Assessment of implicit language and theory of mind in multiple sclerosis.

BACKGROUND: Increasing evidence suggests that social cognition, especially theory of mind (ToM), is impaired in individuals with multiple sclerosis (MS). ToM appears to be a determining factor for social functioning, but research has shown a connection between ToM and pragmatic language disorders among people with neurological or psychiatric disorders. Yet, pragmatic language remains a domain rarely referenced in MS. OBJECTIVE: We investigated the effect of MS in terms of the ability for making inferences via pragmatic understanding and ToM. METHODS: We included 21 individuals with MS and 21 healthy controls matched for age, education and linguistic skills who performed verbal tasks involving pragmatic language (Implicit Information Management Test, Narrative Discourse Task), ToM (Test of Social Faux Pas) and a visual task of making inferences (Visual Inferences Test). RESULTS: Performance was significantly lower for individuals with MS than controls in the Test of Social Faux Pas (total score), but performance in pragmatic tasks did not differ. Performance was significantly lower for MS individuals for logical inference on the Implicit Information Management Test and pragmatic inference on the Visual Inferences Test. Additionally, for the MS group, the total score on the Implicit Information Management Test was correlated with the faux pas test total score and hits. CONCLUSION: Even with lack of marked cognitive decline and disability in individuals with MS and lack of differences between groups in pragmatic tasks, the MS group showed lower performance in making inferences and interpreting implicit and social situations. This study highlights the link between pragmatic language and ToM difficulties in MS.

Pain-related mood influences pain perception differently in fibromyalgia and multiple sclerosis.

In patients, the perception of pain intensity may be influenced by the subjective representation of their disease. Although both multiple sclerosis (MS) and fibromyalgia (FM) possibly include chronic pain, they seem to elicit different disease representations because of the difference in their respective etiology, the former presenting evidence of underlying lesions as opposed to the latter. Thus, we investigated whether patients with FM differed from patients with MS with respect to their perception of "own" pain as well as others' pain. In addition, the psychological concomitant factors associated with chronic pain were considered. Chronic pain patients with FM (n=13) or with MS (n=13) participated in this study. To assess specific pain-related features, they were contrasted with 12 other patients with MS but without chronic pain and 31 controls. A questionnaire describing imaginary painful situations showed that FM patients rated situations applied to themselves as less painful than did the controls. Additionally, pain intensity attributed to facial expressions was estimated as more intense in FM compared with the other groups of participants. There is good evidence that the mood and catastrophizing reactions expressed in FM differentially modulated the perception of pain according to whether it was their own pain or other's pain.