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Although focused ultrasound subthalamotomy (FUS\u2010STN) effectively treats Parkinson's disease (PD) clinical motor features, its impact and safety on cognitive\u2010behavioral interactions\/interpersonal awareness are unknown. This study investigated the effects of unilateral FUS\u2010STN on facial emotion recognition (FER) and affective and cognitive theory of mind (ToM) in PD patients from a randomized sham\u2010controlled trial (NCT03454425). Subjects performed SC evaluation before and 4\u2009months after the procedure while still under blind assessment conditions. The SC assessment included the Karolinska Directed Emotional Faces task for FER, the Reading the Mind in the Eyes (RME) test for affective ToM, and The Theory of Mind Picture Stories Task (ToM PST) (order, questions, and total score) for cognitive ToM. The active treatment group showed anecdotal\u2010to\u2010moderate evidence of no worsening in SC after FUS\u2010STN. Anecdotal evidence for an improvement was recognized in the SC score changes, from baseline to post\u2010treatment, for the active treatment group compared with sham for the RME, ToM PST order, ToM PST total, FER total, and recognition of fear, disgust, and anger. This study provides the first evidence that unilateral FUS\u2010STN does not impair social cognitive abilities, indicating that it can be considered a safe treatment approach for this domain in PD patients. Furthermore, the results suggest FUS\u2010STN may even lead to some improvement in social cognitive outcomes, which should be considered as a preliminary finding requiring further investigation with larger samples sizes. \u00a9 2024 International Parkinson and Movement Disorder Society.<\/jats:p>","DOI":"10.1002\/mds.29945","type":"journal-article","created":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T05:53:22Z","timestamp":1723614802000},"page":"1763-1772","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Social Cognition in Parkinson's Disease after Focused Ultrasound Subthalamotomy: A Controlled Study"],"prefix":"10.1002","volume":"39","author":[{"given":"Pasqualina","family":"Guida","sequence":"first","affiliation":[{"name":"HM CINAC (Centro Integral de Neurociencias Abarca Campal) Hospital Universitario HM Puerta del Sur, HM Hospitales  Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria HM 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