Empathy and executive functions in neuromuscular diseases

Objective: the relationship between Executive Functions (EFs) and Empathy, in particular Theory of Mind (ToM), is well known, considering neuropsychological performances and the neural correlates underpinning each one. Evidences regarding deficits on ToM skills related to impairment in EFs are nowadays well known in Amyotrophic Lateral Sclerosis (ALS) and Myothonic dystrophy (DM1). The aim of the present study was the evaluation of ToM and its association with EFs in four neuromuscular diseases in which EFs can be impaired, and so: Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD), Facioscapulohumeral dystrophy (FSHD) and X-linked Spinal and Bulbar Muscular Atrophy (X-SBMA). Moreover, also abilities related to Affective Empathy have been investigated. Methods: the study involved 25 DMD patients, 21 BMD patients, 21 FSHD patients, 64 X-SBMA patients and 145 healthy controls matched for age, education and gender. Both patients and controls completed tests and questionnaires with the aim to assess EFs, ToM and Affective Empathy abilities. Results: deficits in EFs have been found only in DMD patients. EFs impairment resulted to be associated with deficits in ToM ability but also with problems related to Affective Empathy. Conclusions: DMD patients without mental retardation manifest problems on EFs. These deficits are related to impairments in ToM abilities and Affective Empathy skills. These results can give an important contribution to clinical practice: know the Empathic abilities of patients may be useful to clinicians in order to create a good alliance which is extremely useful in the compliance of treatments and therapeutic choices