BackgroundTheory of mind (ToM), the ability to infer others' mental state, is essential for social interaction among human beings. It has been widely reported that both cognitive (inference of knowledge) and affective (inference of emotion) components of ToM are disrupted in Parkinson's disease (PD). Previous studies usually focused on the involvement of the prefrontal cortex.ObjectiveThis study investigated the causal role of the subthalamic nucleus (STN), a key hub of the fronto‐basal ganglia loops, in ToM.MethodsThirty‐four patients with idiopathic PD (15 women, aged 62.2 ± 8.3 years) completed a Yoni task with deep brain stimulation (DBS) ON and OFF. The Yoni task was designed to separate the cognitive and affective components of ToM. Volumes of tissue activated (VTA) were computed for three subregions of the STN.ResultsDBS showed insignificant effects on ToM inference costs at the group level, which may be due to the large interindividual variability. The associative VTA correlated with the cognitive inference cost change but not the affective inference cost change. Patients with greater associative STN stimulation infer more slowly on cognitive ToM. Stimulating associative STN can adversely affect cognitive ToM in PD patients, especially in patients with a wide range of stimulation (≥0.157) or cognitive decline (Montreal Cognitive Assessment < 26).ConclusionsThe associative STN plays a causal role in cognitive ToM in patients with PD. However, stimulating the associative STN likely impairs cognitive ToM and potentially leads to social interaction deficits in PD. © 2024 International Parkinson and Movement Disorder Society.

中文翻译：

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丘脑底核刺激调节帕金森病的心理认知理论

背景心理理论（ToM），即推断他人心理状态的能力，对于人类之间的社会互动至关重要。据广泛报道，帕金森病 (PD) 中 ToM 的认知（知识推理）和情感（情感推理）部分均受到破坏。先前的研究通常集中于前额皮质的参与。 目的本研究调查了丘脑底核 (STN)（额基底神经节环的关键枢纽）在 ToM 中的因果作用。方法 34 名特发性 PD 患者（15 名女性） ，年龄 62.2 ± 8.3 岁）在深部脑刺激 (DBS) 打开和关闭的情况下完成了 Yoni 任务。 Yoni 任务旨在分离 ToM 的认知和情感部分。计算了 STN 三个子区域的组织激活体积 (VTA)。结果 DBS 显示对群体水平的 ToM 推理成本影响不显着，这可能是由于个体间差异较大。联想 VTA 与认知推理成本变化相关，但与情感推理成本变化无关。联想 STN 刺激较大的患者在认知 ToM 上的推断速度较慢。刺激联想STN会对PD患者的认知ToM产生不利影响，尤其是大范围刺激（≥0.157）或认知能力下降（蒙特利尔认知评估<26）的患者。结论联想STN在PD患者认知ToM中起因果作用。然而，刺激联想 STN 可能会损害认知 ToM，并可能导致 PD 中的社交互动缺陷。 © 2024 国际帕金森和运动障碍协会。