Functional alterations in resting‐state networks for Theory of Mind in Parkinson's disease

In Parkinson's disease (PD), impairment of Theory of Mind (ToM) has recently attracted an increasing number of neuroscientific investigations. If and how functional connectivity of the ToM network is altered in PD is still an open question. First, we explored whether ToM network connectivity shows potential PD‐specific functional alterations when compared to healthy controls (HC). Second, we tested the role of the duration of PD in the evolution of functional alterations in the ToM network. Between‐group connectivity alterations were computed adopting resting‐state functional magnetic resonance imaging (rs‐fMRI) data of four groups: PD patients with short disease duration (PD‐1, n = 72); PD patients with long disease duration (PD‐2, n = 22); healthy controls for PD‐1 (HC‐1, n = 69); healthy controls for PD‐2 (HC‐2, n = 22). We explored connectivity differences in the ToM network within and between its three subnetworks: Affective, Cognitive and Core. PD‐1 presented a global pattern of decreased functional connectivity within the ToM network, compared to HC‐1. The alterations mainly involved the Cognitive and Affective ToM subnetworks and their reciprocal connections. PD‐2—those with longer disease duration—showed an increased connectivity spanning the entire ToM network, albeit less consistently in the Core ToM network, compared to both the PD‐1 and the HC‐2 groups. Functional connectivity within the ToM network is altered in PD. The alterations follow a graded pattern, with decreased connectivity at short disease duration, which broadens to a generalized increase with longer disease duration. The alterations involve both the Cognitive and Affective subnetworks of ToM. Theory of Mind (ToM) network in Parkinson's disease (PD) shows substantial functional connectivity alterations. We showed a graded pattern, consisting of a general decreased connectivity in the early years of disease (PD short disease duration) compared to healthy controls, which progresses to an overall aberrant connectivity increase in PD with longer disease duration. These widespread functional alterations occur in both the Affective and Cognitive subnetworks of ToM.