Social Cognition Impairments in Relation to General Cognitive Deficits, Injury Severity, and Prefrontal Lesions in Traumatic Brain Injury Patients

Abstract

Impairments in social behavior are frequently found in moderate to severe traumatic brain injury (TBI) patients and are associated with an unfavorable outcome with regard to return to work and social reintegration. Neuropsychological tests measuring aspects of social cognition are thought to be sensitive to these problems. However, little is known about the effect of general cognitive problems on these tests, nor about their sensitivity to injury severity and frontal lesions. In the present study 28 chronic TBI patients with a moderate to severe TBI were assessed with tests for social cognition (emotion recognition, Theory of Mind, and empathy), and for general, non-social cognition (memory, mental speed, attention, and executive function). The patients performed significantly worse than healthy controls on all measures, with the highest effect size for the emotion recognition test, the Facial Expressions of Emotion-Stimuli and Tests (FEEST). Correlation analyses yielded no significant (partial) correlations between social and non-social cognition tests. Consequently, poor performance on social cognition tests was not due to general cognitive deficits. In addition, the emotion recognition test was the only measure that was significantly related to post-traumatic amnesia (PTA) duration, Glasgow Coma Scale (GCS) score, and the presence of prefrontal lesions. Hence, we conclude that social cognition tests are a valuable supplement to a standard neuropsychological examination, and we strongly recommend the incorporation of measurements of social cognition in clinical practice. Preferably, a broader range of social cognition tests would be applied, since our study demonstrated that each of the measures represents a unique aspect of social cognition, but if capacity is limited, at least a test for emotion recognition should be included.

Theory of Mind in Adults with Traumatic Brain Injury

“…According to the studies, individuals with TBI were impaired in mentalistic inferences and faux pas stories (4,39,45,46,50,53,54). In some studies, TBI persons were not impaired in the nonmental/physical/logical inferences, no faux pas stories, and logical stories (4,27,36,39,46).…”

Therapeutic Potential of Mood Stabilizers Lithium and Valproic Acid: Beyond Bipolar Disorder

“…Memory impairments are frequent in both patients with TBI and animal models (Spikman et al, 2012), and Ab levels were found to be elevated in CSF and postmortem brain samples from patient with TBI (Uryu et al, 2007). Hyperactivity of GSK-3 has been implicated in the pathogenesis of AD (Hooper et al, 2008), an idea supported by the fact that lithium treatment produces many benefits in various A proposed model to demonstrate the molecular actions of lithium and VPA in preclinical models of cerebral ischemia.…”

Social Behavior and Impairments in Social Cognition Following Traumatic Brain Injury

“…Croker & McDonald, 2005;Babbage et al, 2011, Ietswaart, Milders, Crawford, Currie & Scott, 2008Spikman, Timmerman, Milders, Veenstra & van der Naalt, 2012;Williams & Wood, 2010). Understanding other people's intentions and beliefs, also referred to as theory of mind (ToM), can also be impaired following TBI (Bibby & McDonald, 2005;Bivona et al, 2014;Geraci, Surian, Ferraro, Cantagallo, 2010;Havet-Thomassin, Allain, Etcharry-Bouyx & Le Gall, 2005;McLellan & Mckinlay, 2013;Milders, Ietswaart, Crawford & Currie, 2006, 2012Muller, Simion, Reviriego, Galera, Mazaux, Barat & Joseph, 2010;Spikman et al, 2012). Selecting appropriate social behaviour in response to the context would rely on adequate executive functioning (Shany-Ur & Rankin, 2013), in particular, flexibility to adjust behaviour in accordance with the situation and inhibition to suppress initial, and possibly inappropriate, responses.…”