Theory of Mind and Executive Functioning Following Stroke

Abstract

A reduction in the ability to attribute mental states to others following right hemisphere stroke may adversely affect psychosocial functioning, disrupt interpersonal relationships, and lead to reduced quality of life. The clinical importance of these findings, implications for clinical practice and future research are discussed.

The relationship between social cognition and participation in the long term after stroke

“…In stroke patients, impairments in social cognition have been reported with regard to the ability to recognize emotions in others (Abbott, Wijeratne, Hughes, Perre, & Lindell, 2014;Leite, Guerreiro, Almeida, & Peixoto, 2017;Nijsse, Spikman, Visser-Meily, de Kort, & van Heugten, 2019b;Yuvaraj et al, 2013) and the ability to reason about one's own and others' beliefs, feelings, intentions and knowledge (theory of mind; ToM) (Hamilton, Radlak, Morris, & Phillips, 2017;Martín-Rodríguez & León-Carrión, 2010;Nijsse et al, 2019b;Yeh & Tsai, 2014). Findings are mixed for the domain of empathy, with some (Hillis, 2014;Leigh et al, 2013;Yeh & Tsai, 2014) but not all studies reporting a decrease in sharing of emotions and feeling with another's feelings (Nijsse et al, 2019b).…”

“…Findings are mixed for the domain of empathy, with some (Hillis, 2014;Leigh et al, 2013;Yeh & Tsai, 2014) but not all studies reporting a decrease in sharing of emotions and feeling with another's feelings (Nijsse et al, 2019b). Most research on social cognition after stroke aimed to determine its neural underpinnings, specifically lateralization of impairments (Baldo, Kacinik, Moncrief, Beghin, & Dronkers, 2016;Hamilton et al, 2017;Yeh & Tsai, 2014;Yeh, Lo, Tsai, & Tsai, 2015;Yuvaraj et al, 2013).…”

Social cognitive deficits following stroke

“…Abbott et al, 2014a;Cooper et al, 2014) and others finding greater impairment for strokes lateralised to the right relative to the left hemisphere (e.g. Hamilton et al, 2017). Nonetheless, this highlights a potentially important distinction with regard to stroke categorisation.…”

“…Indeed, the research to date that has been conducted in this area has typically identified significant social cognitive impairment following stroke (e.g. Blonder et al, 2012;Cooper et al, 2014;Hamilton, Radlak, Morris & Phillips, 2017;Happé Brownell & Winner, 1999;Yeh & Tsai, 2014;Yuvaraj, Murugappan, Norlinah, Sundaraj & Khairiyah, 2013). However, some stroke patients may be more vulnerable to difficulties than others.…”

“…With respect to different types of stroke, while many clinical characteristics are potentially important, in the present meta-analysis it was only possible to investigate the potential influence of stroke laterality, as only for this stroke characteristic were there sufficient studies that reported data separately for these stroke sub-types. While a number of studies have reported no difference in level of social cognitive impairment as a function of stroke laterality (Abbott et al, 2014a;Braun et al, 2005;Cheung, Lee, Yip, King & Li, 2006;Cooper et al, 2014;Pell, 2006;Pell & Baum, 1997a;Twist, Squires, Spielholz & Silverglide, 1991), others have identified greater impairment for strokes lateralised to the right hemisphere, relative to those lateralised to the left hemisphere (Blonder, Bowers & Heilman, 1991;Borod, Koff, Lorch & Nicholas, 1986;Hamilton et al, 2017;Kucharska-Pietura, Phillips, Gernand & David, 2003;Ross & Monnot, 2008;Siegal, Carrington & Radel, 1996;Surian & Siegal, 2001;Paradee et al, 2008;Walker, Daigle & Buzzard, 2002). In addition, data from non-clinical social neuroscience studies suggest that social cognitive functions may be slightly lateralised to the right hemisphere.…”