Discrepancies exist in reports of social cognition deficits in individuals with premanifest Huntington’s disease (HD); however, the reason for this variability has not been investigated. The aims of this study were to (1) evaluate group- and individual-level social cognitive performance and (2) examine intra-individual variability (dispersion) across social cognitive domains in individuals with premanifest HD.

Theory of mind (ToM), social perception, empathy, and social connectedness were evaluated in 35 individuals with premanifest HD and 29 healthy controls. Cut-off values beneath the median and 1.5 × the interquartile range below the 25th percentile (P25 – 1.5 × IQR) of healthy controls for each variable were established for a profiling method. Dispersion between social cognitive domains was also calculated.

Compared to healthy controls, individuals with premanifest HD performed worse on all social cognitive domains except empathy. Application of the profiling method revealed a large proportion of people with premanifest HD fell below healthy control median values across ToM (>80%), social perception (>57%), empathy (>54%), and social behaviour (>40%), with a percentage of these individuals displaying more pronounced impairments in empathy (20%) and ToM (22%). Social cognition dispersion did not differ between groups. No significant correlations were found between social cognitive domains and mood, sleep, and neurocognitive outcomes.

Significant group-level social cognition deficits were observed in the premanifest HD cohort. However, our profiling method showed that only a small percentage of these individuals experienced marked difficulties in social cognition, indicating the importance of individual-level assessments, particularly regarding future personalised treatments.

亨廷顿病 (HD) 患者的社会认知缺陷报告存在差异；然而，尚未调查这种可变性的原因。本研究的目的是 (1) 评估群体和个人层面的社会认知表现，以及 (2) 检查在表现前 HD 的个体中跨社会认知领域的个体内部变异性（分散性）。

心智理论 (ToM)、社会感知、同理心和社会联系在 35 名 HD 患者和 29 名健康对照者中进行了评估。为分析方法建立了低于中位数和 1.5 × 低于第 25 个百分位 (P 25 – 1.5 × IQR) 的健康对照的四分位数范围的截止值。还计算了社会认知领域之间的离散度。

与健康对照组相比，表现前 HD 的个体在除同理心之外的所有社会认知领域表现更差。剖析方法的应用显示，在 ToM (>80%)、社会感知 (>57%)、同理心 (>54%) 和社会行为 (>40%) 方面，有很大比例的 HD 患者低于健康控制中值)，其中一定比例的人在同理心 (20%) 和 ToM (22%) 方面表现出更明显的障碍。社会认知分散在群体之间没有差异。在社会认知领域与情绪、睡眠和神经认知结果之间没有发现显着的相关性。

在表现前的 HD 队列中观察到显着的群体水平社会认知缺陷。然而，我们的分析方法表明，这些人中只有一小部分在社会认知方面遇到了明显的困难，这表明了个人水平评估的重要性，特别是在未来的个性化治疗方面。