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Isolated theory of mind deficits and risk for frontotemporal dementia: a longitudinal pilot study
  1. Matteo Pardini1,2,3,
  2. Leonardo Emberti Gialloreti3,4,
  3. Maria Mascolo1,
  4. Francesca Benassi4,
  5. Lucia Abate1,
  6. Silvia Guida5,
  7. Erica Viani1,
  8. Olga Dal Monte6,
  9. Selene Schintu7,8,
  10. Frank Krueger9,10,
  11. Leonardo Cocito1
  1. 1Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy
  2. 2Department of Magnetic Resonance Research Centre on Nervous System Diseases, University of Genoa, Genoa, Italy
  3. 3Centre for Communication and Neurorehabilitation Research-CNAPP, Rome, Italy
  4. 4Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
  5. 5Neuropsychiatric Rehabilitation Service ‘Due Mari’, Genoa, Italy
  6. 6Department of Neuropsychology, University of Turin, Turin, Italy
  7. 7INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Centre, ImpAct Team, Lyon, France
  8. 8University Lyon 1, Lyon, France
  9. 9Molecular Neuroscience Department, George Mason University, Fairfax, Virginia, USA
  10. 10Department of Psychology, George Mason University, Fairfax, Virginia, USA
  1. Correspondence to Dr Matteo Pardini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa 16100, Italy; matteo.pardini{at}


Objective Recent data suggest that theory of mind (ToM) deficits represent an early symptom of the behavioural variant of frontotemporal dementia (bvFTD). However, longitudinal data on the natural history of subjects presenting with isolated ToM deficits are lacking. The aim of the study was to verify if isolated ToM deficits represent an at-risk state for prefrontal dysfunction and bvFTD.

Methods A population of healthy subjects (n=4150, age range: 50–60 years) completed a clinical and neuropsychological evaluation including the Reading the Mind in the Eyes Test (RMET), a widely used ToM task. From this group, we recruited a low-RMET group (n=83) including subjects with RMET scores lower than 2 SDs but an otherwise normal neuropsychological evaluation and a control group. All subjects underwent evaluation at baseline and after 2 years.

Results Subjects in the low-RMET group showed decline in prefrontal functions at follow-up. Moreover, at follow-up 12 subjects in the low-RMET group presented with findings suggestive of bvFTD. Neuropsychological performance was stable in the control group.

Conclusions Our data suggest that isolated ToM deficits could represent an at-risk situation for the development of future prefrontal dysfunction and bvFTD. ToM evaluation should be included in neuropsychological protocols aimed to evaluate the early phases of dementia.

  • Dementia
  • Cognitive Neuropsychology
  • Frontal Lobe
  • Neuropsychology

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