Validity and diagnostics of the Reading the Mind in the Eyes Test (RMET) in non-demented amyotrophic lateral sclerosis (ALS) patients

Abstract

BackgroundThe aim of this study was to explore the construct validity and diagnostic properties of the Reading the Mind in the Eyes Test (RMET) in non-demented patients with amyotrophic lateral sclerosis (ALS).MaterialsA total of 61 consecutive patients and 50 healthy controls (HCs) were administered the 36-item RMET. Additionally, patients underwent a comprehensive assessment of social cognition via the Story-Based Empathy Task (SET), which encompasses three subtests targeting Causal Inference, Emotion Attribution (SET-EA), and Intention Attribution (SET-IA), as well as global cognitive [the Edinburgh Cognitive and Behavioral ALS Screen (ECAS)] and behavioral screening [the Frontal Behavioral Inventory (FBI); the Dimensional Apathy Scale (DAS); the Beck Depression Inventory (BDI); and the State and Trait Anxiety Inventory-Y]. The construct validity of the RMET was tested by regressing it within a stepwise model that encompassed as predictors the abovementioned cognitive and behavioral measures, covarying for demographic and motor confounders. Receiver-operating characteristics (ROC) analyses allowed exploring intrinsic and post-test properties of the RMET both in discriminating patients from HCs and in identifying patients with a defective SET-EA performance.ResultsThe RMET was solely predicted by the SET-EA (p = 0.003) and SET-IA (p = 0.005). RMET scores showed high accuracy both in discriminating patients from HCs (AUC = 0.81) and in identifying patients with a defective SET-EA score (AUC = 0.82), with adequate-to-optimal both intrinsic and post-test properties.DiscussionThe RMET is a convergently and divergently valid measure of affective social cognition in non-demented ALS patients, also featuring optimal intrinsic and post-test diagnostic properties in both case-control and case-finding scenarios.

An exploratory study on counterfactual thinking in amyotrophic lateral sclerosis

“…Additionally, patients were assessed for global cognition [Edinburgh Cognitive and Behavioral ALS Screen, ECAS (Poletti et al, 2016 )], executive [Frontal Assessment Battery, FAB (Appollonio et al, 2005 ; Aiello et al, 2023a )], social-cognitive functions [Reading the Mind in the Eyes Test, RMET (Aiello et al, 2022 ; Maddaluno et al, 2022 ); Emotion Attribution subtest of the Story-Based Empathy Task, SET-EA (Dodich et al, 2015 ; Aiello et al, 2023b )], behavior [State- and Trait-Anxiety Inventory-Form Y, STAI-Y1/-Y2 (Spielberger et al, 1971 ); Beck Depression Inventory, BDI (Beck et al, 1961 ); Beaumont Behavioral Inventory, BBI (Iazzolino et al, 2022 ); Dimensional Apathy Scale, DAS (Santangelo et al, 2017 )], and motor-functional status [ALS Functional Rating Scale-Revised, ALSFRS-R (Cedarbaum et al, 1999 )]. Progression rate (ΔFS) was computed as (48-ALSFRS-R score)/disease duration in months (Kimura et al, 2006 ), and disease staging was retrieved via King's (Roche et al, 2012 ) and Milano-Torino (MiToS) (Chiò et al, 2015 ) systems.…”

Neuropsychological impairment in amyotrophic lateral sclerosis–frontotemporal spectrum disorder

“…Emotion recognition is typically assessed by the Ekman faces test 36,40 , and patients with ALS have particular problems recognizing negative emotions of disgust, anger, fear and sadness 41 . A test that combines both inference of intention and emotion recognition is the Reading the Mind in the Eyes Test 42 , which has been validated in ALS 43 . A short form of this test has been produced 44 and has shown sensitivity in ALS, although like its longer counterpart, it suffers from issues with gender stereotypes and lack of racial diversity.…”