Cognitive, Affective, & Behavioral Neuroscience

, Volume 18, Issue 6, pp 1065–1075 | Cite as

Enhancing theory of mind in behavioural variant frontotemporal dementia with transcranial direct current stimulation

  • Maria Cotelli
  • Mauro AdenzatoEmail author
  • Valentina Cantoni
  • Rosa Manenti
  • Antonella Alberici
  • Ivan Enrici
  • Alberto Benussi
  • Valentina Dell’Era
  • Elisa Bonetta
  • Alessandro Padovani
  • Barbara Borroni


Behavioural variant frontotemporal dementia (bvFTD) is a form of frontotemporal degeneration characterized by early changes in personality, emotional blunting, and/or loss of empathy. Recent research has highlighted that these features may be at least partially explained by impairments in the theory of mind (ToM; i.e., the ability to understand and predict other people’s behaviour by attributing independent mental states to them). The aim of this randomized, double-blind, placebo-controlled study was to test the hypothesis that transcranial direct current stimulation (tDCS) over the medial frontal cortex (MFC) selectively enhances communicative intention processing, a specific ToM ability. Using a single-session online design, we administered a ToM task that measures the ability to represent other people’s private and communicative intentions during active or sham tDCS to 16 bvFTD patients. To assess the impact of dementia on performance on the ToM task, we included 16 age-matched healthy volunteers who were asked to perform the entire experimental ToM task. BvFTD is characterized by an impairment in the comprehension of both communicative and private intentions relative to a healthy control group and by a disproportional impairment in communicative intention compared with private intention processing. Significant and selective accuracy improvement in the comprehension of communicative intentions after active stimulation was observed in patients with bvFTD. This is the first study that analyses ToM ability in patients with bvFTD using tDCS stimulation. Our findings could potentially contribute to the development of an effective, noninvasive brain stimulation treatment of ToM impairments in patients with bvFTD.


Anodal transcranial direct current stimulation (tDCS) Behavioural variant frontotemporal dementia (bvFTD) Theory of mind (ToM) Medial frontal cortex (MFC) 



We wish to thank all the patients and caregivers who volunteered their time to participate in this study.

Mauro Adenzato was supported by the University of Turin (Ricerca scientifica finanziata dall’Università “Cognizione sociale e attaccamento in popolazioni cliniche e non cliniche”). Ivan Enrici was supported by University of Turin grants (Ricerca scientifica finanziata dall’Università “Linea Generale” and “Linea Giovani”).

Compliance with ethical standards

Conflict of interest



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Copyright information

© Psychonomic Society, Inc. 2018

Authors and Affiliations

  • Maria Cotelli
    • 1
  • Mauro Adenzato
    • 2
    • 3
    Email author
  • Valentina Cantoni
    • 4
    • 5
  • Rosa Manenti
    • 1
  • Antonella Alberici
    • 4
  • Ivan Enrici
    • 3
    • 6
  • Alberto Benussi
    • 5
  • Valentina Dell’Era
    • 5
  • Elisa Bonetta
    • 5
  • Alessandro Padovani
    • 5
  • Barbara Borroni
    • 5
  1. 1.Neuropsychology UnitIRCCS Centro San Giovanni di Dio–FatebenefratelliBresciaItaly
  2. 2.Department of PsychologyUniversity of TurinTurinItaly
  3. 3.Neuroscience Institute of TurinTurinItaly
  4. 4.Department of Neuroscience, Psychology, Drug Research and Child HealthUniversity of FlorenceFlorenceItaly
  5. 5.Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
  6. 6.Department of Philosophy and Educational SciencesUniversity of TurinTurinItaly

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