Brain damage robbed a patient of the ability to put himself in other people's shoes — and the ability to recognize that failure

Anosognosia for Theory of Mind deficits: a single case study and a review of the literature. alentina Pacella et al. Neuropsychologia, October 13 2020, 107641. https://doi.org/10.1016/j.neuropsychologia.2020.107641

Rolf Degen's take: 

Highlights

• Anosognosia after TBI can be selective for Theory of Mind deficits.

•Theory of Mind deficits are not secondary to executive functions impairment.

• The limbic, monitoring and attentional systems play a role in anosognosia.

Abstract: Being aware of one’s own ability to interact socially is crucial to everyday life. After a brain injury, patients may lose their capacity to understand others’ intentions and beliefs, that is, the Theory of Mind (ToM). To date, the debate on the association between ToM and other cognitive deficits (in particular executive functions and behavioural disorders) remains open and data regarding awareness of ToM deficits are meagre. By means of an ad-hoc neuropsychological battery of tests, we report on a patient who suffers from ToM deficits and is not aware of these disorders, although aware of his other symptoms. The study is accompanied by a review of the literature (PRISMA guidelines) demonstrating that ToM deficits are independent from executive functions. Furthermore, an advanced lesion analysis including tractography was executed. The results indicate that: i) ToM deficits can be specific and independent from other cognitive symptoms; ii) unawareness may be specific for ToM impairment and not involve other disorders and iii) the medial structures of the limbic, monitoring and attentional systems may be involved in anosognosia for ToM impairment.

Keywords: AnosognosiaTheory of MindDTIAwarenessFrontal Lesion