Emotion recognition and theory of mind are impaired in hereditary ataxias.

Impairment is independent of the motor, cognitive, or neuropsychiatric symptoms.

Severity is comparable to social cognitive deficit in schizophrenia or ASD.

Social cognition (SC) refers to a set of skills necessary for successful social communication and interpersonal relationships. Accumulating evidence points toward a crucial role of the cerebellum in SC. This narrative review summarizes and discusses the social cognitive impairment in cerebellar ataxias (CA), a group of hereditary neurodegenerative diseases of the cerebellum. Substantial impairment in emotion recognition and theory of mind, two essential components of SC, is present in CA. The social cognitive impairment is largely independent of the motor disability, general cognitive deficit, or neuropsychiatric symptoms. Since the impairment reaches comparable levels to autism or schizophrenia, it can substantially impact patients’ quality of life and deserves further attention in future research.

© 2023 The Authors. Published by Elsevier Ltd.