A 20-Year Systematic Review of the 'Reading the Mind in the Eyes' Test across Neurodegenerative Conditions

Social cognition has a broad theoretical definition, which includes the ability to mentalise, i.e., recognise and infer mental states to explain and predict another's behaviour. There is growing recognition of the clinical, diagnostic, and prognostic value of assessing a person's ability to perform social cognitive tasks, particularly aspects of theory of mind, such as mentalising. One such measure of mentalising is the 'Reading the Mind in the Eyes' test (RMET). This systematic review and meta-analysis consider performance on the RMET, applied to people with neurodegenerative conditions in matched control studies, since its publication in 2001. Overall, this review includes 22 papers with data from N = 800 participants with neurodegenerative conditions: Alzheimer's disease, n = 31; Parkinson's disease, n = 221; Lewy body dementia, n = 33; motor neuron disease, n = 218; Huntington's disease n = 80; multiple sclerosis, n = 217; and N = 601 matched typical controls. Our meta-analyses show that deficits in mentalising, as measured by the RMET, are consistently reported across neurodegenerative conditions, with participants in both early and late disease stages being affected. Social cognition is an emerging field of cognitive neuroscience requiring specific and sensitive measurement across each subdomain. Adult-based meta-normative data feature, for which future groups or individuals could be compared against, and hypotheses relating to the source of these mentalising deficits are further discussed. This review was registered with PROSPERO (CRD42020182874).

Association between speech rate measures and cognitive function in people with relapsing and progressive multiple sclerosis

Background

Cognitive impairments are well-documented in multiple sclerosis (MS), while speech impairments are often overlooked despite their significant effect on quality of life. For effective clinical management of multisystem conditions such as MS, consideration should be given to the interaction between deficits in multiple domains, such as speech and cognition. To evaluate speech rate measures of spontaneous and read speech, in people with MS and to examine the link between speech and cognition.

Methods

Forty-five people with MS and 25 controls underwent an extensive cognitive battery, including executive functioning, information processing and memory tasks, and completed two speech tasks: a reading task and a picture description task, from which speech rate measures were derived.

Results

The progressive MS cohort had reduced articulation (p < 0.04) and speech rate (p < 0.02) compared to controls and those with relapsing MS. Regression models also revealed information processing speed accounted for 18% to 30% of the variance of spontaneous speech rate measures, and 27% of read speech. Executive functioning accounted for a further 10% of the variance of speech rate in those with MS.

Conclusions

The present study suggests that speech production is contingent on cognitive ability, with information processing speed and executive functioning linked with speech timing patterns.

238 Cogniton and mood disorder in cervical dystonia

Background

Cervical dystonia patients have a high prevalence of anxiety and depression which is the main predictor of quality of life. Reports of abnormal cognition in cervical dystonia may be confounded by concurrent mood disorder.

Aim

To assess the relationships between measures of cognition, mood disorder, disease severity, and quality of life in cervical dystonia.

Methods

In 45 cervical dystonia partici- pants, we assessed clinical measures of disease severity, mood disorder using the Beck Anxiety Inventory and Beck Depression Inventory, quality of life by the Cervical Dystonia Impact Profile and Utility Values from the EQ-5D-5L and administered an extensive neuropsychological assessment battery. The outcomes of clinical and neuropsychological variables were compared between participants with and without signifi- cant mood disorder.

Results

Significant anxiety and/or depression were reported in 18 participants (40%); 27 participants (60%) had no prevalent anxiety or depression. Significant deficits in executive function were found in participants with mood disorder in comparison to those without mood disorder; otherwise neuropsychological testing showed no between-group abnormalities. Mood disorder significantly cor- related with measures of executive function and quality of life. Abnormal Social Cognition was found in cervical dystonia, unrelated to prevalent mood disorder.

Conclusion

Mood disorder in cervical dystonia is a significant independent predictor of both measures of executive function and quality of life. Other than in Social Cognition, there was no evidence of any primary cognitive impairment in cervical dystonia.

mhutchin2@mac.com

Traumatic thoracoabdominal hernia repair using a novel chest-wall reconstruction technique: a case report

Thoracoabdominal hernia following blunt trauma is extremely rare. Abdominal viscera are more likely to herniate into the thorax if there is traumatic diaphragmatic rupture. We report the case of a patient presenting with a traumatic thoracoabdominal hernia containing part of the right lobe of the liver and the hepatic flexure of the colon. The hernia migrated cranially, to protrude through a seventh intercostal defect despite the diaphragm remaining fully intact. The need for early multispecialty (thoracic and hepatobiliary) surgical repair is highlighted, with improvements in surgical outcome for a complex trauma case by using a novel chest-wall reconstruction technique.