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The Stroop effect is a well-documented phenomenon, demonstrating both interference and facilitation effects. Many versions of the Stroop task were created, according to the purposes of its applications, varying in numerous aspects. While many versions are developed to investigate the mechanisms of the effect itself, the Stroop effect is also considered a general measure of attention, inhibitory control, and executive functions. In this paper, we implement "eStroop": a new digital version based on verbal responses, measuring the main processes involved in the traditional effect. eStroop features four categories of stimuli in four different colors: (1) geometrical shapes, (2) neutral words, (3) congruent words, and (4) incongruent words. The results of the administration to 307 University students confirm the Stroop effect and offer baseline data for future research and clinical testing. Direct comparisons with other recent versions of the task are discussed, offering insights into differences and similarities between different task variables., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Brunetti, Indraccolo, Del Gatto, Farina, Imperatori, Fontana, Penso, Ardito and Adenzato.)

In this study, we investigated the relationship between sensory abnormalities evaluated by quantitative sensory testing (QST) and alexithymia, depression and anxiety in patients with neuropathic pain involving the upper limbs. We enrolled 62 patients (34 with carpal tunnel syndrome, 7 with brachial plexopathy, 3 with cervical painful radiculopathy, 5 with ulnar entrapment neuropathy at elbow and 13 with post-burn hypertrophic scars) and 48 healthy controls. All underwent nerve conduction studies (NCS), evaluation of cold, heat pain and vibration detection threshold (VDT) by QST and evaluation of alexithymia by Toronto Alexithymia Scale (TAS-20), depression by Beck Depression Inventory II (BDI-II), anxiety by State-Trait Anxiety Inventory (STAI-Y), level of psychological distress by 12-item General Health Questionnaire (GHQ-12) and perceived social support by the Multidimensional Scale of Perceived Social Support (MSPSS). The general linear model analysis revealed a significant relationship between TAS-20 overall and TAS-20 sub-score for difficulty identifying feelings and VDT z-scores in the left index with no interaction by year of education and sensory NCS results. Our results demonstrated the association between impairment of vibratory sensation of the left hand, reflecting cutaneous mechanoceptor dysfunction, and alexithymia, particularly the difficulty to identify feelings. The importance of delivering to patients with neuropathic pain personalized care that takes into account not only the neurophysiological aspects but also the aspects of mental functioning is discussed.

We investigated in a sample of non-clinical adults the association between Theory of Mind (ToM) and Executive Functions (EFs), that is the set of skills that allow people to control and modulate lower-level cognitive processes in order to produce appropriate behaviour. To this aim, we assessed both affective (i.e., understanding other people's emotions and feelings) and cognitive (i.e., understanding others' beliefs and intentions) ToM, as well four subcomponents of EFs, that is Updating, Shifting, Inhibition, and Access. The association between ToM and non-verbal fluid intelligence, verbal reasoning, and cognitive estimation abilities was also investigated. Eighty-one healthy participants were recruited, and a set of psychometrically validated tests was administered. Multiple regression analyses were run to assess significant predictors of ToM performance when potentially confounding predictors (sociodemographic variables) were controlled for. Results showed a lack of association between affective/cognitive ToM and EFs, whereas non-verbal fluid intelligence for cognitive ToM and verbal reasoning for affective ToM were found to be significant predictors of ToM performance. These results represent a contribution toward a deeper understanding of the ToM-EFs relationships and highlight the importance of broadening the analysis of these relationships to the role played by other domain-general functions in both affective and cognitive ToM.

Background: Alexithymia is a personality construct characterised by difficulty in identifying and describing one's emotions. We investigated whether people with alexithymia, who struggle with emotion-processing abilities, have diminished emotion-related social cognitive competencies, where social cognition encompasses the set of abilities that allows one to navigate one's social environment., Methods: We assessed alexithymia and four components of social cognition: recognition of others' emotions, representation of others' affective and cognitive mental states, empathy, and regulation of one's own feelings. We investigated whether alexithymia could significantly predict each of these components, beyond the effect of other individual difference variables (i.e., anxiety/depressive symptoms), which have been previously associated with both social cognition and alexithymia. Two hundred six participants were recruited. Multiple hierarchical regression analyses were performed to assess the possible relationships between alexithymia and social cognition skills., Results: Alexithymia significantly predicted emotion recognition, empathy, and emotional regulation, even after controlling for the effect of potentially competing factors (i.e., anxiety/depressive symptoms). Alexithymia did not predict representation of others' affective and cognitive mental states., Limitations: The present study adopted a cross-sectional design, which does not permit us to draw firm conclusions about the causality of the emergent relationships., Conclusions: These data provide support for the argument that recognising others' emotions and feelings relies on the ability to identify correctly one's own feelings. Our results also indicate the importance of taking into consideration individual differences in levels of alexithymia when investigating social cognition in non-clinical populations, as alexithymia appears to be clearly related to social cognitive functioning., Competing Interests: Declaration of Competing Interest All authors declare no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Transcranial Direct Current Stimulation (tDCS) has become an increasingly promising tool for understanding the relationship between brain and behavior. The purpose of this study was to investigate whether the magnitude of sex- and age-related tDCS effects previously found in the medial prefrontal cortex (mPFC) during a Theory of Mind (ToM) task correlates with social cognition performance; in particular, we explored whether different patterns of activity would be detected in high- and low-performing participants. For this, young and elderly, male and female participants were categorized as a low- or high-performer according to their score on the Reading the Mind in the Eyes task. Furthermore, we explored whether sex- and age-related effects associated with active tDCS on the mPFC were related to cognitive functioning. We observed the following results: (i) elderly participants experience a significant decline in ToM performance compared to young participants; (ii) low-performing elderly females report slowing of reaction time when anodal tDCS is applied over the mPFC during a ToM task; and (iii) low-performing elderly females are characterized by lower scores in executive control functions, verbal fluency and verbal short-term memory. The relationship between tDCS results and cognitive functioning is discussed in light of the neuroscientific literature on sex- and age-related differences.

Background: Doll therapy is a non-pharmacological intervention for people with dementia aimed to reduce distressing behaviours. Reliable results on the efficacy of Doll therapy for people with dementia are needed. The concept of attachment theorised by Bowlby has been proposed to explain the Doll therapy process, but it has not been proven to influence the response to doll presentation., Methods/design: This single-blind, randomised controlled trial will involve people with dementia living in nursing homes of the Canton Ticino (Switzerland). Participants will be randomised to one of two interventions: Doll Therapy Intervention or Sham Intervention with a non-anthropomorphic object, using a 1:1 allocation ratio. The two interventions will consist of 30 daily sessions lasting an hour at most, led by a trained nurse for an hour at most. We will enrol 64 participants per group, according to power analysis using an estimated medium effect size (f = 0.25), an alpha level of 0.05, and a power of 0.8. The primary goal is to test the efficacy of the Doll Therapy Intervention versus the Sham Intervention as the net change in the following measures from baseline to 30 days (blinded outcomes): the Neuropsychiatric Inventory-Nursing Home administered by a trained psychologist blinded to group assignment, the professional caregivers' perceived stress scale of the Neuropsychiatric Inventory-Nursing Home, patients' physiological indices of stress (salivary cortisol, blood pressure and heart rate) and interactive behaviours. The secondary goal is to assess the relationship between attachment styles of people with dementia (detected by means of the Adult Attachment Interview to the patients' offspring) and their caregiving behaviours shown during the Doll Therapy Intervention., Discussion: This is the first single-blind, randomised controlled trial on the efficacy of Doll therapy for dementia and an explanatory model of the response of people with dementia to doll presentation., Trial Registration: ClinicalTrials.gov, ID: NCT03224143. Retrospectively registered on 21 July 2017.

Aging is accompanied by changes in cognitive abilities and a great interest is spreading among researchers about aging impact on social cognition skills, such as the Theory of Mind (ToM). Transcranial direct current stimulation (tDCS) has been used in social cognition studies founding evidence of sex-related different effects on cognitive ToM task in a young people sample. In this randomized, double-blind, sham-controlled study, we applied one active and one sham tDCS session on the medial prefrontal cortex (mPFC) during a cognitive ToM task, including both social (i.e., communicative) and nonsocial (i.e., private) intention attribution conditions, in sixty healthy aging individuals (30 males and 30 females). In half of the participants the anode was positioned over the mPFC, whereas in the other half the cathode was positioned over the mPFC. The results showed that: (i) anodal tDCS over the mPFC led to significant slower reaction times (vs. sham) for social intention attribution task only in female participants; (ii) No effects were found in both females and males during cathodal stimulation. We show for the first time sex-related differences in cognitive ToM abilities in healthy aging, extending previous findings concerning young participants.

Dysfunctional parenting constitutes a factor of psychopathological vulnerability affecting development both at neurobiological and psychological level. The default mode network (DMN), a large scale network for brain functional integration, is supposed to play a crucial role in those psychological functions altered by dysfunctional parenting. Here we investigate electroencephalography DMN functional connectivity in relation to perceived dysfunctional parenting (PDP) in a non-clinical sample. We hypothesized that participants with high PDP would exhibit decreased DMN connectivity after the activation of attachment memories. Our results support this hypothesis: participants with high PDP showed a decrease of theta connectivity between left temporoparietal junction and right anterior cingulate cortex after the activation of attachment memories, and, compared to participants with low PDP, showed a decrease of delta connectivity in the same brain areas. We interpret these decreased DMN connectivity in participants with high PDP as the "neurophysiological signature" of the impaired ability to mentalize their own relational experiences with significant others after the activation of early attachment memories. Thus, the activation of attachment memories in individuals exposed to dysfunctional parenting could lead to a transitory failure of functional brain connectivity and consequent disturbance of high integrative mental functions, such as emotional regulation and mentalization., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Although several researches investigated Default Mode Network (DMN) alterations in individuals with anxiety disorders, up to now no studies have investigated DMN functional connectivity in non-clinical individuals with high-trait-anxiety using quantitative electroencephalography (EEG). Here, the main aim was to extend previous findings investigating the association between trait anxiety and DMN EEG functional connectivity., Methods: Twenty-three individuals with high-trait-anxiety and twenty-four controls were enrolled. EEG was recorded during 5 min of resting state (RS). EEG analyses were conducted by means of the exact Low-Resolution Electromagnetic Tomography software (eLORETA)., Results: Compared to controls, individuals with high-trait-anxiety showed a decrease of theta connectivity between right medial prefrontal cortex (mPFC) and right posterior cingulate/retrosplenial cortex. A decrease of beta connectivity was also observed between right mPFC and right anterior cingulate cortex. Furthermore, DMN functional connectivity strength was negatively related with STAI-T total score (i.e., lower connectivity was associated with higher trait anxiety), even when controlling for potential confounding variables (i.e., sex, age, and general psychopathology)., Limitations: Small sample size makes it difficult to draw definitive conclusions. Furthermore, we did not assess state variation of anxiety, which make our interpretation specific to trait anxiety., Conclusions: Taken together, our results suggest that high-trait-anxiety individuals fail to synchronize DMN during RS, reflecting a possible top-down cognitive control deficit. These results may help in the understanding of the individual differences in functional brain networks associated with trait anxiety, a crucial aim in the prevention and in the early etiology understanding of clinical anxiety and related sequelae., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: The Fear of Pain Questionnaire-III (FPQ-III) is a self-report instrument developed to assess fear of different stimuli usually causing pain. The present study aimed to construct an Italian version of the FPQ-III and examine its psychometric properties in a heterogeneous sample of Italian healthy individuals., Methods: The questionnaire was translated following the forward-backward method and completed by 511 Italian adults who met the inclusion criteria. Within 2 months of the first assessment, a subgroup of participants (n = 164) was re-tested. The factorial structure of the FPQ-III was assessed by confirmatory factor analysis (CFA). To better comprehend the FPQ-III's factorial structure, a CFA was also performed for each of the two reduced versions of the FPQ-III, namely the FPQ-Short Form and the FPQ-9. Divergent validity, test-retest reliability, and gender/age measurement invariance were also evaluated., Results: The results of the CFA revealed that the original three-factor model poorly fitted the data, but it became satisfactory after allowing correlated error terms. Concerning divergent validity, correlations between FPQ-III scores and pain intensity, depression, and anxiety were found to be positive but weak in magnitude (< .20). FPQ-III subscales and total scores showed good internal consistency and time reliability. Finally, scalar invariance was only partially obtained, whereas all the other types of invariance were fully respected both for gender and age., Conclusions: The current findings indicate that the Italian version of the FPQ-III provides valid and reliable scores for the assessment of fear of pain in the Italian population., Competing Interests: The authors have declared that no competing interests exist.

Background: Parkinson's Disease (PD) with mild cognitive impairment (MCI) (PD-MCI) represents one of the most dreaded complications for patients with PD and is associated with a higher risk of developing dementia. Although transcranial direct current stimulation (tDCS) has been demonstrated to improve motor and non-motor symptoms in PD, to date, no study has investigated the effects of tDCS on Theory of Mind (ToM), i.e., the ability to understand and predict other people's behaviours, in PD-MCI., Methods: In this randomized, double-blind, sham-controlled study, we applied active tDCS over the medial frontal cortex (MFC) to modulate ToM performance in twenty patients with PD-MCI. Twenty matched healthy controls (HC) were also enrolled and were asked to perform the ToM task without receiving tDCS., Results: In the patients with PD-MCI, i) ToM performance was worse than that in the HC, ii) ToM abilities were poorer in those with fronto-executive difficulties, and iii) tDCS over the MFC led to significant shortening of latency for ToM tasks., Conclusions: We show for the first time that active tDCS over the MFC enhances ToM in patients with PD-MCI, and suggest that non-invasive brain stimulation could be used to ameliorate ToM deficits observed in these patients., Competing Interests: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee. Informed consent was obtained from all individual participants included in the study. Ethics approval was obtained from the local Ethical Committee (IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy).Not applicableThe authors declare that they have no competing interests.

Behavioural variant frontotemporal dementia (bvFTD) is a form of frontotemporal degeneration characterized by early changes in personality, emotional blunting, and/or loss of empathy. Recent research has highlighted that these features may be at least partially explained by impairments in the theory of mind (ToM; i.e., the ability to understand and predict other people's behaviour by attributing independent mental states to them). The aim of this randomized, double-blind, placebo-controlled study was to test the hypothesis that transcranial direct current stimulation (tDCS) over the medial frontal cortex (MFC) selectively enhances communicative intention processing, a specific ToM ability. Using a single-session online design, we administered a ToM task that measures the ability to represent other people's private and communicative intentions during active or sham tDCS to 16 bvFTD patients. To assess the impact of dementia on performance on the ToM task, we included 16 age-matched healthy volunteers who were asked to perform the entire experimental ToM task. BvFTD is characterized by an impairment in the comprehension of both communicative and private intentions relative to a healthy control group and by a disproportional impairment in communicative intention compared with private intention processing. Significant and selective accuracy improvement in the comprehension of communicative intentions after active stimulation was observed in patients with bvFTD. This is the first study that analyses ToM ability in patients with bvFTD using tDCS stimulation. Our findings could potentially contribute to the development of an effective, noninvasive brain stimulation treatment of ToM impairments in patients with bvFTD.

Background: Fibromyalgia (FM) is a syndrome characterized by chronic, widespread musculoskeletal pain, occurring predominantly in women. Previous studies have shown that patients with FM display a pattern of selective processing or cognitive bias which fosters the encoding of pain-related information. The present study tested the hypothesis of an increased attribution of pain to facial expressions of emotions (FEE), in patients with FM. As previous studies have shown that alexithymia influences the processing of facial expressions, independent of specific clinical conditions, we also investigated whether alexithymia, rather than FM per se, influenced attribution of pain to FEE., Methods: One hundred and twenty-three women (41 with FM, 82 healthy controls, HC) were enrolled in this cross-sectional case-control study. We adopted two pain-attribution tasks, the Emotional Pain Estimation and the Emotional Pain Ascription, both using a modified version of the Ekman 60 Faces Test. Psychological distress was assessed using the Hospital Anxiety and Depression Scale, and alexithymia was assessed using the Toronto Alexithymia Scale., Results: Patients with FM did not report increased attribution of pain to FEE. Alexithymic individuals demonstrated no specific problem in the recognition of basic emotions, but attributed significantly more pain to angry facial expression., Limitations: Our study involved a relatively small sample size. The use of self-reported instruments might have led to underestimation of the presence of frank alexithymia in individuals having borderline cut-off scores., Conclusions: Alexithymia, rather than FM per se, plays a key role in explaining the observed differences in pain attribution to anger-related facial expressions., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a treatment option for patients with advanced idiopathic PD successful at alleviating disabling motor symptoms. Nevertheless, the effects of STN-DBS on cognitive functions remain controversial and few studies have investigated modification of social cognitive abilities in patients with PD treated with STN-DBS. Here we expanded the typically-investigated spectrum of these abilities by simultaneously examining emotion recognition, and both affective and cognitive Theory of Mind (ToM). By means of a cross-sectional study, 20 patients with PD under dopaminergic replacement therapy, 18 patients with PD treated with STN-DBS, and 20 healthy controls performed the Ekman 60-Faces test, the full version of the Reading the Mind in the Eyes test, and the Protocol for the Attribution of Communicative Intentions. There were no differences between the PD groups (treated and not treated with STN-DBS) on any of the social cognitive tests. Our results suggest that patients with PD who are treated with STN-DBS do not experience detrimental effects on their social cognitive abilities. The present study, the first one examining a wide spectrum of social cognitive abilities after DBS of the STN, suggests that this surgical procedure can be considered safe from this standpoint.

An Intention Processing Network (IPN), involving the medial prefrontal cortex, precuneus, bilateral posterior superior temporal sulcus, and temporoparietal junctions, plays a fundamental role in comprehending intentions underlying action goals. In a previous fMRI study, we showed that, depending on the linguistic or extralinguistic (gestural) modality used to convey the intention, the IPN is complemented by activation of additional brain areas, reflecting distinct modality-specific input gateways to the IPN. These areas involve, for the linguistic modality, the left inferior frontal gyrus (LIFG), and for the extralinguistic modality, the right inferior frontal gyrus (RIFG). Here, we tested the modality-specific gateway hypothesis, by using DCM to measure inter-regional functional integration dynamics between the IPN and LIFG/RIFG gateways. We found strong evidence of a well-defined effective connectivity architecture mediating the functional integration between the IPN and the inferior frontal cortices. The connectivity dynamics indicate a modality-specific propagation of stimulus information from LIFG to IPN for the linguistic modality, and from RIFG to IPN for the extralinguistic modality. Thus, we suggest a functional model in which the modality-specific gateways mediate the structural and semantic decoding of the stimuli, and allow for the modality-specific communicative information to be integrated in Theory of Mind inferences elaborated through the IPN., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Gender differences in social cognition are a long discussed issue, in particular those concerning Theory of Mind (ToM), i.e., the ability to explain and predict other people's mental states. The aim of this randomized, double-blind, placebo-controlled study was to test the hypothesis that anodal tDCS over the medial prefrontal cortex (mPFC) selectively enhances cognitive ToM performance in females. In the first experiment we administered to sixteen females and sixteen males a cognitive ToM task during anodal or placebo tDCS over the mPFC. In the second experiment further sixteen females completed the task receiving anodal or placebo tDCS over the vertex. The results showed that anodal tDCS over the mPFC enhances ToM in females but not in males, an effect indicated by enhanced ToM in females that received anodal tDCS over the mPFC compared with females that received tDCS over the vertex. These findings are relevant for three reasons. First, we found evidence of gender-related differences in cognitive ToM, extending previous findings concerning affective ToM. Second, these differences emerge with anodal stimulation of the mPFC, confirming the crucial role of this area in cognitive ToM. Third, we show that taking into account gender-related differences is mandatory for the investigation of ToM.

Preclinical Research The neuropeptide oxytocin (Oxt) is implicated in complex emotional and social behaviors and appears to play an important role in learning and memory. Animal studies have shown that the effects of exogenous Oxt on memory vary according to the timing of administration, context, gender, and dose and may improve the memory of social, but not nonsocial stimuli. Oxt is intimately involved in a broad array of neuropsychiatric functions and may therefore be a pharmacological target for several psychiatric disorders. This review summarizes the potential effects of Oxt on long-term memory processes in healthy humans based on a PubMed search over the period 1980-2016. The effects of intranasal Oxt on human memory are controversial and the studies included in this review have applied a variety of learning paradigms, in turn producing variable outcomes. Specifically, data on the long-term memory of nonemotional stimuli found no effect or even worsening in memory, while studies using emotional stimuli showed an improvement of long-term memory performance. In conclusion, this review identified a link between long-term memory performance and exogenous intranasal Oxt in humans, although these results still warrant further confirmation in large, multicenter randomized controlled trials. Drug Dev Res 77 : 479-488, 2016. © 2016 Wiley Periodicals, Inc., (© 2016 Wiley Periodicals, Inc.)

Background: Parkinson's disease (PD) is characterised by well-known motor symptoms, whereas the presence of cognitive non-motor symptoms, such as emotional disturbances, is still underestimated. One of the major problems in studying emotion deficits in PD is an atomising approach that does not take into account different levels of emotion elaboration. Our study addressed the question of whether people with PD exhibit difficulties in one or more specific dimensions of emotion processing, investigating three different levels of analyses, that is, recognition, representation, and regulation., Methodology: Thirty-two consecutive medicated patients with PD and 25 healthy controls were enrolled in the study. Participants performed a three-level analysis assessment of emotional processing using quantitative standardised emotional tasks: the Ekman 60-Faces for emotion recognition, the full 36-item version of the Reading the Mind in the Eyes (RME) for emotion representation, and the 20-item Toronto Alexithymia Scale (TAS-20) for emotion regulation., Principal Findings: Regarding emotion recognition, patients obtained significantly worse scores than controls in the total score of Ekman 60-Faces but not in any other basic emotions. For emotion representation, patients obtained significantly worse scores than controls in the RME experimental score but no in the RME gender control task. Finally, on emotion regulation, PD and controls did not perform differently at TAS-20 and no specific differences were found on TAS-20 subscales. The PD impairments on emotion recognition and representation do not correlate with dopamine therapy, disease severity, or with the duration of illness. These results are independent from other cognitive processes, such as global cognitive status and executive function, or from psychiatric status, such as depression, anxiety or apathy., Conclusions: These results may contribute to better understanding of the emotional problems that are often seen in patients with PD and the measures used to test these problems, in particular on the use of different versions of the RME task.

Background: Fibromyalgia (FM) is a syndrome primarily characterised by chronic, widespread musculoskeletal pain. In the aetiology of this syndrome a crucial role is played by complex interactions among biological, genetic, psychological, and socio-cultural factors. Recently, researchers have started to explore emotional functioning in FM, with their attention focused on alexithymia, a personality construct that affects the regulation of a person's own emotions. On the other hand, the detection and experience of emotional signals from other people have only been sparsely investigated in FM syndrome and no studies have investigated the ability to represent other people's mental states (i.e. Theory of Mind, ToM) in these patients. Here we present the first study investigating a large set of social-cognitive abilities, and the possible relationships between these abilities and the performance on executive-function tasks, in a homogenous sample of patients with FM., Methodology: Forty women with FM and forty-one healthy women matched for education and age were involved in the study. Social cognition was assessed with a set of validated experimental tasks. Measures of executive function were used to test the correlations between this dimension and the social-cognitive profile of patients with FM. Relationships between social-cognitive abilities and demographic, clinical and psychological variables were also investigated., Principal Findings: Patients with FM have impairments both in the regulation of their own affect and in the recognition of other's emotions, as well as in representing other people's mental states. No significant correlations were found between social cognition tasks and the subcomponents of the executive function that were analysed., Conclusions: The results show the presence of several impairments in social cognition skills in patients with FM, which are largely independent of both executive function deficits and symptoms of psychological distress. The impairments reported highlight the importance of adequately assessing ToM and emotional functioning in clinical practice.

In their 2002 seminal paper Hauser, Chomsky and Fitch hypothesize that recursion is the only human-specific and language-specific mechanism of the faculty of language. While debate focused primarily on the meaning of recursion in the hypothesis and on the human-specific and syntax-specific character of recursion, the present work focuses on the claim that recursion is language-specific. We argue that there are recursive structures in the domain of motor intentionality by way of extending John R. Searle's analysis of intentional action. We then discuss evidence from cognitive science and neuroscience supporting the claim that motor-intentional recursion is language-independent and suggest some explanatory hypotheses: (1) linguistic recursion is embodied in sensory-motor processing; (2) linguistic and motor-intentional recursions are distinct and mutually independent mechanisms. Finally, we propose some reflections about the epistemic status of HCF as presenting an empirically falsifiable hypothesis, and on the possibility of testing recursion in different cognitive domains., (Copyright © 2014 Elsevier Inc. All rights reserved.)

The paper reviews of all of the current evidence on Theory of Mind (ToM) abilities in patients with neurodegenerative diseases. ToM refers to the abilities to attribute mental states to others. Two neural systems are involved in processing other people's beliefs and intentions (cognitive component) and others' emotions and feelings (affective component). We hypothesize that patients with different neurodegenerative diseases may present different patterns of ToM deficits on the basis of how different neuropathological processes affect the neural bases of ToM components during the progression of a disease. The studies we reviewed provided evidence of a deficit of the cognitive ToM component in cortical (Alzheimer's disease and frontotemporal dementia) and frontal-subcortical (amyotrophic lateral sclerosis and basal ganglia disorders) neurodegenerative diseases. As regards the affective ToM component, it resulted markedly impaired in frontotemporal dementia; it also resulted that performances in tasks assessing this process are heterogeneous in Parkinson's disease and amyotrophic lateral sclerosis. The findings presented support the opportunity to introduce validated ToM tasks in the neuropsychological assessment of neurodegenerative diseases., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Background: The findings of the few studies that have to date investigated the way in which individuals with Anorexia Nervosa (AN) navigate their social environment are somewhat contradictory. We undertook this study to shed new light on the social-cognitive profile of patients with AN, analysing Theory of Mind and emotional functioning. Starting from previous evidence on the role of the amygdala in the neurobiology of AN and in the social cognition, we hypothesise preserved Theory of Mind and impaired emotional functioning in patients with AN., Methodology: Thirty women diagnosed with AN and thirty-two women matched for education and age were involved in the study. Theory of Mind and emotional functioning were assessed with a set of validated experimental tasks. A measure of perceived social support was also used to test the correlations between this dimension and the social-cognitive profile of AN patients., Principal Findings: The performance of patients with AN is significantly worse than that of healthy controls on tasks assessing emotional functioning, whereas patients' performance is comparable to that of healthy controls on the Theory of Mind task. Correlation analyses showed no relationship between scores on any of the social-cognition tasks and either age of onset or duration of illness. A correlation between social support and emotional functioning was found. This latter result seems to suggest a potential role of social support in the treatment and recovery of AN., Conclusions: The pattern of results followed the experimental hypothesis. They may be useful to help us better understand the social-cognitive profile of patients with AN and to contribute to the development of effective interventions based on the ways in which patients with AN actually perceive their social environment.

Human communicative competence is based on the ability to process a specific class of mental states, namely, communicative intention. The present fMRI study aims to analyze whether intention processing in communication is affected by the expressive means through which a communicative intention is conveyed, that is, the linguistic or extralinguistic gestural means. Combined factorial and conjunction analyses were used to test two sets of predictions: first, that a common brain network is recruited for the comprehension of communicative intentions independently of the modality through which they are conveyed; second, that additional brain areas are specifically recruited depending on the communicative modality used, reflecting distinct sensorimotor gateways. Our results clearly showed that a common neural network is engaged in communicative intention processing independently of the modality used. This network includes the precuneus, the left and right posterior STS and TPJ, and the medial pFC. Additional brain areas outside those involved in intention processing are specifically engaged by the particular communicative modality, that is, a peri-sylvian language network for the linguistic modality and a sensorimotor network for the extralinguistic modality. Thus, common representation of communicative intention may be accessed by modality-specific gateways, which are distinct for linguistic versus extralinguistic expressive means. Taken together, our results indicate that the information acquired by different communicative modalities is equivalent from a mental processing standpoint, in particular, at the point at which the actor's communicative intention has to be reconstructed.

The ability to infer other people's mental states (i.e. Theory of Mind, ToM) is a major topic of interest in various neurological and psychiatric disorders. However, it is only recently that there has been an assessment of cognitive and affective components of ToM ability in neurodegenerative disorders. In this review, we examine studies investigating the ToM ability in Parkinson's disease (PD). Taken together, these studies provide preliminary evidence that ToM difficulties may occur in PD patients. In particular, these difficulties principally involve the cognitive component of ToM in the early stages of the disease. The spatio-temporal progression of dopamine depletion supports the hypothesis that the affective component may only be affected in the advanced stages of the disease. The relationships between executive functioning, dopaminergic therapies, and ToM in PD as well as the relationships between frontostriatal circuits and ToM processing are discussed., (Copyright © 2011 Elsevier B.V. All rights reserved.)

IN THIS PAPER WE SHOW HOW WE EMPIRICALLY TESTED ONE OF THE MOST RELEVANT TOPICS IN PHILOSOPHY OF MIND THROUGH A SERIES OF FMRI EXPERIMENTS: the classification of different types of intention. To this aim, firstly we trace a theoretical distinction among private, prospective, and communicative intentions. Second, we propose a set of predictions concerning the recognition of these three types of intention in healthy individuals, and we report the experimental results corroborating our theoretical model of intention. Third, we derive from our model predictions relevant for the domain of psychopathological functioning. In particular, we treat the cases of both hyper-intentionality (as in paranoid schizophrenia) and hypo-intentionality (as in autistic spectrum disorders). Our conclusion is that the theoretical model of intention we propose contributes to enlarge our knowledge on the neurobiological bases of intention processing, in both healthy people and in people with impairments to the neurocognitive system that underlies intention recognition.

The present study aims at clarifying the nature of the Theory of Mind (ToM) deficits associated with Amyotrophic Lateral Sclerosis (ALS). ToM is the ability to attribute mental states such as intentions and beliefs to others in order to understand and predict their behaviour and to behave accordingly. Several neuroimaging studies reported the prefrontal cortices as the brain region underlying a key ToM ability, i.e. the comprehension of social intentions. Dysfunction of the prefrontal cortices in patients with ALS has been indicated by a range of neuroimaging studies. The frontal syndrome that appears to characterize up to 50% of ALS has been noted to be similar to the profile that characterizes patients with frontotemporal dementia (FTD), a neurodegenerative condition characterised by ToM deficits. In the present paper, we hypothesize that the performance of patients with ALS is significantly worse than healthy controls' performance on tasks requiring the comprehension of social contexts, whereas patients' performance is comparable to healthy controls' performance on tasks not requiring the comprehension of social contexts. To this end, we tested 15 patients with ALS with an experimental protocol that distinguishes between private (non-social) intentions and social intentions. The pattern of results followed the experimental hypothesis: the performance of patients with ALS and healthy controls significantly differed on the comprehension of social context only, with an impairment in patients with ALS. Single case analysis confirmed the findings at an individual level. The present study is the first which has examined and compared the understanding of social and non-social contexts in patients with ALS and shown a specific and selective deficit in the former only. The current findings further support the notion of a continuum of cognitive dysfunction ranging from ALS to FTD, with parallel cognitive profiles in both disorders.

The paper reviews convergent evidence on the ability to attribute mental states to one's self and to others (i.e., theory of mind, ToM) in patients affected by the behavioural variant of frontotemporal dementia (bv-FTD). This disease represents a particular challenge for researchers and clinicians, due to its insidious onset and ambiguous clinical features, which frequently render difficult a precise and timely diagnosis. The paper proposes a way to shed new light on the hypothesis that the neuropsychiatric profile of individuals with bv-FTD can be at least partially explained by a deficit in ToM ability. We examined both neuroimaging data on the neural correlates of ToM ability in healthy participants and studies investigating the progressive cerebral atrophy in patients with bv-FTD. Our findings suggest a link between the progressive degeneration of the anterior regions of medial frontal structures characterising the early stages of the bv-FTD and the ToM deficit these patients show. They also suggest the importance of using ToM tests during the diagnostic process of bv-FTD.

Recent studies have demonstrated that patients suffering from frontotemporal lobar degeneration (FTLD) show impairments in empathy and emotional processing. In this study, we examined two different aspects of these abilities in a patient with semantic dementia (SD), a variant of FTLD. The first aspect was the assessment of the cognitive and emotional components of empathy through the Interpersonal Reactivity Index. The second was the naming and comprehension of emotions using the Ekman 60 Faces Test. The patient's emotion word knowledge was spared and the emotional aspects of empathy preserved. Conversely, the patient performed below average for all of the basic emotions when an emotion word had to be matched with a picture. When picture-to-picture matching was tested, however, the patient was able to recognize happiness. This case is a good example of a dissociation of covert and overt emotional functioning in SD. Results are discussed in terms of the impaired empathic behavior and emotional functioning in FTLD.

In this fMRI study, we investigated theory of mind (ToM) in patients with paranoid schizophrenia. We hypothesized that the network supporting the representation of intentions is dysfunctional in patients with schizophrenia dependent on the type of intention involved. We used a paradigm including a control condition (physical causation) and three intention conditions (private intention, prospective social intention and communicative intentions) differing in the degree of social interaction. In all four experimental conditions patients performed worse than controls regarding accuracy and reaction time. They showed significantly less activation in three regions typically activated in ToM tasks, i.e. paracingulate cortex and bilateral temporo-parietal junctions. However, this dysfunction was dependent on the type of intention represented, i.e. was present only for social but not for non-social intentions. Moreover, part of the reduced activation was related to the fact that there was no signal drop in these regions for the physical causality condition as usually found in controls. This may be due to the tendency of schizophrenic patients to attribute intentionality to physical objects. Our findings have implications for the study and understanding of ToM in schizophrenia but also in other disorders like autism.

Hemispheric asymmetry in emotional perception has been traditionally studied for basic emotions and very little is known about laterality for more complex social emotions. Here, we used the "redundant target paradigm" to investigate interhemispheric asymmetry and cooperation for two social emotions in healthy subjects. Facial expressions of flirtatiousness or arrogance were briefly presented either unilaterally in the left (LVF) or right visual field (RVF), or simultaneously to both visual fields (BVF) while participants responded to the target expression (flirtatious or arrogant, counterbalanced between blocks). In bilateral conditions the faces could show the same emotion (congruent condition) or two different expressions (incongruent condition). No difference between unilateral presentations was found, suggesting that the perception of social emotions is not hemispherically lateralized. Responses were faster and more accurate in bilateral displays with two emotionally congruent but physically different faces (i.e., a male and a female expressing the same emotion) than in unilateral conditions. This "redundant target effect" was consistent with a neural summation model, thereby showing that interhemispheric cooperation may occur for social emotions despite major perceptual differences between faces posing the same expression.

This study investigated whether the lack of visual experience affects the ability to create spatial inferential representations of the survey type. We compared the performance of persons with congenital blindness and that of blindfolded sighted persons on four survey representation-based tasks (Experiment 1). Results showed that persons with blindness performed better than blindfolded sighted controls. We repeated the same tests introducing a third group of persons with late blindness (Experiment 2). This last group performed better than blindfolded sighted participants, whereas differences between participants with late and congenital blindness were nonsignificant. The present findings are compatible with results of other studies, which found that when visual perception is lacking, skill in gathering environmental spatial information provided by nonvisual modalities may contribute to a proper spatial encoding. It is concluded that, although it cannot be asserted that total lack of visual experience incurs no cost, our findings are further evidence that visual experience is not a necessary condition for the development of spatial inferential complex representations.

In this paper we present theoretical and experimental evidence for a set of mechanisms by which intention is understood. We propose that three basic aspects are involved in the understanding of intention. The first aspect to consider is intention recognition, i.e., the process by which we recognize other people's intentions, distinguishing among different types. The second aspect concerns the attribution of intention to its author: the existence of shared neural representations provides a parsimonious explanation of how we recognize other people's intentions (what they are doing), but in and of itself, is not sufficient to determine who the agent is. Once the intention has been recognized and attributed to an agent, the reasons for, and the aim of, the intention are to be considered. Hence, the third aspect concerns the aim-intention motivating the execution of a certain action. We discuss the neural basis of these three theoretical aspects suggesting a conceptual synthesis.

Development of reliable procedures to assess fitness to safe driving after traumatic brain injury (TBI) is a crucial step in rehabilitation. However, prior studies are highly inconsistent in the choice of measures recommended for predicting driving fitness from different pre-driving measures. In the present paper the relevant literature is reviewed with the aim of shedding light on the reasons for these inconsistencies. The discrepant results reflect investigative choices which differ in five aspects: (1) the type of predictors used as pre-driving screening; (2) the type of measures considered as the criterion for the determination of fitness to drive after TBI; (3) the severity of the TBI in the sample of patients studied; (4) the extent of the neural structures damaged by TBI and the overlap of these areas with those involved in driving tasks; (5) the length of the follow-up considered. The strengths and weaknesses of the different methods and measures are discussed with their implications for future research and clinical rehabilitation. Encouraging findings come from recent studies that combined together medical, psychosocial, and personality measures, thereby improving the explanatory power of the predictors used. The use of post-injury driving fitness measures with great ecological and external validity seems equally promising in assessing actual driving in the real world.

Neuroimaging studies have identified the anterior paracingulate cortex (PCC) as the key prefrontal region subserving theory of mind. We adopt an evolutionary perspective hypothesizing that, in response to the pressures of social complexity, a mechanism for manipulating information concerning social interaction has emerged in the anterior PCC. To date, neuroimaging studies have not properly distinguished between intentions of persons involved in social interactions and intentions of an isolated person. In two separate fMRI experiments, we demonstrated that the anterior PCC is not necessarily involved in the understanding of other people's intentions per se, but primarily in the understanding of the intentions of people involved in social interaction. Moreover, this brain region showed activation when a represented intention implies social interaction and therefore had not yet actually occurred. This result suggests that the anterior PCC is also involved in our ability to predict future intentional social interaction, based on an isolated agent's behavior. We conclude that distinct areas of the neural system underlying theory of mind are specialized in processing distinct classes of social stimuli.

Recent experimental research in the field of neurophysiology has led to the discovery of two classes of visuomotor neurons: canonical neurons and mirror neurons. In light of these studies, we propose here an overview of two classical themes in the cognitive science panorama: James Gibson's theory of affordances and Eleanor Rosch's principles of categorization. We discuss how theoretical perspectives and neuroscientific evidence are converging towards the current paradigm of embodied cognition. From this perspective, we discuss the role of action and simulation in cognitive processes, which lead to the perceptual recognition of objects, and actions and to their conceptual categorization.

This study explores how maternal interactive behaviors experienced during the childhood of adults with congenital blindness are associated with their subsequent development and personality. Many researchers have found a high frequency of maternal directiveness and overprotection in sighted mother-congenitally blind child relationships. One open question is whether these behaviors may have negative effects on congenitally blind children's subsequent development, or whether they may have a functionally adaptive-strategic role. The purpose of this study was to discriminate between the two hypotheses. This objective was pursued by adopting the theory of attachment and administering the Adult Attachment Interview to 15 participants with congenital blindness. Results suggested that directive and overprotective maternal behaviors are experienced by the persons with congenital blindness as encouraging and functional as long as they are accompanied by an affective, loving, and supportive attitude. Results did not support the hypothesis that directive and overprotective maternal interactive behaviors have a necessarily negative effect on the development of persons with congenital blindness.