Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 31198
Theory of Mind and Its Brain Distribution in Patients with Temporal Lobe Epilepsy

Authors: Wei-Han Wang, Hsiang-Yu Yu, Mau-Sun Hua


Theory of Mind (ToM) refers to the ability to infer another’s mental state. With appropriate ToM, one can behave well in social interactions. A growing body of evidence has demonstrated that patients with temporal lobe epilepsy (TLE) may damage ToM by affecting on regions of the underlying neural network of ToM. However, the question of whether there is cerebral laterality for ToM functions remains open. This study aimed to examine whether there is cerebral lateralization for ToM abilities in TLE patients. Sixty-seven adult TLE patients and 30 matched healthy controls (HC) were recruited. Patients were classified into right (RTLE), left (LTLE), and bilateral (BTLE) TLE groups on the basis of a consensus panel review of their seizure semiology, EEG findings, and brain imaging results. All participants completed an intellectual test and four tasks measuring basic and advanced ToM. The results showed that, on all ToM tasks, (1) each patient group performed worse than HC; (2) there were no significant differences between LTLE and RTLE groups; and (3) the BTLE group performed the worst. It appears that the neural network responsible for ToM is distributed evenly between the cerebral hemispheres.

Keywords: Theory of Mind, Social Cognition, cerebral lateralization, temporal lobe epilepsy

Digital Object Identifier (DOI):

Procedia APA BibTeX Chicago EndNote Harvard JSON MLA RIS XML ISO 690 PDF Downloads 1677


[1] Lin JJ, Mula M, Hermann BP. Uncovering the neurobehavioural comorbidities of epilepsy over the lifespan. Lancet 2012;380:1180–1192.
[2] Wang WH, Liou HH, Chen CC, et al. Neuropsychological performance and seizure-related risk factors in patients with temporal lobe epilepsy: A retrospective cross-sectional study. Epilepsy Behav 2011;22:728–734.
[3] Giovagnoli AR. The importance of theory of mind in epilepsy. Epilepsy Behav 2014;39:145–153.
[4] Li YH, Chiu MJ, Yeh ZT, Liou HH, Cheng TW, Hua MS. Theory of Mind in patients with Temporal Lobe Epilepsy. J Int Neuropsych Soc 2013;19:594–600
[5] Schurz M., Radua J., Aichhorn M., Richlan F., Perner J. Fractionating theory of mind: A meta-analysis of functional brain imaging studies. Neurosci Biobehav Rev 2014;42:9–34
[6] Carrington SJ & Bailey AJ. Are there theory of mind regions in the brain? A review of the neuroimaging literature. Hum Brain Mapp 2009;30:2313–2335.
[7] Adolphs R. The social brain: neural basis of social knowledge. Annu Rev Psychol 2009;60:693–716.
[8] Mahy CE, Moses LJ, Pfeifer JH. How and where: Theory-of-mind in the brain. Dev Cogn Neurosci 2014;9:68–81.
[9] Mar RA. The neural bases of social cognition and story comprehension. Annu Rev Psychol 2011;62:103–134.
[10] Broicher SD, Kuchukhidze G, Grunwald T, Krämer G, Kurthen M, Jokeit H. “Tell me how do I feel” - emotion recognition and theory of mind in symptomatic mesial temporal lobe epilepsy. Neuropsychologia 2012;50:118–128.
[11] Giovagnoli AR, Parente A, Villani F, Franceschetti S, Spreafico R. Theory of mind and epilepsy: What clinical implications? Epilepsia 2013;54(9):1639–1646.
[12] Schacher M, Winkler R, Grunwald T, et al. Mesial temporal lobe epilepsy impairs advanced social cognition. Epilepsia 2006;47(12):2141–2146.
[13] Giovagnoli AR, Franceschetti S, Reati F, et al. Theory of mind in frontal and temporal lobe epilepsy: cognitive and neural aspects. Epilepsia 2011;52:1995–2002.
[14] Shaw P, Lawrence E, Bramaham J, Brierley B, Radbourne C, David AS. A prospective study of the effects of anterior temporal lobe on emotion recognition and theory of mind. Neuropsychologia 2007;45:2783–2790.
[15] Yeh ZT, Hua MS, Liu SI. Guess what I think? The reliability and validity of chinese Theory of Mind tasks and performance in the elderly. Chin J Psychol 2009;51:375–395.
[16] Wimmer, H., & Perner, J. Beliefs about beliefs: Representation and constraining function of wrong beliefs in young children's understanding of deception. Cognition 1983;13(1):103–128.
[17] Baron-Cohen S, O’Riordan M, Stone V, et al. Recognition of faux pas by normally developing children and children with Asperger syndrome or high-functioning autism. J Autism Dev Disord 1999;29(5):407–418.
[18] Happé, FG. An advanced test of theory of mind: understanding of story characters' thoughts and feelings by able autistic, mentally handicapped, and normal children and adults. J Autism Dev Disord 1994;24(2):129– 154.
[19] Chen JH, Chen HY. Wechsler adult intelligence scale. 3rd ed. (Chinese) (Manual). Chinese Behavioral Science Corp, Taipei; 2002.
[20] McDonald S. New frontiers in neuropsychological assessment: Assessing social perception using a standardised instrument, The Awareness of Social Inference Test. Australian Psychologist 2012;47:39–48.