Frontal and Temporo-Parietal Lobe Contributions to Theory of Mind: Neuropsychological Evidence from a False-Belief Task with Reduced Language and Executive Demands

A model of the functional and anatomical basis of belief reasoning is essential for understanding the relationship between belief reasoning and other cognitive processes in both normal development and pathology. Studies of brain-damaged patients can give valuable insights into the nature of belief processing but pose unique methodological problems. The current study addresses these problems by using a nonlinguistic belief-reasoning task with substantially reduced executive demands. A case series of 12 brain-damaged patients is presented. The belief-reasoning errors of four patients with damage to the prefrontal cortex appeared to arise from these patients' executive function problems. The belief-reasoning errors of three patients with damage to the temporo-parietal junction could not easily be accounted for in this way, raising the possibility that this brain region has a necessary role in representing beliefs, rather than handling the executive demands of belief-reasoning tasks. We discuss the importance of gaining empirical evidence about the scope of “theory of mind” impairments, and the important role for neuropsychological studies in this project.