Impaired Self-Other Distinction and Subcortical Gray-Matter Alterations Characterize Socio-Cognitive Disturbances in Multiple Sclerosis

Kristína Czekóová, Daniel Joel Shaw, K. Saxunova, M. Dufek, R. Marecek, J. Vanicek, M. Brazdil

Research output: Contribution to journalArticlepeer-review


Introduction: Recent studies of patients with multiple sclerosis (MS) have revealed disturbances in distinct components of social cognition, such as impaired mentalizing and empathy. The present study investigated this socio-cognitive profile in MS patients in more detail, by examining their performance on tasks measuring more fundamental components of social cognition and any associated disruptions to gray-matter volume (GMV). Methods: We compared 43 patients with relapse-remitting MS with 43 age- and sex-matched healthy controls (HCs) on clinical characteristics (depression, fatigue), cognitive processing speed, and three aspects of low-level social cognition; specifically, imitative tendencies, visual perspective taking, and emotion recognition. Using voxel-based morphometry, we then explored relationships between GMV and these clinical and behavioral measures. Results: Patients exhibited significantly slower processing speed, poorer perspective taking, and less imitation compared with HCs. These impairments were related to reduced GMV throughout the putamen, thalami, and anterior insula, predominantly in the left hemisphere. Surprisingly, differences between the groups in emotion recognition were not significant. Conclusion: Less imitation and poorer perspective taking indicate a cognitive self-bias when faced with conflicting self- and other-representations. This suggests that impaired self-other distinction, and an associated subcortical pattern of GM atrophy, might underlie the socio-cognitive disturbances observed in MS.

Original languageEnglish
Article number525
JournalFrontiers in Neurology
Issue numberMAY
Publication statusPublished - 21 May 2019

Bibliographical note

© 2019 Czekóová, Shaw, Saxunová, Dufek, Mareček, Vaníček and Brázdil. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Funding: Czech Science Foundation (project No. GA15-16738S), MEYS CR (LM2015062 Czech-BioImaging).


  • Automatic imitation
  • Gray-matter volume
  • Multiple sclerosis
  • Self-other distinction
  • Social cognition
  • Visual perspective taking
  • Voxel-based morphometry


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