A novel framework for understanding reduced awareness of dyskinesias in Parkinson's Disease

Background Although dyskinesias-reduced-self-awareness (DRSA) in Parkinson's disease (PD) is related to deficit in metacognition, other factors, such as “Theory of Mind” (ToM), could operate. Methods Forty-one PD patients were assessed using the Global Awareness of Movement Disorders (GAM) and the Dyskinesias Subtracted-Index (DS-I). To study whether GAM and DS-I scores could be influenced by second-type ToM or Reading the Mind in the Eyes (RME) tasks, we conducted two multiple logistic regression analyses. Results The association between the GAM, the DS-I and RME task were highly significant. The association between DS-I and Trail Making Test B-A version was also verified. Conclusion DRSA was related with affective component of ToM and executive functions, thus caused by a complex interplay between specific neuropsychological and motor factors