Social cognition in idiopathic focal dystonia: preliminary evidence on its relationship with cognitive and affective-behavioral functioning

Introduction: Although motor symptoms are the defining feature of dystonia, increasing evidence indicates that non-motor symptoms substantially affect patients’ quality of life. Among these, social cognition remains insufficiently explored, particularly in relation to global cognitive functioning and affective-behavioral dimensions. Methods: In this study, 25 patients diagnosed with Idiopathic Focal Dystonia (IFD) and 25 healthy controls (HCs) underwent assessments of social cognition (cognitive and affective Theory of Mind [ToM] and empathy), global cognitive functioning (MoCA), depression (BDI) and apathy (DAS). Results: Patients diagnosed with IFD performed significantly worse than HCs on cognitive and affective ToM tasks, whereas no group differences were observed for the remaining measures. Within the IFD group, cognitive ToM performance correlated with global cognitive functioning, and affective ToM correlated with apathy but not with depression. Conclusion: These findings demonstrate specific impairments in social cognition and suggest links between ToM deficits, cognitive dysfunction and motivational disturbance. By identifying a pattern of social cognition deficit in IFD patients, this study advances understanding of its non-motor symptoms and underscores the need for further research on its impact on daily functioning and quality of life.