title: Disconnection mechanism and regional cortical atrophy contribute to impaired processing of facial expressions and theory of mind in multiple sclerosis: a structural MRI study.
abstract: Successful socialization requires the ability of understanding of others' mental states. This ability called as mentalization (Theory of Mind) may become deficient and contribute to everyday life difficulties in multiple sclerosis. We aimed to explore the impact of brain pathology on mentalization performance in multiple sclerosis. Mentalization performance of 49 patients with multiple sclerosis was compared to 24 age- and gender matched healthy controls. T1- and T2-weighted three-dimensional brain MRI images were acquired at 3Tesla from patients with multiple sclerosis and 18 gender- and age matched healthy controls. We assessed overall brain cortical thickness in patients with multiple sclerosis and the scanned healthy controls, and measured the total and regional T1 and T2 white matter lesion volumes in patients with multiple sclerosis. Performances in tests of recognition of mental states and emotions from facial expressions and eye gazes correlated with both total T1-lesion load and regional T1-lesion load of association fiber tracts interconnecting cortical regions related to visual and emotion processing (genu and splenium of corpus callosum, right inferior longitudinal fasciculus, right inferior fronto-occipital fasciculus, uncinate fasciculus). Both of these tests showed correlations with specific cortical areas involved in emotion recognition from facial expressions (right and left fusiform face area, frontal eye filed), processing of emotions (right entorhinal cortex) and socially relevant information (left temporal pole). Thus, both disconnection mechanism due to white matter lesions and cortical thinning of specific brain areas may result in cognitive deficit in multiple sclerosis affecting emotion and mental state processing from facial expressions and contributing to everyday and social life difficulties of these patients.
authors.affiliation: Division of Clinical and Experimental Neuroimmunology, Department of Neurology, University of Pecs, Pecs, Hungary ; Center for Neurological Imaging, Departments of Radiology and Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America.
authors.forename: Andrea
authors.initials: A
authors.lastname: Mike
authors.affiliation: Division of Clinical and Experimental Neuroimmunology, Department of Neurology, University of Pecs, Pecs, Hungary.
authors.forename: Erzsebet
authors.initials: E
authors.lastname: Strammer
authors.affiliation: Diagnostic Center of Pecs, University of Pecs, Pecs, Hungary.
authors.forename: Mihaly
authors.initials: M
authors.lastname: Aradi
authors.affiliation: Diagnostic Center of Pecs, University of Pecs, Pecs, Hungary ; MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary.
authors.forename: Gergely
authors.initials: G
authors.lastname: Orsi
authors.affiliation: Diagnostic Center of Pecs, University of Pecs, Pecs, Hungary ; MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary.
authors.forename: Gabor
authors.initials: G
authors.lastname: Perlaki
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Pecs, Pecs, Hungary.
authors.forename: Andras
authors.initials: A
authors.lastname: Hajnal
authors.affiliation: Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
authors.forename: Janos
authors.initials: J
authors.lastname: Sandor
authors.affiliation: Division of Clinical and Experimental Neuroimmunology, Department of Neurology, University of Pecs, Pecs, Hungary.
authors.forename: Miklos
authors.initials: M
authors.lastname: Banati
authors.affiliation: Division of Clinical and Experimental Neuroimmunology, Department of Neurology, University of Pecs, Pecs, Hungary.
authors.forename: Eniko
authors.initials: E
authors.lastname: Illes
authors.affiliation: Center for Neurological Imaging, Departments of Radiology and Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America.
authors.forename: Alexander
authors.initials: A
authors.lastname: Zaitsev
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Pecs, Pecs, Hungary.
authors.forename: Robert
authors.initials: R
authors.lastname: Herold
authors.affiliation: Center for Neurological Imaging, Departments of Radiology and Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America.
authors.forename: Charles R G
authors.initials: CR
authors.lastname: Guttmann
authors.affiliation: Division of Clinical and Experimental Neuroimmunology, Department of Neurology, University of Pecs, Pecs, Hungary ; MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary ; Department of Neurology, Institute of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Illes
mesh_terms: D000328:Adult; D001284:Atrophy; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology* / Q000503:physiopathology*; D003071:Cognition; D003710:Demography; D005149:Facial Expression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008606:Mental Processes / Q000502:physiology*; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology* / Q000503:physiopathology*; D012919:Social Behavior; D056345:Theory of Mind; D055815:Young Adult