THEORY
OF MIND IMPAIRMENT AND NEURAL UNDERPINNINGS
L.
Zackheim
Theory of mind
(ToM), the ability to ‘read’ other people’s mental
states, is a
critical component of social function. It forms the basis of
humans’ ability to
cooperate and empathize with others, understand
humour, and
appreciate deception. ToM impairment following brain
injury may result
in devastating social consequences, but there is
debate about its
neural underpinnings. The present research
investigated the
relative contributions of the medial prefrontal cortex
(mPFC),
temporoparietal junction (TPJ), and temporal poles (TPs) to
ToM. To this end,
ToM was examined in 15 adults with focal lesions to
these regions, 15
adults with focal lesions to regions that have not
been strongly
implicated in ToM, and 28 healthy controls. A second
part of the study
examined ToM in additional cases with combined
lesions to the mPFC
and TP/amygdala. Patients underwent
comprehensive
neuropsychological and behavioural testing, including
ToM measures that
differ on several dimensions, including degree of
affective analysis.
Findings offer insight into the necessary role of the
mPFC in
affective/immersive ToM, an additional role for the TPs in the
inference of
sarcastic/empathic intent, and a domain-specific role of
TPJ in spatial
attention and/or representing intention based on action.
These findings have
significant implications for understanding,
assessing, and
treating ToM impairment with a view to helping
patients lead
socially fulfilling lives.
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