Assessment of theory of mind in stroke populations

Over the last twenty years there have been several investigations exploring theory of mind (ToM) abilities within populations with acquired brain injury, including stroke survivors. Most neuropsychology studies involving people with acquired brain injury have assessed the cognitively-demanding, social-cognitive component of ToM, whereas the literature concerned with exploring social-perceptual ToM is limited by its reliance on measures that are not representative of ToM processes within real-world situations.

The current study aimed to examine the use and utility of an ecologically-valid (verisimilitudinous) social-perceptual ToM task within stroke survivors, known as the Cambridge Mindreading Face-Voice Battery (CAM; Golan, Baron-Cohen, & Hill, 2006). Group comparisons of CAM performance between 22 stroke survivors and 20 age- and education-matched healthy control participants showed no significant differences. In addition, the CAM was unable to accurately distinguish between the groups. An exploratory cluster analysis revealed differential patterns of ToM impairment and preservation within the sample of stroke survivors. These findings suggest studies that have attempted to tap social-perceptual ToM through artificial tasks and/or static stimuli may be overestimating the deficits observed within stroke samples, and tentatively points towards functional fractionation of social-perceptual ToM abilities dependent on modality.

Some recommendations for future research combining neuropsychology and neuroimaging methodology are discussed.