Executive functioning in multiple sclerosis: association with theory of mind, empathy and quality of life.

Abstract

Background: Multiple Sclerosis (MS) is a chronic, degenerative, neurological condition affecting approximately 85,000 people in the UK. The impact of MS on physical abilities is well‐known and there is increasing recognition of the impact of MS on mood and cognitive function. Recently MS has been linked to impaired emotion recognition and impaired Theory of Mind (ToM –the ability to attribute mental states, e.g. beliefs to oneself and others). Methods: This study measured executive function, ToM, empathy and quality of life in an MS sample (n=42). A correlational analysis was then conducted to determine whether executive function was associated with the other variables. Results: Two executive function measures (Mental Flexibility and Response to Feedback) were significantly associated with two ToM tasks (Revised Eyes and Stories). Mental Flexibility and the Revised Eyes ToM task were significantly associated with measures of empathy, but this effect was not present in the other executive function or ToM tasks. Neither executive functioning nor ToM measures were significantly associated with reported quality of life. Conclusion: Overall, the MS sample demonstrated specific ToM impairment, no significant empathy impairment and widespread executive impairment relative to normative data. Low rates of depression (10%) and higher levels of anxiety (29%) were found. MS participants rated the psychological impact of MS as equivalent to the physical impact, highlighting the importance of addressing psychological aspects of MS.