Theory of Mind is defined as the ability to attribute mental state and emotions to other people and is relevant to social relationships. The cortical and subcortical regions involved in Theory of Mind are damaged by neurodegenerative processes of Parkinsonian syndromes, so the aim of the present study was to explore, for the first time, possible deficits of Theory of Mind and their cognitive correlates in multiple system atrophy (MSA). Twenty-six patients with MSA, 25 patients with Parkinson’s disease (PD) and 25 healthy subjects were enrolled. Cognitive and affective subcomponents of Theory of Mind, executive functions, long-term memory and apathy were evaluated. The three groups did not differ on demographic variables. MSA and PD groups performed worse than healthy subjects on both cognitive (advanced test of ToM) and affective (emotion attribution task) ToM tasks, but no significant difference was found between patients’ groups. However, when using another affective ToM task (Eyes Test), MSA group had poorer performance than healthy subjects and Parkinsonian patients, whereas Parkinsonian patients had similar performance to healthy subjects. Regression analysis revealed an association between poor cognitive flexibility and dysfunctional cognitive component of Theory of Mind. Deficit of cognitive and affective components of Theory of Mind occurred in MSA. Dysfunction of cognitive component was related to executive dysfunction (i.e. cognitive rigidity). These findings might suggest the usefulness of an early evaluation of social cognition in MSA to identify individuals with impaired Theory of Mind who are at risk of social withdrawal, and reduced quality of life.

心理理论被定义为将心理状态和情绪归因于他人的能力，并且与社会关系相关。帕金森综合征的神经退行性过程损害了心智理论所涉及的皮层和皮层下区域，因此本研究的目的是首次探讨心智理论可能存在的缺陷及其在多系统萎缩中的认知相关性。 MSA）。招募了 26 名 MSA 患者、25 名帕金森病 (PD) 患者和 25 名健康受试者。评估了心理理论的认知和情感子成分、执行功能、长期记忆和冷漠。三组在人口统计学变量上没有差异。MSA 和 PD 组在认知（ToM 高级测试）和情感（情感归因任务）ToM 任务上的表现都比健康受试者差，但在患者组之间没有发现显着差异。然而，当使用另一个情感 ToM 任务（眼睛测试）时，MSA 组的表现比健康受试者和帕金森患者差，而帕金森患者的表现与健康受试者相似。回归分析揭示了认知灵活性差与心智理论认知功能障碍之间的关联。MSA 出现心理理论认知和情感成分的缺陷。认知成分的功能障碍与执行功能障碍（即认知僵化）有关。