Theory of Mind abilities in neurodegenerative diseases: An update and a call to introduce mentalizing tasks in standard neuropsychological assessments

There is fast-growing interest in the study of Theory of Mind (ToM) abilities in neurodegenerative diseases. In a previous work, we reviewed all the evidence of altered ToM abilities in patients with neurodegenerative diseases in the literature published until then. In the present paper, we extend that analysis by integrating our conclusions with the most updated evidence that is now available. This new analysis allows for a clarification of some pending questions, such as at which stage ToM deficits begin to appear in dementing disorders, what is the relationship between executive functioning and ToM abilities in patients with Parkinson’s disease, and how can ToM tasks help clinicians to discriminate between different neurodegenerative disorders. Furthermore, we now provide the first review of all articles on ToM abilities in patients with multiple sclerosis. The data discussed here strongly suggest overall that a neuropsychological assessment of patients with neurodegenerative diseases should routinely include an accurate investigation of ToM abilities. Increasing evidence has shown that different ToM tasks may help clinicians in the diagnostic process and caregivers in understanding the behavioural problems that are often shown by their suffering relatives.