1. Participants were asked to recall a negative
personal event, they were then asked what
would have happened if they had behaved
differently
2. Example of a CIT question:
James has missed the train for 5 minutes. Edward
has missed the train for more than an hour.
Who will spend more time thinking about the lost
train?
• James
• Edward
• Both / do not know
Counterfactual thinking in Tourette’s patients
1 DELLI PONTI, A., 2 ZAGO, S., 1 MASTROIANNI, S., 3 SOLCA, F., 3 POLETTI, B., 1 PORTA, M. , 1 RAUGNA, M., 1 COLOMBO, V., 1D’ADDA, F., 1 SERVELLO, D., 1 ZANABONI, C.
1Centro Tourette e Sindromi Correlate, IRCCS Ospedale Galeazzi, Milano 2U.O.C. Neurologia, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano
3U.O. IRCCS Istituto Auxologico Italiano, Milano
COUNTERFACTUAL THINKING
‘Counterfactual thinking or reasoning' (CT) is the ability to mentally represent possible behaviors or alternative
scenarios. This ability affects the skill to produce behavioral intentions and has important repercussions on the
capacity of choice in many areas of mental and social life. Recent neuroimaging studies show that CT requires
brain activation in a large circuit of structures involved in mnestic, attentional and executive processes, such as
temporal lobes, posterior medial cortex, lateral prefrontal cortex and inferior parietal lobule.
ANATOMICAL CORRELATES
Clinical evidence suggests that patients with frontal lobes damage are able to generate a limited number of
alternatives and are also unable to predict possible negative consequences of their actions. In particular, CT
deficiency have been reported in patients with focal damage to frontal lobes, specifically the orbitofrontal region, and
in some psychiatric and neurological disorders related to frontal lobe, such as schizophrenia, Parkinson's disease and
Huntington's disease. On the contrary, an increase of CT was highlighted in anxious and depressed patients.
CT Tests:
1. A task of spontaneous generation of
alternative scenarios to reality
2. A translated version of the Hooker’s
Counterfactual Interference Test (CIT)
RESULTS AND CONCLUSIONS
No differences emerge between TS patients and control subjects performances in CT tests.
These results may be explained by frequent spontaneous improvement of TS over time that differentiates it from
other considered fronto-striatal diseases.
TS patients may have superior cognitive performances in comparison with other patients with basal ganglia
dysfunctions because brain circuits implicated in TS may bypass cortical pathway, only secondarily involved.
A PILOT STUDY
In this work, we evaluated a group of 30 adults
with Tourette syndrome, a neurological disorder
closely related to changes in the fronto-striatal
circuit, compared with a group of healthy subjects
matched for sex, age and education. Results are
shown in the graph.
2013 Annual Meeting of the European Society for the Study of Tourette Syndrome COST International Conference for Tourette Syndrome
Athens, Greece - April 26-27 2013
REFERENCES
Hooker, C., Roese, N.J., Park, S. (2000). Impoverished counterfactual thinking is associated with schizophrenia. Psychiatry, 63(4), 326–35.
Mcnamara, P., Durso, R., Brown, A., Lynch, A. (2003). Counterfactual cognitive deficit in persons with Parkinson’s disease. Journal of Neurology, Neurosurgery, and Psychiatry, 74, 1065–70.