Theory of mind, executive functions, and laterality: An evolutionary and neuropsychiatric perspective

Introduction: Executive functions and Theory of Mind play important roles in appropriate responses to unexpected stimuli; the same applies to the functional asymmetry of the brain cortex. Materials and methods: We reviewed and analyzed recent Medline-indexed research published in the last 5 years, as well as certain older publications (articles, books) that were often cited. The Medline search was carried out with MeSH search terms Theory of Mind, Executive Functions, cerebral asymmetry (and related variants), alone and in conjunction with autism, attention deficit hyperactivity disorder, and schizophrenia. Results: Recent research suggests that hyperactivation or inappropriate activation of the above-mentioned functions may be the cause of pervasive developmental disorder, schizophrenia, and attention deficit and hyperactivity disorder. Discussion: We present a hypothesis in which Theory of Mind, Executive Functions, and asymmetric activation of the brain cortex are all part of a comprehensive system, which may have been important, from an evolutionary point of view, in improving the survival of humans. Conversely, pathological hyperactivation or dysregulated activation of this system (secondary to alteration of one or more of its components) may be the biological basis for certain neuropsychiatric disorders. If verified, this model could be used to create specific treatments.