However, performance on the non-mentalising task was inversely associated with grey matter volume in ventro-medial PFC (p < .05 after FWE correction for multiple comparisons over the whole-brain). When neuroanatomical associations of performance in each task were compared in a combined design, performance on the mentalising

task was significantly more see more strongly associated with grey matter in ventro-medial PFC than was performance on the non-mentalising task (p < .05 after FWE correction for multiple comparisons over the whole-brain); no significant grey matter associations of the reverse contrast were identified. Here we have presented evidence that ability to attribute surrogate affective mental states to music is impaired in bvFTD.

These findings move beyond previous work demonstrating that Enzalutamide chemical structure the ability to label simple emotions in music is impaired in bvFTD as part of a more general multimodal impairment of emotion processing (Omar et al., 2011; Hsieh et al., 2012): the deficit demonstrated here lay with attribution of more complex feeling states to music, and furthermore, the deficit was at least partly specific for the attribution of mental states versus other, non-mental representations within the domain of music. This musical mentalising deficit was not attributable to general executive dysfunction, lower premorbid intelligence or other potentially relevant confounding factors, but did correlate specifically with performance on a test of social inference (TASIT) requiring interpretation of others’ mental states, as well as with carer-reported real-world quantitative estimates of patients’ ability to interpret others’ mental states on the CBI (an index shown previously to be sensitive

to functional behavioural changes in bvFTD: [Kipps et al., 2009a]). We cannot completely exclude the possibility that performance on the musical mentalising task was driven by processing of word and picture labels rather than musical pieces per se: however, a selective musical mentalising deficit was demonstrated after adjusting for certain relevant characteristics of the labels in each condition and adjusting for general verbal semantic capacity. The specific correlation of experimental mentalising task performance here with standard measures STK38 of mentalising performance provides further evidence that our mentalising task here did, indeed, index musical mentalising capacity. The relative specificity of the mentalising deficit shown by our patients is in keeping with previous evidence that patients with bvFTD can exhibit dissociable impairments of ToM function independent of general executive capacity (Lough et al., 2001). The present findings show that, remarkably, the mentalising deficit in bvFTD extends to the abstract realm of music. Because music is a somewhat unusual vehicle for attributions of this kind, the question arises whether the results could simply reflect a task difficulty effect.