Objective: Our objective was to assess the social cognition (Theory of Mind) and emotional processing (alexithymia) in patients with functional movement disorders (FMD).
Background: The contemporary etiological explanations of FMD have moved away from psychodynamic, trauma-based models to dysfunction of the higher-order cognitive processes. However, it is not known how the patients with FMD process and interpret affective and social cognitive stimuli and how potentially altered processing of social information may affect the clinical presentation and severity of the disease.
Method: Twenty one patient with clinically established FMD and 19 age, sex and education matched patients with “organic” movement disorders (OMD) underwent a thorough evaluation of psychiatric and cognitive characteristics. Faux Pas situation recognition stories and images for Reading the Mind in the Eye Test (RMET) were used to assess the ToM, while 20-item Toronto Alexithymia Scale (TAS-20) was used for alexithymia analysis.
Results: Compared to OMD, patients with FMD had higher scores for depression, anxiety, and non-motor symptoms, and lower score of the ACE-R subscale for fluency. FMD group in comparison to OMD had lower scores on recognition of Faux Pas (40.8±23.3 and 57.0±19.2, p=0.022) and Ne-Faux Pas situations (57.9±26.0 and 79.2±18.8, p=0.032), while RMET scores did not differ between groups. Also, FMD patients were more alexithymic in comparison to OMD (58.9±9.1 and 48.9±7.5, p=0.001). The lower scores on fluency, language, and attention ACE-R subdomains correlated with ToM deficiency in FMD. The association of different psychiatric symptoms (anxiety, depression, apathy and non-motor symptoms) with the severity of alexithymia in both study groups was shown.
Conclusion: The results of our study show that social cognition impairment together with altered emotional processing are present in FMD, and may represent a significant etiopathogenetic factor, as well as the background for the new therapeutic approach – mentalization-based psychotherapy.
To cite this abstract in AMA style:
A. Tomic, I. Petrovic, M. Jecmenica Lukic, N. Dragasevic Miskovic, N. Kresojevic, V. Markovic, M. Svetel, V. Kostic. Social cognition and emotional processing in functional movement disorders [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/social-cognition-and-emotional-processing-in-functional-movement-disorders/. Accessed June 14, 2025.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/social-cognition-and-emotional-processing-in-functional-movement-disorders/