Transdiagnostic overlap in brain correlates of affective and cognitive theory of mind deficits

Social cognitive symptoms characterize multiple neurological disorders, including brain tumours and neurodegeneration. Recently, Campanella and colleagues investigated deficits in cognitive and affective theory of mind (TOM) in 105 tumour patients using a non-verbal task of 18 stimuli that required patients to select one out of three possible endings of a cartoon story, i.e. the Story-based Empathy Task (SET). The SET includes three conditions [Causal Inference (CI), Intention Attribution (IA) and Emotion Attribution (EA)], reflecting the type of inference the items tap into: inference of physical properties, intentions, or characters’ emotional state, respectively. The behavioural results of Campanella’s study revealed specific EA deficits in patients with temporal lobe tumours. Furthermore, the authors used parcel-based lesion-symptom mapping (PLSM) and reported an association between a right anterior temporal cluster and EA performance. Right amygdalar lesions showed a stronger association with EA than with IA. The association between EA deficits and amygdalar volume has also been also reported in behavioural variant frontotemporal dementia (bvFTD), a neurodegenerative disorder, characterized by deficits in social cognition, including cognitive and affective TOM. Consistent with the findings of Campanella, we also observed an association between performance on the EA condition and grey matter volume of the right temporal lobe and amygdala (Fig. 1). As documented by Campanella and colleagues, such common neural correlates of EA performance largely overlap with a ‘reasoning about emotions’ network derived from a recent meta-analysis of functional brain imaging studies in healthy participants. These combined findings converge in supporting a critical role of the right amygdala and temporal lobe in emotion attribution.