Disconnection Mechanism and Regional Cortical Atrophy Contribute to Impaired Processing of Facial Expressions and Theory of Mind in Multiple Sclerosis: A Structural MRI Study

Mike, Andrea; Strammer, Erzsebet; Aradi, Mihály; Orsi, G.; Perlaki, Gábor; Hajnal, A.; Sándor, János; Bánáti, Miklós; Illes, Eniko; Zaitsev, Alexander; Herold, Róbert; Guttmann, Charles R.G.; Illés, Zsolt

doi:10.1371/journal.pone.0082422

Cited by 69 publications

(96 citation statements)

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“…The limited structural and functional imaging evidence among patients with MS to date suggests that social cognitive deficits may be due to abnormalities in the neural circuitry that underlie these processes. [43][44][45][46] However, further analyses, particularly for ToM, are warranted to improve our understanding of social cognitive decline. Similarly, the relationship between social cognitive and neurocognitive deficits in MS remains unclear and would benefit from longitudinal evaluation.…”

Section: Resultsmentioning

confidence: 99%

Social cognition in multiple sclerosis

et al. 2016

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Objective: To quantify the magnitude of deficits in theory of mind (ToM) and facial emotion recognition among patients with multiple sclerosis (MS) relative to healthy controls.Methods: An electronic database search of Ovid MEDLINE, PsycINFO, and Embase was conducted from inception to April 1, 2016. Eligible studies were original research articles published in peer-reviewed journals that examined ToM or facial emotion recognition among patients with a diagnosis of MS and a healthy control comparison group. Data were independently extracted by 2 authors. Effect sizes were calculated using Hedges g.Results: Twenty-one eligible studies were identified assessing ToM (12 studies) and/or facial emotion recognition (13 studies) among 722 patients with MS and 635 controls. Deficits in both ToM (g 5 20.71, 95% confidence interval [CI] 20.88 to 20.55, p , 0.001) and facial emotion recognition (g 5 20.64, 95% CI 20.81 to 20.47, p , 0.001) were identified among patients with MS relative to healthy controls. The largest deficits were observed for visual ToM tasks and for the recognition of negative facial emotional expressions. Older age predicted larger emotion recognition deficits. Other cognitive domains were inconsistently associated with social cognitive performance.Conclusions: Social cognitive deficits are an overlooked but potentially important aspect of cognitive impairment in MS with potential prognostic significance for social functioning and quality of life. Further research is required to clarify the longitudinal course of social cognitive dysfunction, its association with MS disease characteristics and neurocognitive impairment, and the MSspecific neurologic damage underlying these deficits.

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Section: Resultsmentioning

confidence: 99%

Social cognition in multiple sclerosis

et al. 2016

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“…abnormalities in brain regions involved in social cognition) factors playing a role. Few studies have directly investigated the relationship between brain imaging abnormalities and social cognition in MS. Mike et al (2013) reported that disconnection between cortical regions involving the processing of emotions and socially relevant information can be related to deficits in facial emotion recognition in MS. This study also reported an association between cortical atrophy (temporal and prefrontal cortices) and performance in RMET but not in faux pas recognition.…”

Section: Discussionmentioning

confidence: 99%

“…Inclusion criteria were studies that: (1) Compared ToM or facial emotion recognition performances of MS and healthy controls; (2) reported sufficient data to calculate the effect size and standard error of the social cognition measure. Two brain imaging studies (Krause et al 2009;Mike et al 2013) and a thesis whose samples overlap with two included study (Banati et al 2010;Berneiser et al 2014) were excluded. We contacted authors of two conference papers for unpublished data or papers but we were unable to ascertain this data.…”

Section: Study Selectionmentioning

confidence: 99%

Social Cognition in Multiple Sclerosis: a Meta-Analysis

et al. 2016

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Multiple sclerosis (MS) is associated with cognitive decline and impairment in social functioning. Accumulating evidence suggests that patients with MS are impaired in social cognition, including theory of mind (ToM) and emotion recognition. In this meta-analysis of 24 studies, facial emotion recognition and ToM performances of 989 patients with MS and 836 healthy controls were compared. MS was associated with significant impairments with medium effect sizes in ToM (d = 0.57) and facial emotion recognition (d = 0.61). Among individual emotions recognition of fear and anger were particularly impaired. The severity of social cognitive deficits was significantly associated with non-social cognitive impairment. These deficits in social cognition may underpin difficulties in social functioning in MS. However, there is a need for further studies investigating the longitudinal evolution of social cognitive deficits and their neural correlates in MS.

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“…A correlation has been established among specific cortical areas involved in emotion identification from facial expression (right and left fusiform face area, frontal eye), emotion processing (right entorhinal cortex) and socially relevant information (left temporal pole) [95]. According to a model of Ross and Mesulam, affective prosody comprehension could be related to the right-sided perisylvian region, whose structure is similar to the language areas in the left hemisphere [96].…”

Section: Social Brainmentioning

confidence: 99%

Social Cognition Impairments in Patients with Multiple Sclerosis and Comparison with Imaging Studies, Disease Duration and Grade of Disability

Ignatova¹,

Todorova²,

Surchev³

2016

Trending Topics in Multiple Sclerosis

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Cognitive impairments in multiple sclerosis (MS) are heterogeneous and their rate varies between 43% and 70%. A less studied aspect of cognition is social cognition, which is not a uniform theoretical construct. It includes emotion perception, prosody, empathy, theory of mind (ToM) and assessment of mood. In addition to progressive physical disability, social cognitive impairments are a reason for job loss in 24-80% of patients with MS, increased divorce rate, dissolution of partnerships and social communication difficulties.Social cognitive impairments are the result of disruptions in the mentalization network at the neuroanatomical, neurochemical and/or genetic level, which can lead to malfunctions in the dopaminergic-serotoninergic system and to compromising the development of neuroanatomical targets within the network. The wide dissemination of demyelinating lesions and cortical thinning typical of patients with MS often lead to anatomic and functional disorders of the above-mentioned specific brain structures. A correlation has been established among specific cortical areas involved in emotion identification from facial expression (right and left fusiform face area, frontal eye), emotion processing (right entorhinal cortex) and socially relevant information (left temporal pole). The most active brain region involved in social cognitive processing is the medal frontal cortex (MFC), which is described as the brain's social cognitive center. During performance of various sociocognitive tasks for mental state attribution, common areas of increased activation in the medial prefrontal gyrus and the temporoparietal junctions are registered bilaterally, while the area of the medial prefrontal cortex (the paracingulate cortex) is the only region uniquely activated by the performance of ToM.Most MRI studies of patients with MS found a correlation between the cognitive and/or affective disorders, on the one hand, and lesion localization, total lesion load, or cerebral atrophy, on the other. A significant correlation was also reported between © 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.abnormal activities in specific cortical zones on fMRI, on the one hand, and clinical manifestation, conventional MRI findings and behavioral changes, on the other. Altered patterns of brain activity were found in all clinical phenotypes of MS, including when cognitive abilities were intact and/or restored, social cognitive dysfunction in MS actually affects all stages of the disease and all types of clinical course. The cortical plastic changes are a dynamic phenomenon that can be modulated by external factors. This phenomenon would facilitate the mapping of individual strategies for adequate treatment and rehabilitation of each patient.

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Disconnection Mechanism and Regional Cortical Atrophy Contribute to Impaired Processing of Facial Expressions and Theory of Mind in Multiple Sclerosis: A Structural MRI Study

Cited by 69 publications

References 64 publications

Social cognition in multiple sclerosis

Social cognition in multiple sclerosis

Social Cognition in Multiple Sclerosis: a Meta-Analysis

Social Cognition Impairments in Patients with Multiple Sclerosis and Comparison with Imaging Studies, Disease Duration and Grade of Disability

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