive domains. To further examine the white matter tracts that may underlie these domains, we use a two-tensor tractography method to investigate the white matter microstructure of 809 participants from the Human Connectome Project. 20 association white matter tracts (10 in each hemisphere) are uniquely identified by leveraging a neuroanatomist-curated automated white matter tract atlas. The fractional anisotropy (FA), mean diffusivity (MD), and number of streamlines (NoS) are measured for each white matter tract. Performance on neuropsychological assessments of semantic memory (NIH Toolbox Picture Vocabulary Test, TPVT) and emotion perception (Penn Emotion Recognition Test, PERT) are used to measure critical subcomponents of the language and ToM networks, respectively. Regression models are constructed to examine how structural measurements of left and right white matter tracts influence performance across these two assessments. We find that semantic memory performance is influenced by the number of streamlines of the left superior longitudinal fasciculus III (SLF-III), and emotion perception performance is influenced by the number of streamlines of the right SLF-III. Additionally, we find that performance on both semantic memory & emotion perception is influenced by the FA of the left arcuate fasciculus (AF). The results point to multiple, overlapping white matter tracts that underlie the cognitive domains of language and ToM. Results are discussed in terms of hemispheric dominance and concordance with prior investigations.

Decreased gray matter volume is associated with theory of mind deficit in adolescents with schizophrenia

Schizophrenia patients often suffer from deficit in theory of mind (TOM). Prior neuroimaging studies revealed neuroimaging correlates of TOM deficit in adults with schizophrenia, neuroimaging correlates of TOM in adolescents is less well established. This study aimed to investigate gray matter volume (GMV) abnormalities and TOM deficits in schizophrenic adolescents, and examine the relationship between them. Twenty adolescent schizophrenic patients and 25 age, sex-matched healthy controls underwent T1-weighted magnetic resonance imaging (MRI) scans, and were examined for TOM based on the Reading the Mind in the Eyes test (RMET). Univariate voxel-based morphometry (VBM) and multivariate source-based morphometry (SBM) were employed to examine alterations of two GMV phenotypes in schizophrenic adolescents: voxel-wise GMV and covarying structural brain patterns (SBPs). Compared with controls, our results revealed a significant deficit in RMET performance of the patients, Voxel-wise VBM analysis revealed that patients exhibited decreased GMV in bilateral insula, orbitofrontal cortex, and right rolandic operculum, and GMV of these brain regions were positively correlated with RMET performance. Multivariate SBM analysis identified a significantly different between-group SBP comprising of bilateral insula and inferior frontal cortex, bilateral superior temporal cortex, and bilateral lateral parietal cortex and right rolandic operculum. The loading scores of this SBP was positively correlated with RMET performance. This study revealed impairment of TOM ability in schizophrenic adolescents and revealed an association between TOM deficit and decreased GMV in regions which are crucial for social cognition, thereby provided insight and possible target regions for understanding the neural pathology and normalizing TOM deficit in adolescent schizophrenia patients.

Reading Covered Faces

Covering faces with masks, due to mandatory pandemic safety regulations, we can no longer rely on the habitual daily-life information. This may be thought-provoking for healthy people, but particularly challenging for individuals with neuropsychiatric and neurodevelopmental conditions. Au fait research on reading covered faces reveals that: 1) wearing masks hampers facial affect recognition, though it leaves reliable inferring basic emotional expressions; 2) by buffering facial affect, masks lead to narrowing of emotional spectrum and dampen veridical evaluation of counterparts; 3) masks may affect perceived face attractiveness; 4) covered (either by masks or other veils) faces have a certain signal function introducing perceptual biases and prejudices; 5) reading covered faces is gender- and age-specific, being more challenging for males and more variable even in healthy aging; 6) the hampering effects of masks on social cognition occur over the globe; and 7) reading covered faces is likely to be supported by the large-scale assemblies of the neural circuits far beyond the social brain. Challenges and limitations of ongoing research and parallels to the Reading the Mind in the Eyes Test are assessed. Clarification of how masks affect face reading in the real world, where we deal with dynamic faces and have entrée to additional valuable social signals such as body language, as well as the specificity of neural networks underlying reading covered faces calls for further tailored research.

A large-scale structural and functional connectome of social mentalizing

Humans have a remarkable ability to infer the mind of others. This mentalizing skill relies on a distributed network of brain regions but how these regions connect and interact is not well understood. Here we leveraged large-scale multimodal neuroimaging data to elucidate the brain-wide organization and mechanisms of mentalizing processing. Key connectomic features of the mentalizing network (MTN) have been delineated in exquisite detail. We found the structural architecture of MTN is organized by two parallel subsystems and constructed redundantly by local and long-range white matter fibers. We uncovered an intrinsic functional architecture that is synchronized according to the degree of mentalizing, and its hierarchy reflects the inherent information integration order. We also examined the correspondence between the structural and functional connectivity in the network and revealed their differences in network topology, individual variance, spatial specificity, and functional specificity. Finally, we scrutinized the connectome resemblance between the default mode network and MTN and elaborated their inherent differences in dynamic patterns, laterality, and homogeneity. Overall, our study demonstrates that mentalizing processing unfolds across functionally heterogeneous regions with highly structured fiber tracts and unique hierarchical functional architecture, which make it distinguishable from the default mode network and other vicinity brain networks supporting autobiographical memory, semantic memory, self-referential, moral reasoning, and mental time travel.

Similar Theory of Mind Deficits in Community Dwelling Older Adults with Vascular Risk Profile and Patients with Mild Cognitive Impairment: The Case of Paradoxical Sarcasm Comprehension

Recent studies deal with disorders and deficits caused by vascular syndrome in efforts for prediction and prevention. Cardiovascular health declines with age due to vascular risk factors, and this leads to an increasing risk of cognitive decline. Mild cognitive impairment (MCI) is defined as the negative cognitive changes beyond what is expected in normal aging. The purpose of the study was to compare older adults with vascular risk factors (VRF), MCI patients, and healthy controls (HC) in social cognition and especially in theory of mind ability (ToM). The sample comprised a total of 109 adults, aged 50 to 85 years (M = 66.09, SD = 9.02). They were divided into three groups: (a) older adults with VRF, (b) MCI patients, and (c) healthy controls (HC). VRF and MCI did not differ significantly in age, educational level or gender as was the case with HC. Specifically, for assessing ToM, a social inference test was used, which was designed to measure sarcasm comprehension. Results showed that the performance of the VRF group and MCI patients is not differentiated, while HC performed higher compared to the other two groups. The findings may imply that the development of a vascular disorder affecting vessels of the brain is associated from its “first steps” to ToM decline, at least regarding specific aspects of it, such as paradoxical sarcasm understanding.

Neuroanatomical Correlates of Social Intelligence Measured by the Guilford Test

Social interactions are a crucial aspect of human behaviour. Numerous neurophysiological studies have focused on socio-cognitive processes associated with the so-called theory of mind-the ability to attribute mental states to oneself and others. Theory of mind is closely related to social intelligence defined as a set of abilities that facilitate effective social interactions. Social intelligence encompasses multiple theory of mind components and can be measured by the Four Factor Test of Social Intelligence (the Guilford-Sullivan test). However, it is unclear whether the differences in social intelligence are reflected in structural brain differences. During the experiment, 48 healthy right-handed individuals completed the Guilford-Sullivan test. T1-weighted structural MRI images were obtained for all participants. Voxel-based morphometry analysis was performed to reveal grey matter volume differences between the two groups (24 subjects in each)-with high social intelligence scores and with low social intelligence scores, respectively. Participants with high social intelligence scores had larger grey matter volumes of the bilateral caudate. The obtained results suggest the caudate nucleus involvement in the neural system of socio-cognitive processes, reflected by its structural characteristics.

White Matter Correlates of Theory of Mind in Patients With First-Episode Psychosis

Deficits in theory of mind (ToM) are considered as a distinctive feature of schizophrenia. Functional magnetic resonance imaging (fMRI) studies have suggested that aberrant activity among the regions comprising the mentalizing network is related to observed ToM deficits. However, the white matter structures underlying the ToM functional network in schizophrenia remain unclear. To investigate the relationship between white matter integrity and ToM impairment, 35 patients with first-episode psychosis (FEP) and 29 matched healthy controls (HCs) underwent diffusion tensor imaging (DTI). Using tract-based spatial statistics (TBSS), fractional anisotropy (FA) values of the two regions of interest (ROI)-the cingulum and superior longitudinal fasciculus (SLF)-were acquired, and correlational analysis with ToM task scores was performed. Among the patients with FEP, ToM strange story scores were positively correlated with the FA values of the left cingulum and left SLF. There was no significant correlation between FA and ToM task scores in HCs. These results suggest that the left cingulum and SLF constitute a possible neural basis for ToM deficits in schizophrenia. Our study is the first to demonstrate the white matter connectivity underlying the mentalizing network, as well as its relation to ToM ability in patients with FEP.

Age- and Sex-Specific Standard Scores for the Reading the Mind in the Eyes Test

The reliable, valid and economic assessment of social cognition is more relevant than ever in the field of clinical psychology. Theory of Mind is one of the most important socio-cognitive abilities but standardized assessment instruments for adults are rare. The Reading the Mind in the Eyes Test (RMET) is well-established and captures the ability to identify mental states from gaze. Here, we computed standard scores for the German version of the RMET derived from a large, community-dwelling sample of healthy adults (20–79 years). The standardization sample contains 966 healthy adult individuals of the population-based Leipzig Research Center for Civilization Diseases (LIFE) study. Before standardization, weighting factors were applied to match the current sample with distribution characteristics of the German population regarding age, sex, and education. RMET scores were translated into percentage ranks for men and women of five age groups (20–29, 30–39, 40–49, 50–59, 60+ years). Age-specific percentage ranks are provided for men and women. Independent of age, men present a larger variance in test scores compared to women. Within the specific age groups, women score higher and their scoring range is less variable. With increasing age, the scoring variance increases in both men and women. This is the first study providing age- and sex-specific RMET standard scores. Data was weighted to match German population characteristics, enabling the application of standard scores across German-speaking areas. Our results contribute to the standardized assessment of socio-cognitive abilities in clinical diagnostics.

Neurovascular coupling alterations in type 2 diabetes: a 5-year longitudinal MRI study

INTRODUCTION

Respective alterations in resting-state brain neural activity and cerebral blood flow (CBF) in type 2 diabetes mellitus (T2DM) have been reported. However, their coupling alteration in T2DM remains largely unknown.

RESEARCH DESIGN AND METHODS

Twenty-seven patients with T2DM aged 40-67 years and 36 well-matched healthy controls (HCs) underwent resting-state functional MRI (rs-fMRI) and arterial spin labeling (ASL) scans at two time points with a 5-year interval. Regional homogeneity (ReHo) and CBF were calculated from rs-fMRI and ASL, respectively. The standardized ReHo:CBF ratio (mReHo:mCBF ratio), the spontaneous neuronal activity per unit CBF supply, was compared between the two time points. Relationships between the mReHo:mCBF ratio and memory performance were analyzed.

RESULTS

Over 5 years, decreased mReHo:mCBF ratios in patients with T2DM were mainly distributed in four regions, among which the left insula exhibited more severely decreased mReHo:mCBF ratio in patients with T2DM than in HCs, while the left postcentral gyrus, the right Rolandic operculum, and the right precentral gyrus showed no significant intergroup difference. Correlations between the mReHo:mCBF ratio and memory performance were also found in patients with T2DM.

CONCLUSIONS

This study suggests that T2DM may accelerate neurovascular coupling impairment in specific brain regions (the left insula), contributing to memory decline. This study implies that the mReHo:mCBF ratio is a potential imaging marker for detecting neurovascular changes.

How does brief guided mindfulness meditation enhance empathic concern in novice meditators?: A pilot test of the suggestion hypothesis vs. the mindfulness hypothesis

Despite the widespread popularity of mindfulness meditation for its various benefits, the mechanism underlying the meditation process has rarely been explored. Here, we present two preliminary studies designed to test alternative hypotheses: whether the effect of brief guided mindfulness meditation on empathic concern arises from verbal suggestion (suggestion hypothesis) or as a byproduct of an induced mindfulness state (mindfulness hypothesis). Study 1 was a pilot randomized control trial of sitting (breath-and-body) meditation vs. compassion meditation that provided preliminary support for the mindfulness hypothesis. Study 2 was set up to rule out the possibility that the meditation effects observed in Study 1 were the effects of repeated measures. An inactive control group of participants underwent the repeated measures of empathic concern with no meditation in between. The pre-post comparison demonstrated no significant changes in the measures. Thus, the results of two studies supported the mindfulness hypothesis. Limitations of the present study and future research directions are discussed.

Social Cognition in Rehabilitation Context: Different Evolution of Affective and Cognitive Theory of Mind in Mild Cognitive Impairment

Maintaining social skills such as Theory of Mind (ToM) competences is important to counteract the conversion into dementia in Mild Cognitive Impairment (MCI). Multidimensional nonpharmacological interventions demonstrated their potential in improving cognitive and behavioral abilities; however, little is known about the long-term effect of such interventions on social skills in people with MCI. The aim of this longitudinal study was to monitor ToM competences considering both cognitive and affective domains in an amnestic MCI (aMCI) sample involved in a home-based multistimulation treatment (MST@H). 30 aMCI subjects (M : F = 15 : 15; mean age ± SD = 77.00 ± 4.60) were enrolled, and three steps of evaluation with neuropsychological tests and ToM tasks have been implemented. 21 healthy controls (HC) were also included (M : F = 9 : 12; mean age ± SD = 74.95 ± 3.88) to characterize the aMCI sample regarding differences in ToM performance compared to HC at the baseline evaluation. Our results show that the aMCI group statistically significantly underperformed the HC group only in the advanced ToM tasks, confirming an initial decline of high-level ToM competences in this population. The longitudinal evaluation revealed time changes not only in some subcognitive domains of MoCA (memory and executive functions) but also in cognitive and affective ToM dimensions in aMCI subjects. Our findings suggest that cognitive and affective ToM can be considered useful outcome measures to test the long-term effect of treatment over time.

Theory of Mind Performance Predicts tDCS-Mediated Effects on the Medial Prefrontal Cortex: A Pilot Study to Investigate the Role of Sex and Age

Transcranial Direct Current Stimulation (tDCS) has become an increasingly promising tool for understanding the relationship between brain and behavior. The purpose of this study was to investigate whether the magnitude of sex- and age-related tDCS effects previously found in the medial prefrontal cortex (mPFC) during a Theory of Mind (ToM) task correlates with social cognition performance; in particular, we explored whether different patterns of activity would be detected in high- and low-performing participants. For this, young and elderly, male and female participants were categorized as a low- or high-performer according to their score on the Reading the Mind in the Eyes task. Furthermore, we explored whether sex- and age-related effects associated with active tDCS on the mPFC were related to cognitive functioning. We observed the following results: (i) elderly participants experience a significant decline in ToM performance compared to young participants; (ii) low-performing elderly females report slowing of reaction time when anodal tDCS is applied over the mPFC during a ToM task; and (iii) low-performing elderly females are characterized by lower scores in executive control functions, verbal fluency and verbal short-term memory. The relationship between tDCS results and cognitive functioning is discussed in light of the neuroscientific literature on sex- and age-related differences.

Social cognition in psychosis: Predictors and effects of META-cognitive training

Social cognition deficits are found in schizophrenia and bipolar disorder, but its neural underpinnings are poorly understood. Given the complexity of psychological functions underlying this kind of cognition, we hypothesized that alterations in global structural connectivity could contribute to those deficits. To test this hypothesis, we studied a group of schizophrenia and bipolar patients with connectomics based on diffusion magnetic resonance imaging and assessments of general and social cognition. The latter was assessed using the Mayer, Salovey and Caruso Emotional Intelligence Test (MSCEIT) for emotional intelligence and the Spanish Group for Schizophrenia Treatment Optimization (Grupo Español para la OPtimización del Tratamiento de la Esquizofrenia, GEOPTE) test for behavioral aspects of social cognition. Graph theory applied to fractional anisotropy for the connections among cortical regions was used to obtain the small-world (SW) index of the structural connectivity network. In addition, we assessed the possibility of predicting the response of social cognition deficits to Meta-cognitive Training based on their possible underpinnings in a subgroup of patients. Patients showed lower scores in emotional intelligence and behavioral social cognition. MSCEIT scores were associated with SW index and working memory, and GEOPTE scores were related to verbal memory. Improvement in social cognition after Meta-cognitive Training was associated with lower scores of the social cognition in the baseline, according to the GEOPTE scale. Our findings support structural connectivity as one of the factors underlying emotional intelligence in schizophrenia, and the use of Meta-cognitive Training to improve social cognition in patients with larger deficits.

Affective theory of mind in human aging: is there any relation with executive functioning?

Theory of Mind (ToM) refers to the ability to make inferences on other's mental or emotional states. Although there is evidence suggesting that impaired executive functions due to aging could have a negative impact on cognitive ToM, there is still controversy about the effect of age and age-related executive dysfunctions on affective ToM. To investigate affective ToM in healthy aging and its relationship with executive functions, we examined Reading Mind in the Eyes Test (RMET) performance and executive functions among young and older adults. There was no significant difference between age groups regarding their RMET scores. While affective ToM was correlated to executive functioning within the younger group, short term memory was found to be associated with RMET performance among older participants. Furthermore, within the older group, women performed better than men. Our findings suggest a preserved ability of affective ToM in healthy aging, which appears to be independent of executive functioning.

Social Mind and Long-Lasting Disease: Focus on Affective and Cognitive Theory of Mind in Multiple Sclerosis

The role of social cognition, including theory of mind (ToM), in affecting quality of life (QoL) along the course of diseases has been reported. This is a considerable aspect in chronic pathologies, such as multiple sclerosis (MS), in which supporting and maintaining QoL is of crucial importance. We aimed to investigate the relation between ToM, clinical variables and neuropsychological profile in a cohort of adults with long lasting disease, such as different clinical MS phenotypes (Relapsing Remitting -RR- versus Progressive -Pr). In particular, our study focuses on (1) how (affective and cognitive) ToM impairment occurs in different phenotypes, (2) whether MS ToM impairment is secondary to or independent from cognitive deficit and (3) whether ToM deficit impacts QoL. 42 adults with MS (18 M: 24 F, 52.38 ± 10.31 mean age, 21.24 ± 10.94 mean disease duration, 26 RR and 16 Pr) and 26 matched healthy controls (HC) (7 M: 19 F, 51.35 ± 12.42 mean age) were screened with a neuropsychological and ToM battery, assessing both affective and cognitive components. We found statistically significant groups differences in cognitive but not affective ToM, with a lower performance in PrMS than those with a RRMS disease course. Also, significant predictive effects of neuropsychological tests on ToM were identified in MS group. Finally, MS people with different level of affective ToM differed significantly in QoL. ToM deficit in moderately disabled people with MS involves cognitive but not affective ToM components with implications on QoL. It also appears to be related to cognitive performance. As neurological and neurocognitive profiles influence mentalizing in MS, ToM evaluation should be considered for inclusion in clinical screening.

White matter pathways and social cognition

There is a growing consensus that social cognition and behavior emerge from interactions across distributed regions of the "social brain". Researchers have traditionally focused their attention on functional response properties of these gray matter networks and neglected the vital role of white matter connections in establishing such networks and their functions. In this article, we conduct a comprehensive review of prior research on structural connectivity in social neuroscience and highlight the importance of this literature in clarifying brain mechanisms of social cognition. We pay particular attention to three key social processes: face processing, embodied cognition, and theory of mind, and their respective underlying neural networks. To fully identify and characterize the anatomical architecture of these networks, we further implement probabilistic tractography on a large sample of diffusion-weighted imaging data. The combination of an in-depth literature review and the empirical investigation gives us an unprecedented, well-defined landscape of white matter pathways underlying major social brain networks. Finally, we discuss current problems in the field, outline suggestions for best practice in diffusion-imaging data collection and analysis, and offer new directions for future research.

White matter hyperintensities associated with small vessel disease impair social cognition beside attention and memory

Age-related white matter hyperintensities (WMH) are a manifestation of white matter damage seen on magnetic resonance imaging (MRI). They are related to vascular risk factors and cognitive impairment. This study investigated the cognitive profile at different stages of WMH in a large community-dwelling sample; 849 subjects aged 21 to 79 years were classified on the 4-stage Fazekas scale according to hyperintense lesions seen on individual T2-weighted fluid-attenuated inversion recovery MRI scans. The evaluation of cognitive functioning included seven domains of cognitive performance and five domains of subjective impairment, as proposed by the DSM-5. For the first time, the impact of age-related WMH on Theory of Mind was investigated. Differences between Fazekas groups were analyzed non-parametrically and effect sizes were computed. Effect sizes revealed a slight overall cognitive decline in Fazekas groups 1 and 2 relative to healthy subjects. Fazekas group 3 presented substantial decline in social cognition, attention and memory, although characterized by a high inter-individual variability. WMH groups reported subjective cognitive decline. We demonstrate that extensive WMH are associated with specific impairment in attention, memory, social cognition, and subjective cognitive performance. The detailed neuropsychological characterization of WMH offers new therapeutic possibilities for those affected by vascular cognitive decline.

The Original Social Network: White Matter and Social Cognition

Social neuroscience has traditionally focused on the functionality of gray matter regions, ignoring the critical role played by axonal fiber pathways in supporting complex social processes. In this paper, we argue that research on white matter is essential for understanding a range of topics in social neuroscience, such as face processing, theory of mind, empathy, and imitation, as well as clinical disorders defined by aberrant social behavior, such as prosopagnosia, autism, and schizophrenia. We provide practical advice on how best to carry out these studies, which ultimately will substantially deepen our understanding of the neurobiological basis of social behavior.

Neural Networks Mediating High-Level Mentalizing in Patients With Right Cerebral Hemispheric Gliomas

Mentalizing is the ability to understand others' mental state through external cues. It consists of two networks, namely low-level and high-level metalizing. Although it is an essential function in our daily social life, surgical resection of right cerebral hemisphere disturbs mentalizing processing with high possibility. In the past, little was known about the white matter related to high-level mentalizing, and the conservation of high-level mentalizing during surgery has not been a focus of attention. Therefore, the main purpose of this study was to examine the neural networks underlying high-level mentalizing and then, secondarily, investigate the usefulness of awake surgery in preserving the mentalizing network. A total of 20 patients with glioma localized in the right hemisphere who underwent awake surgery participated in this study. All patients were assigned to two groups: with or without intraoperative assessment of high-level mentalizing. Their high-level mentalizing abilities were assessed before surgery and 1 week and 3 months after surgery. At 3 months after surgery, only patients who received the intraoperative high-level mentalizing test showed the same score as normal healthy volunteers. The tract-based lesion symptom analysis was performed to confirm the severity of damage of associated fibers and high-level mentalizing accuracy. This analysis revealed the superior longitudinal fascicles (SLF) III and fronto-striatal tract (FST) to be associated with high-level mentalizing processing. Moreover, the voxel-based lesion symptom analysis demonstrated that resection of orbito-frontal cortex (OFC) causes persistent mentalizing dysfunction. Our study indicates that damage of the OFC and structural connectivity of the SLF and FST causes the disorder of mentalizing after surgery, and assessing high-level mentalizing during surgery may be useful to preserve these pathways.

Social cognition in autism is associated with the neurodevelopment of the posterior superior temporal sulcus

OBJECTIVE

The posterior superior temporal sulcus (pSTS) plays a critical role in the 'social brain'. Its neurodevelopment and relationship with the social impairment in autism spectrum disorders (ASD) are not well understood. We explored the relationship between social cognition and the neurodevelopment of the pSTS in ASD.

METHOD

We included 44 adults with high-functioning ASD and 36 controls. We assessed their performances on the 'Reading the mind in the eyes' test (for 34 of 44 subjects with ASD and 30 of 36 controls), their fixation time on the eyes with eye tracking (for 35 of 44 subjects with ASD and 30 of 36 controls) and the morphology of the caudal branches of the pSTS (length and depth), markers of the neurodevelopment, with structural MRI.

RESULTS

The right anterior caudal ramus of the pSTS was significantly longer in patients with ASD compared with controls (52.6 mm vs. 38.3 mm; P = 1.4 × 10^-3 ; Cohen's d = 0.76). Its length negatively correlated with fixation time on the eyes (P = 0.03) in the ASD group and with the 'Reading the mind in the eyes' test scores in both groups (P = 0.03).

CONCLUSION

Our findings suggest that the neurodevelopment of the pSTS is related to the ASD social impairments.

Peer Interaction Does Not Always Improve Children's Mental State Talk Production in Oral Narratives. A Study in 6- to 10-Year-Old Italian Children

Joint narratives are a mean through which children develop and practice their Theory of Mind (ToM), thus they represent an ideal means to explore children's use and development of mental state talk. However, creating a learning environment for storytelling based on peer interaction, does not necessarily mean that students will automatically exploit it by engaging in productive collaboration, thus it is important to explore under what conditions peer interaction promotes children's ToM. This study extends our understanding of social aspects of ToM, focusing on the effect of joint narratives on school-age children's mental state talk. Fifty-six Italian primary school children participated in the study (19 females and 37 males). Children created a story in two different experimental conditions (individually and with a partner randomly assigned). Each story told by the children, as well as their dialogs were recorded and transcribed. Transcriptions of narratives were coded in terms of text quality and mental state talk, whereas transcriptions of dialogs were coded in terms of quality of interaction. The results from this study confirmed that peer interaction does not always improve children's mental state talk performances in oral narratives, but certain conditions need to be satisfied. Peer interaction was more effective on mental state talk with lower individual levels and productive interactions, particularly in terms of capacity to regulate the interactions. When children were able to focus on the interaction, as well as the product, they were also exposed to each other's reasoning behind their viewpoint. This level of intersubjectivity, in turn, allowed them to take more in consideration the contribution of mental states to the narrative.

Theory of Mind and the Whole Brain Functional Connectivity: Behavioral and Neural Evidences with the Amsterdam Resting State Questionnaire

A topic of common interest to psychologists and philosophers is the spontaneous flow of thoughts when the individual is awake but not involved in cognitive demands. This argument, classically referred to as the "stream of consciousness" of James, is now known in the psychological literature as "Mind-Wandering." Although of great interest, this construct has been scarcely investigated so far. Diaz et al. (2013) created the Amsterdam Resting State Questionnaire (ARSQ), composed of 27 items, distributed in seven factors: discontinuity of mind, theory of mind (ToM), self, planning, sleepiness, comfort, and somatic awareness. The present study aims at: testing psychometric properties of the ARSQ in a sample of 670 Italian subjects; exploring the neural correlates of a subsample of participants (N = 28) divided into two groups on the basis of the scores obtained in the ToM factor. Results show a satisfactory reliability of the original factional structure in the Italian sample. In the subjects with a high mean in the ToM factor compared to low mean subjects, functional MRI revealed: a network (48 nodes) with higher functional connectivity (FC) with a dominance of the left hemisphere; an increased within-lobe FC in frontal and insular lobes. In both neural and behavioral terms, our results support the idea that the mind, which does not rest even when explicitly asked to do so, has various and interesting mentalistic-like contents.