Vocal emotion processing in Parkinson's disease: Reduced sensitivity to negative emotions

Changes in speech prosody perception during Parkinson's disease: A comprehensive analysis

INTRODUCTION

Parkinson's disease (PD) is a progressive neurodegenerative disorder that affects approximately 1%-2% of individuals aged 60 and above. Communication disorders in PD can significantly impact the overall quality of life. As prosody plays a vital role in verbal communication, the present study examines Persian prosody perception in PD, focusing on linguistic and emotional aspects of prosody.

METHODS

This cross-sectional study aimed to compare the perception of linguistic and emotional prosody in three groups: middle-aged adults (n = 22; mean age = 50.40 years), healthy older adults (n = 22; mean age = 68.31 years), and individuals with Parkinson's disease (n = 22; mean age = 65years). All individuals with PD were classified in stages 1; 1.5; 2; 2.5, and 3 of the disease using the Hoehn and Yahr scale. All participants had an MMSE score of 24 or above. The Florida Affect Battery (FAB) was used to evaluate prosody perception. This Battery was validated in the Persian language and its reliability and validity were reported as 94 % and 100 % respectively.

RESULTS

Participants with PD presented significantly lower scores than the older adults in all subtests of the FAB (p < 0.05), while healthy older adults were significantly different only in linguistic discrimination (β = -2.14; -3.68 to -0.61), and linguistic naming of prosody (β = 1.25; 0.17 to 2.33) compared to middle-aged adults.

CONCLUSIONS

The present study sheds light on the influence of PD on Persian prosody perception. Given the crucial role of prosody in verbal communication, these findings enhance our understanding of communication disorders in PD and could bring attention to consider prosody perception, among other aspects, when assessing individuals affected by PD.

The Impact of Parkinson's Disease on Social Communication: An Exploratory Questionnaire Study

Individuals with Parkinson's disease (PD) often show breakdown in the production and interpretation of aspects of social communication. However, there is no current method of assessment for evaluating social communication dysfunction in individuals with PD. The aim of this study was to develop a self-report questionnaire for individuals with PD to identify their social communication skills, and further recognize the impact of PD on social communication. Fifty-one individuals with Parkinson's disease answered 28 survey questions. These questions pertained to emotional expression and perception, social communication, sarcasm/humor, and pragmatic skills. Exploratory factor analysis and reliability analysis were conducted to identify items loading onto the factors and to check the internal consistency of the items. Individuals with PD reported changes in emotional expression and perception, social communication, sarcasm and humor, and pragmatic skill domains post-PD diagnosis. No correlations were found between age or time since diagnosis and emotional expression, social communication, sarcasm, and humor. This study provides self-reported evidence that individuals with PD experience social communication challenges. Future research should further quantify these challenges, study their impact on daily communicative functioning, and use the results to develop social communication interventions that improve the quality of life for persons with PD.

Laterality in Parkinson's disease: A neuropsychological review

Laterality of motor symptom onset in Parkinson's disease is both well-known and under-appreciated. Treatment of disorders that have asymmetric pathological features, such as stroke and epilepsy, demonstrate the importance of incorporating hemispheric lateralization and specialization into therapy and care planning. These practices could theoretically extend to Parkinson's disease, providing increased diagnostic accuracy and improved treatment outcomes. Additionally, while motor symptoms have generally received the majority of attention, non-motor features (e.g., autonomic dysfunction) also decrease quality of life and are influenced by asymmetrical neurodegeneration. Due to the laterality of cognitive and behavioral processes in the two brain hemispheres, analysis of hemibody side of onset can potentially give insight into expected symptom profile of the patient and allow for increased predictive accuracy of disease progression and outcome, thus opening the door to personalized and improved therapy in treating Parkinson's disease patients. This review discusses motor and non-motor symptoms (namely autonomic, sensory, emotional, and cognitive dysfunction) of Parkinson's disease in respect to hemispheric lateralization from a theoretical perspective in hopes of providing a framework for future research and personalized treatment.

Emotional Sentence Processing in Parkinson's Disease

PURPOSE

Emotional processing allows us to predict our own and others' behavior, communicate our wants and needs, and understand those of others. Thus, deficits in emotional processing can negatively impact one's quality of life. While changes in emotional processing across several domains (e.g., prosody, faces) in Parkinson's disease (PD) are widely accepted, there is a dearth of literature, with equivocal results, regarding how emotional language processing is affected by PD. This study investigated emotional sentence processing in this population.

METHOD

Eighteen persons with PD and 22 healthy adults (HAs) completed a language task in which they rated sentences on their pleasantness (valence), and a battery of cognitive tasks and mood measures that were examined as factors influencing performance. As an interaction between emotionality and concreteness during processing has been indicated in prior research, concreteness of sentence stimuli was also manipulated.

RESULTS

Individuals with PD rated negatively valenced sentences as less negative and positively-valenced sentences as less positive than HAs. The PD group also demonstrated a reduced overall range of valence rating scores. Sentence concreteness did not influence ratings. Results for positive sentences could be explained by individual differences in working memory (WM), whereas individual differences in WM, depression, and group explained differences in ratings to negative sentences.

CONCLUSIONS

Our study provides one of few accounts of emotional language processing deficits in PD, particularly beyond the word level. Individuals with PD may experience difficulty perceiving and assessing the intensity of the emotional content of language, and deficits may disproportionately impact processing of sentences about negative situations.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21313713.

Social decision-making in Parkinson's disease

INTRODUCTION

Parkinson's Disease (PD) commonly affects cognition and communicative functions, including the ability to perceive socially meaningful cues from nonverbal behavior and spoken language (e.g., a speaker's tone of voice). However, we know little about how people with PD use social information to make decisions in daily interactions (e.g., decisions to trust another person) and whether this ability rests on intact cognitive functions and executive/decision-making abilities in nonsocial domains.

METHOD

Non-demented adults with and without PD were presented utterances that conveyed differences in speaker confidence or politeness based on the way that speakers formulated their statement and their tone of voice. Participants had to use these speech-related cues to make trust-related decisions about interaction partners while playing the Trust Game. Explicit measures of social perception, nonsocial decision-making, and related cognitive abilities were collected.

RESULTS

Individuals with PD displayed significant differences from control participants in social decision-making; for example, they showed greater trust in game partners whose voice sounded confident and who explicitly stated that they would cooperate with the participant. The PD patients displayed relative intact social perception (speaker confidence or politeness ratings) and were unimpaired on a nonsocial decision-making task (the Dice game). No obvious relationship emerged between measures of social perception, social decision-making, or cognitive functioning in the PD sample.

CONCLUSIONS

Results provide evidence of alterations in decision-making restricted to social contexts in PD individuals with relatively preserved cognition with minimal changes in social perception. Researchers and practitioners interested in how PD affects social perception and cognition should include assessments that emulate social interactions, as non-interactive tasks may fail to detect the full impact of the disease on those affected.

Impaired perceptual phonetic plasticity in Parkinson's disease

Parkinson's disease (PD) is a neurodegenerative condition primarily associated with its motor consequences. Although much of the focus within the speech domain has focused on PD's consequences for production, people with PD have been shown to differ in the perception of emotional prosody, loudness, and speech rate from age-matched controls. The current study targeted the effect of PD on perceptual phonetic plasticity, defined as the ability to learn and adjust to novel phonetic input, both in second language and native language contexts. People with PD were compared to age-matched controls (and, for three of the studies, a younger control population) in tasks of explicit non-native speech learning and adaptation to variation in native speech (compressed rate, accent, and the use of timing information within a sentence to parse ambiguities). The participants with PD showed significantly worse performance on the task of compressed rate and used the duration of an ambiguous fricative to segment speech to a lesser degree than age-matched controls, indicating impaired speech perceptual abilities. Exploratory comparisons also showed people with PD who were on medication performed significantly worse than their peers off medication on those two tasks and the task of explicit non-native learning.

The Effects of a Dance and Music-Based Intervention on Parkinson's Patients' Well-Being: An Interview Study

Previous research has shown the positive effects of music and dance-based interventions on the physical and psychosocial symptoms of Parkinson’s disease (PD). The aims of this study were: (1) to investigate how PD patients subjectively perceive the emotional, cognitive, and social benefits of a music- and dance-based intervention; (2) to apply an innovative methodology for an interview analysis combining findings from a linguistic text with an analytic approach and conducted with the software LIWC and from the content analysis performed by human coders. Extensive, open-ended interviews were conducted with 13 patients with PD who had participated in a dance and music program. The interviews were analyzed using both human coders and the computer-based approach. The results show that emotional and social aspects are considered the most frequent perceived benefits of the dance program. The data confirm the positive impact of dance- and music-based programs on promoting participants’ emotional and social well-being. A combined approach to text analysis appears to be a promising way to achieve more in-depth insights into patients’ subjective perceptions.

Speech dysfunction, cognition, and Parkinson's disease

Communication difficulties are a ubiquitous symptom of Parkinson's disease and include changes to both motor speech and language systems. Communication challenges are a significant driver of lower quality of life. They are associated with decreased communication participation, social withdrawal, and increased risks for social isolation and stigmatization in persons with Parkinson's disease. Recent theoretical advances and experimental evidence underscore the intersection of cognition and motor processes in speech production and their impact on spoken language. This chapter overviews a growing evidence base demonstrating that cognitive impairments interact with motor changes in Parkinson's disease to negatively affect communication abilities in myriad ways, at all stages of the disease, both in the absence and presence of dementia. The chapter highlights common PD interventions (pharmacological, surgical, and non-pharmacological) and how cognitive influences on speech production outcomes are considered in each.

Detecting emotion in speech expressing incongruent emotional cues through voice and content: investigation on dominant modality and language

This research investigated how we detect emotion in speech when the emotional cues in the sound of voice do not match the semantic content. It examined the dominance of the voice or semantics in the perception of emotion from incongruent speech and the influence of language on the interaction between the two modalities. Japanese participants heard a voice emoting anger, happiness or sadness while saying "I'm angry", "I'm pleased" or "I'm sad", which were in their native language, in their second language (English) and in unfamiliar languages (Khmer and Swedish). They reported how much they agree that the speaker is expressing each of the three emotions. Two experiments were conducted with different number of voice stimuli, and both found consistent results. Strong reliance on the voice was found for the speech in participants' second and unfamiliar languages but the dominance was weakened for the speech in their native language. Among the three emotions, voice was most important for perception of sadness. This research concludes that the impact of the emotional cues expressed by the voice and semantics varies depending on the expressed emotions and the language.

(Dys)Prosody in Parkinson's Disease: Effects of Medication and Disease Duration on Intonation and Prosodic Phrasing

The phonology of prosody has received little attention in studies of motor speech disorders. The present study investigates the phonology of intonation (nuclear contours) and speech chunking (prosodic phrasing) in Parkinson’s disease (PD) as a function of medication intake and duration of the disease. Following methods of the prosodic and intonational phonology frameworks, we examined the ability of 30 PD patients to use intonation categories and prosodic phrasing structures in ways similar to 20 healthy controls to convey similar meanings. Speech data from PD patients were collected before and after a dopaminomimetic drug intake and were phonologically analyzed in relation to nuclear contours and intonational phrasing. Besides medication, disease duration and the presence of motor fluctuations were also factors included in the analyses. Overall, PD patients showed a decreased ability to use nuclear contours and prosodic phrasing. Medication improved intonation regardless of disease duration but did not help with dysprosodic phrasing. In turn, disease duration and motor fluctuations affected phrasing patterns but had no impact on intonation. Our study demonstrated that the phonology of prosody is impaired in PD, and prosodic categories and structures may be differently affected, with implications for the understanding of PD neurophysiology and therapy.

Social Cognition and Cognitive Decline in Patients with Parkinson's Disease

Social cognition (SC) comprises an array of cognitive and affective abilities such as social perception, theory of mind, empathy, and social behavior. Previous studies have suggested the existence of deficits in several SC abilities in Parkinson disease (PD), although not unanimously.

OBJECTIVE

The aim of this study is to assess the SC construct and to explore its relationship with cognitive state in PD patients.

METHOD

We compare 19 PD patients with cognitive decline, 27 cognitively preserved PD patients, and 29 healthy control (HC) individuals in social perception (static and dynamic emotional facial recognition), theory of mind, empathy, and social behavior tasks. We also assess processing speed, executive functions, memory, language, and visuospatial ability.

RESULTS

PD patients with cognitive decline perform worse than the other groups in both facial expression recognition tasks and theory of mind. Cognitively preserved PD patients only score worse than HCs in the static facial expression recognition task. We find several significant correlations between each of the SC deficits and diverse cognitive processes.

CONCLUSIONS

The results indicate that some components of SC are impaired in PD patients. These problems seem to be related to a global cognitive decline rather than to specific deficits. Considering the importance of these abilities for social interaction, we suggest that SC be included in the assessment protocols in PD.

The role of the dorsal striatum in the recognition of emotions expressed by voice in Parkinson's disease

BACKGROUND AND PURPOSE

Non-motor impairment such as emotion recognition deficit in both facial and vocal expressions has been previously reported in Parkinson's disease (PD). We investigated whether the decoding of emotional prosody is impaired in PD and whether this deficit is related to striatal damage.

METHODS

Fifteen PD patients and 15 healthy controls (HCs) were requested to listen to six audio tracks and to recognize the emotions expressed by a professional actor while reading a meaning-neutral sentence. All subjects also received a structural MRI examination. Volumetric measurements were extracted for the striatum, a key region involved in emotional processing and typically impaired in PD.

RESULTS

Decoding sadness conveyed by voice was impaired in PD compared with HC and was related to the volume of the dorsal striatum bilaterally.

CONCLUSIONS

The dorsal striatum is involved in the decoding of vocal negative emotions in PD.

The impact of Lee Silverman Voice Treatment (LSVT LOUD®) on voice, communication, and participation: Findings from a prospective, longitudinal study

BACKGROUND

Lee Silverman Voice Treatment (LSVT LOUD®), an intensive 4-week program of voice therapy, is regarded as the most well-researched, efficacious treatment for hypokinetic dysarthria in individuals with Parkinson's disease (PD). Although numerous studies have published acoustic and perceptual findings, there is comparatively little information about the impact of LSVT LOUD® on functional communication outcomes.

METHODS

This prospective, longitudinal study investigated the impact of treatment on daily communication in 25 individuals with PD. Three validated communication measures (the Voice Handicap Index, the Communicative Effectiveness Scale, and the Communicative Participation Item Bank) were given before and after treatment and again 4-8 weeks and 3-6 months following treatment. Communication partners were also asked to rate communication effectiveness at all four timepoints.

RESULTS

Significant improvements were found for all three self-reported scales which remained above baseline across all post-treatment timepoints. In addition, self-reported communicative effectiveness was significantly correlated with the assessments of communication partners. Particular benefits were reported for more complex communicative activities such as asking questions, giving detailed information, communicating in noisy situations, and speaking in groups.

CONCLUSIONS

Overall, the findings suggested that LSVT LOUD® promotes an increased sense of personal control over the communication difficulties resulting from PD by decreasing voice handicap and improving communication effectiveness and communicative participation. For individuals with PD, LSVT LOUD® may reduce the risk of social isolation by improving communication and facilitating social participation.

LEARNING OUTCOMES

As a result of this activity, the participant will be able to (1) describe the impact of PD on voice and communication, (2) discuss how these characteristics may be associated with more global measures of functional communication and particularly communicative participation, (3) explain which aspects of functional communication were affected by LSVT LOUD® as assessed by study participants and their communication partners.

Social Symptoms of Parkinson's Disease

Parkinson's disease (PD) is typically well recognized by its characteristic motor symptoms (e.g., bradykinesia, rigidity, and tremor). The cognitive symptoms of PD are increasingly being acknowledged by clinicians and researchers alike. However, PD also involves a host of emotional and communicative changes which can cause major disruptions to social functioning. These incude problems producing emotional facial expressions (i.e., facial masking) and emotional speech (i.e., dysarthria), as well as difficulties recognizing the verbal and nonverbal emotional cues of others. These social symptoms of PD can result in severe negative social consequences, including stigma, dehumanization, and loneliness, which might affect quality of life to an even greater extent than more well-recognized motor or cognitive symptoms. It is, therefore, imperative that researchers and clinicans become aware of these potential social symptoms and their negative effects, in order to properly investigate and manage the socioemotional aspects of PD. This narrative review provides an examination of the current research surrounding some of the most common social symptoms of PD and their related social consequences and argues that proactively and adequately addressing these issues might improve disease outcomes.

Classifying Parkinson's Disease Patients With Syntactic and Socio-emotional Verbal Measures

Frontostriatal disorders, such as Parkinson's disease (PD), are characterized by progressive disruption of cortico-subcortical dopaminergic loops involved in diverse higher-order domains, including language. Indeed, syntactic and emotional language tasks have emerged as potential biomarkers of frontostriatal disturbances. However, relevant studies and models have typically considered these linguistic dimensions in isolation, overlooking the potential advantages of targeting multidimensional markers. Here, we examined whether patient classification can be improved through the joint assessment of both dimensions using sentential stimuli. We evaluated 31 early PD patients and 24 healthy controls via two syntactic measures (functional-role assignment, parsing of long-distance dependencies) and a verbal task tapping social emotions (envy, Schadenfreude) and compared their classification accuracy when analyzed in isolation and in combination. Complementarily, we replicated our approach to discriminate between patients on and off medication. Results showed that specific measures of each dimension were selectively impaired in PD. In particular, joint analysis of outcomes in functional-role assignment and Schadenfreude improved the classification accuracy of patients and controls, irrespective of their overall cognitive and affective state. These results suggest that multidimensional linguistic assessments may better capture the complexity and multi-functional impact of frontostriatal disruptions, highlighting their potential contributions in the ongoing quest for sensitive markers of PD.

Impaired Recognition of Facial Emotion in Patients With Parkinson Disease Under Dopamine Therapy

INTRODUCTION

Parkinson disease (PD) is a neurodegenerative disorder characterized by motor and nonmotor symptoms. The impaired ability to recognize facial emotion expressions represents an important nonmotor symptom. The aim of this study is to investigate the ability in recognizing facial emotion expressions in patients with PD under dopamine replacement therapy.

METHODS

Thirty medicated patients with PD and 15 healthy controls (HC) were enrolled. All participants performed the Ekman 60-Faces test for emotional recognition. All patients underwent a neuropsychological evaluation for global cognitive functioning, depression, and anxiety.

RESULTS

Patients with PD were impaired in recognizing emotions. Significant differences between PD and HC were found in Ekman 60-Faces test scores (P < .001), and in Ekman 60-Faces test subscales, in particular, sadness, fear, disgust, anger, and surprise (P < .001).

CONCLUSIONS

The nigrostriatal dopaminergic depletion seems to determine emotional information processing dysfunction. This relevant nonmotor symptom could have consequences in daily living reducing interactions and social behavioral competence.

The perception of caricatured emotion in voice

Affective vocalisations such as screams and laughs can convey strong emotional content without verbal information. Previous research using morphed vocalisations (e.g. 25% fear/75% anger) has revealed categorical perception of emotion in voices, showing sudden shifts at emotion category boundaries. However, it is currently unknown how further modulation of vocalisations beyond the veridical emotion (e.g. 125% fear) affects perception. Caricatured facial expressions produce emotions that are perceived as more intense and distinctive, with faster recognition relative to the original and anti-caricatured (e.g. 75% fear) emotions, but a similar effect using vocal caricatures has not been previously examined. Furthermore, caricatures can play a key role in assessing how distinctiveness is identified, in particular by evaluating accounts of emotion perception with reference to prototypes (distance from the central stimulus) and exemplars (density of the stimulus space). Stimuli consisted of four emotions (anger, disgust, fear, and pleasure) morphed at 25% intervals between a neutral expression and each emotion from 25% to 125%, and between each pair of emotions. Emotion perception was assessed using emotion intensity ratings, valence and arousal ratings, speeded categorisation and paired similarity ratings. We report two key findings: 1) across tasks, there was a strongly linear effect of caricaturing, with caricatured emotions (125%) perceived as higher in emotion intensity and arousal, and recognised faster compared to the original emotion (100%) and anti-caricatures (25%-75%); 2) our results reveal evidence for a unique contribution of a prototype-based account in emotion recognition. We show for the first time that vocal caricature effects are comparable to those found previously with facial caricatures. The set of caricatured vocalisations provided open a promising line of research for investigating vocal affect perception and emotion processing deficits in clinical populations.

Brain Networks of Emotional Prosody Processing

The processing of emotional nonlinguistic information in speech is defined as emotional prosody. This auditory nonlinguistic information is essential in the decoding of social interactions and in our capacity to adapt and react adequately by taking into account contextual information. An integrated model is proposed at the functional and brain levels, encompassing 5 main systems that involve cortical and subcortical neural networks relevant for the processing of emotional prosody in its major dimensions, including perception and sound organization; related action tendencies; and associated values that integrate complex social contexts and ambiguous situations.

Dopamine Acts via D2-Like Receptors to Modulate Auditory Responses in the Inferior Colliculus

The ability to understand speech relies on accurate auditory processing of complex sounds. Individuals with Parkinson's disease suffer from speech perception deficits, suggesting that dopamine is involved in the encoding of complex sounds. Recent studies have demonstrated that dopamine has heterogeneous effects on the responses of many neurons in the inferior colliculus (IC) of mice, although the strongest effect is to suppress neural activity. However, it was previously unknown which dopamine receptors are involved in modulating neuronal responses, and whether the observed preponderance of depressive effects reflects the endogenous dopamine system in the IC. In this study, we tested whether dopamine acts via D1- and/or D2-like receptors to alter responses of IC neurons in female and male mice. We also tested the effect of optogenetically induced dopamine release on auditory responses in the IC. We found that the effects of dopamine in the IC occur via D2-like receptors. In iontophoretic and freely behaving experiments, the single-unit and multi-unit effects of dopamine and a D2-like agonist were heterogeneous as both either increased or decreased responses of IC neurons to tones, while a D2-like antagonist had opposite effects. We also found that optogenetic activation of the endogenous dopamine system in the IC alters responses of auditory neurons. Similar to the effects of exogenous dopamine application, optogenetic induction of endogenous dopamine release heterogeneously altered auditory responses in the majority of cells in mice expressing channelrhodopsin-2 (ChR2). Understanding how dopamine modulates auditory processing will ultimately inform therapies targeting mechanisms underlying auditory-related communication disorders.

Intensity Resolution in Individuals With Parkinson's Disease: Sensory and Auditory Memory Limitations

Purpose The purpose of the current study was to examine sensory and auditory memory limitations on intensity resolution in individuals with Parkinson's disease as compared to healthy older and younger adults. Method Nineteen individuals with Parkinson's disease, 10 healthy age- and hearing-matched adults, and 10 healthy young adults were studied. The listeners participated in 2 intensity discrimination tasks: a lower memory load 4IAX task (sensory limitations) and a higher memory load ABX task (auditory memory limitations). Intensity resolution was examined across groups and tasks using a bias-free measurement of signal detectability known as d' (d-prime). Listeners also participated in a loudness scaling task where they were instructed to rate the loudness level of each signal intensity along the experimental continuum using a computerized 150-mm visual analog scale. Results Intensity discrimination sensitivity (d') was significantly poorer in the 4IAX and ABX conditions for the individuals with Parkinson's disease, as compared to the older and younger controls. Furthermore, a significant age-related difference was identified for the loudness scaling condition. The younger controls rated most stimuli along the experimental continuum significantly louder as compared to the older controls and the individuals with Parkinson's disease. Conclusions The present discrimination data suggest sensory and auditory memory limitations may contribute to the intensity resolution issues associated with Parkinson's disease. Age-related differences in loudness scaling will be reviewed.

Social perceptual function in parkinson's disease: A meta-analysis

Social perceptual impairment is a common presenting feature of Parkinson's disease (PD) that has the potential to contribute considerably to disease burden. The current study reports a meta-analytic integration of 79 studies which shows that, relative to controls, PD is associated with a moderate emotion recognition deficit (g = -0.57, K = 73), and that this deficit is robust and almost identical across facial and prosodic modalities. However, the magnitude of this impairment does appear to vary as a function of task and emotion type, with deficits generally greatest for identification tasks (g = -0.65, K = 54), and for negative relative to other basic emotions. With respect to clinical variables, dopaminergic medication, deep brain stimulation, and a predominant left side onset of motor symptoms are each associated with greater social perceptual difficulties. However, the magnitude of social perceptual impairment seen for the four atypical parkinsonian conditions is broadly comparable to that associated with PD. The theoretical and practical implications of these findings are discussed.

Effects of a Cycling Dual Task on Emotional Word Choice in Parkinson's Disease

Purpose Individuals with Parkinson's disease (PD) demonstrate language- and emotion-related impairments; however, emotional language production has received little attention within the literature despite the fact that deficits could significantly impact one's daily interactions with loved ones and others. Multitasking (i.e., dual tasking), specifically while completing language tasks, is a common everyday occurrence and typically impacts performance on 1 or both tasks. This study compared emotional word use during discourse production in individuals with PD and healthy older adults (HOAs) under single- and dual-task conditions. Method Participants completed a discourse task while sitting in a quiet room and while stationary cycling. Discourse output was analyzed along several emotional and intellectual language dimensions obtained from the Linguistic Inquiry and Word Count program (Pennebaker, Booth, & Francis, 2007 ). Results Groups did not differ on any outcome measure in the single-task condition. However, HOAs produced a higher percentage of words associated with affective processes and positive emotion while completing the dual-task condition, whereas the PD group exhibited a decrease in production of these words. Compared to the single-task condition, during cycling, individuals with PD also produced a lower percentage of inhibition-related words. Conclusions These results suggest that cycling, like other types of exercise, improves mood as manifested in discourse word choice in HOAs; however, it may lead to reduced use of emotional words in individuals with PD. Expressing emotion may also be more difficult in those with PD than in HOAs and, therefore, easily disrupted in distracting circumstances.

Emotion processing in Parkinson's disease: a blood oxygenation level-dependent functional magnetic resonance imaging study

Parkinson’s disease is a neurodegenerative disorder caused by loss of dopamine neurons in the substantia nigra pars compacta. Tremor, rigidity, and bradykinesia are the major symptoms of the disease. These motor impairments are often accompanied by affective and emotional dysfunctions which have been largely studied over the last decade. The aim of this study was to investigate emotional processing organization in the brain of patients with Parkinson’s disease and to explore whether there are differences between recognition of different types of emotions in Parkinson’s disease. We examined 18 patients with Parkinson’s disease (8 men, 10 women) with no history of neurological or psychiatric comorbidities. All these patients underwent identical brain blood oxygenation level-dependent functional magnetic resonance imaging for emotion evaluation. Blood oxygenation level-dependent functional magnetic resonance imaging results revealed that the occipito-temporal cortices, insula, orbitofrontal cortex, basal ganglia, and parietal cortex which are involved in emotion processing, were activated during the functional control. Additionally, positive emotions activate larger volumes of the same anatomical entities than neutral and negative emotions. Results also revealed that Parkinson’s disease associated with emotional disorders are increasingly recognized as disabling as classic motor symptoms. These findings help clinical physicians to recognize the emotional dysfunction of patients with Parkinson’s disease.

Brain Processing (Auditory Event-Related Potential) of Stressed Versus Unstressed Words in Thai Speech

This study investigated the effect of the stressed word in Thai language on auditory event-related potential (aERP) in unattended conditions. We presented 30 healthy participants with monosyllabic Thai words consisting of either stressed or unstressed words. We instructed them not to attend to the sound stimuli, but rather to watch and memorize the contents of a silent natural documentary without subtitles. The two listening conditions consisted of 20% deviant stimuli (70 stressed and 70 unstressed words, respectively) and 80% standard stimuli (other 280 unstressed words) presented pseudorandomly and binaurally via a pair of earphones. Participants' aERPs from the two conditions were evaluated by the mismatch negativity (MMN) component of aERP. The mismatch negativity amplitudes in the stressed word condition were significantly higher than those in the unstressed word condition, especially in frontal and left fronto-central brain areas. Therefore, these data show the role of the frontal and left fronto-central brain regions in auditory preattentive processing of stressed word perception among native Thai speakers. This is the first study demonstration that stressed meaningful monosyllable words in tonal language facilitate word perception in this preattentive stage. This result has implications for developing clinical tests evaluating preattentive speech perception.

The Effect of Deep Brain Stimulation Therapy on Fear-Related Capture of Attention in Parkinson's Disease and Essential Tremor: A Comparison to Healthy Individuals

In addition to motor symptoms, Parkinson’s disease (PD) involves significant non-motor sequelae, including disruptions in cognitive and emotional processing. Fear recognition appears to be affected both by the course of the disease and by a common interventional therapy, deep brain stimulation of the subthalamic nucleus (STN-DBS). Here, we examined if these effects extend to other aspects of emotional processing, such as attentional capture by negative emotional stimuli. Performance on an emotional attentional blink (EAB) paradigm, a common paradigm used to study emotional capture of attention, was examined in a cohort of individuals with PD, both on and off STN-DBS therapy (n=20). To contrast effects of healthy aging and other movement disorder and DBS targets, we also examined performance in a healthy elderly (n=20) and young (n=18) sample on the same task, and a sample diagnosed with Essential Tremor (ET) undergoing therapeutic deep brain stimulation of the ventral-intermediate nucleus (VIM-DBS, n=18). All four groups showed a robust attentional capture of emotional stimuli, irrespective of aging processes, movement disorder diagnosis, or stimulation. PD patients on average had overall worse performance, but this decrement in performance was not related to the emotional capture of attention. PD patients exhibited a robust EAB, indicating that the ability of emotion to direct attention remains intact in PD. Congruent with other recent data, these findings suggest that fear recognition deficits in PD may instead reflect a highly specific problem in recognition, rather than a general deficit in emotional processing of fearful stimuli.

Ausência de Prejuízo no Reconhecimento de Expressões Faciais entre Indivíduos com Parkinson

RESUMO: Entre os sintomas não motores da doença de Parkinson, dificuldades no reconhecimento de expressões faciais emocionais vêm sendo amplamente discutidas, pois as áreas cerebrais relacionadas a tal habilidade podem estar afetadas na doença. Este estudo investigou, em idosos, o reconhecimento das seis expressões emocionais faciais consideradas universais por meio do instrumento Teste de Percepção Emocional de Faces, em que participantes executam uma tarefa de reconhecimento de expressões emocionais faciais. Participaram 41 indivíduos com idade média de 64,9 anos, 27 homens e 14 mulheres. Não foi observada significativa dificuldade no reconhecimento de nenhuma das expressões emocionais por parte dos parkinsonianos. Tal resultado pode indicar a necessidade do desenvolvimento de instrumentos e técnicas mais adequadas para esse tipo de investigação na população brasileira.

Neurocircuitry of impaired affective sound processing: A clinical disorders perspective

Decoding affective meaning from sensory information is central to accurate and adaptive behavior in many natural and social contexts. Human vocalizations (speech and non-speech), environmental sounds (e.g. thunder, noise, or animal sounds) and human-produced sounds (e.g. technical sounds or music) can carry a wealth of important aversive, threatening, appealing, or pleasurable affective information that sometimes implicitly influences and guides our behavior. A deficit in processing such affective information is detrimental to adaptive environmental behavior, psychological well-being, and social interactive abilities. These deficits can originate from a diversity of psychiatric and neurological disorders, and are associated with neural dysfunctions across largely distributed brain networks. Recent neuroimaging studies in psychiatric and neurological patients outline the cortical and subcortical neurocircuitry of the complimentary and differential functional roles for affective sound processing. This points to and confirms a recently proposed distributed network rather than a single brain region underlying affective sound processing, and highlights the notion of a multi-functional process that can be differentially impaired in clinical disorders.

Unaltered emotional experience in Parkinson's disease: Pupillometry and behavioral evidence

INTRODUCTION

Recognizing emotions in others is a pivotal part of socioemotional functioning and plays a central role in social interactions. It has been shown that individuals suffering from Parkinson's disease (PD) are less accurate at identifying basic emotions such as fear, sadness, and happiness; however, previous studies have predominantly assessed emotion processing using unimodal stimuli (e.g., pictures) that do not reflect the complexity of real-world processing demands. Dynamic, naturalistic stimuli (e.g., movies) have been shown to elicit stronger subjective emotional experiences than unimodal stimuli and can facilitate emotion recognition.

METHOD

In this experiment, pupil measurements of PD patients and matched healthy controls (HC) were recorded while they watched short film clips. Participants' task was to identify the emotion elicited by each clip and rate the intensity of their emotional response. We explored (a) how PD affects subjective emotional experience in response to dynamic, ecologically valid film stimuli, and (b) whether there are PD-related changes in pupillary response, which may contribute to the differences in emotion processing reported in the literature.

RESULTS

Behavioral results showed that identification of the felt emotion as well as perceived intensity varies by emotion, but no significant group effect was found. Pupil measurements revealed differences in dilation depending on the emotion evoked by the film clips (happy, tender, sadness, fear, and neutral) for both groups.

CONCLUSIONS

Our results suggest that differences in emotional response may be negligible when PD patients and healthy controls are presented with dynamic, ecologically valid emotional stimuli. Given the limited data available on pupil response in PD, this study provides new evidence to suggest that the PD-related deficits in emotion processing reported in the literature may not translate to real-world differences in physiological or subjective emotion processing in early-stage PD patients.

Neural systems for evaluating speaker (Un)believability

Our voice provides salient cues about how confident we sound, which promotes inferences about how believable we are. However, the neural mechanisms involved in these social inferences are largely unknown. Employing functional magnetic resonance imaging, we examined the brain networks and individual differences underlying the evaluation of speaker believability from vocal expressions. Participants (n = 26) listened to statements produced in a confident, unconfident, or "prosodically unmarked" (neutral) voice, and judged how believable the speaker was on a 4-point scale. We found frontal-temporal networks were activated for different levels of confidence, with the left superior and inferior frontal gyrus more activated for confident statements, the right superior temporal gyrus for unconfident expressions, and bilateral cerebellum for statements in a neutral voice. Based on listener's believability judgment, we observed increased activation in the right superior parietal lobule (SPL) associated with higher believability, while increased left posterior central gyrus (PoCG) was associated with less believability. A psychophysiological interaction analysis found that the anterior cingulate cortex and bilateral caudate were connected to the right SPL when higher believability judgments were made, while supplementary motor area was connected with the left PoCG when lower believability judgments were made. Personal characteristics, such as interpersonal reactivity and the individual tendency to trust others, modulated the brain activations and the functional connectivity when making believability judgments. In sum, our data pinpoint neural mechanisms that are involved when inferring one's believability from a speaker's voice and establish ways that these mechanisms are modulated by individual characteristics of a listener. Hum Brain Mapp 38:3732-3749, 2017. © 2017 Wiley Periodicals, Inc.

Misperceptions and Parkinson's disease

Most of the neurobehavioral aspects of Parkinson's disease have been well established and studied, but many are not well known, and hardly studied. This article focuses on several behavioral abnormalities that are common, and frequently cause difficulty for the patient and family due to lack of recognition as part of the disease. While it is well known that L-Dopa dyskinesias are frequently not recognized or under appreciated by patients, a similar lack of recognition may affect the patient's own speech volume, where their center of gravity is located, whether they are tilted to one side, and their under-recognition of others' emotional displays. In addition, PD patients are often misperceived by others incorrect impression of their emotional and cognitive state based purely on facial expression. These changes and others are briefly reviewed.

Altered emotional prosody processing in patients with Parkinson's disease after subthalamic nucleus stimulation

BACKGROUND

Patients with Parkinson's disease (PD) exhibit deficits in recognizing and expressing vocal emotional prosody. The aim of this study was to explore emotional prosody processing in patients with PD shortly after subthalamic nucleus (STN) deep brain stimulation (DBS).

METHODS

Two groups of patients with PD (pre-DBS and post-DBS) and one healthy control (HC) group were recruited as participants. All participants (PD and HC) were assessed using the Montreal Affective Voices database 50 Voices Recognition test. All participants were asked to nonverbally express five basic emotions (happiness, anger, fear, sadness, and neutral) to test emotional prosody expression. Fifteen native Chinese speakers were recruited as raters. We recorded the accuracy rate, reaction time, confidence level, and two acoustic parameters (mean pitch and mean intensity).

RESULTS

The PD groups scored lower than the HC group in recognizing and expressing emotional prosody. STN DBS had no significant effect on the recognition of emotional prosody but had a significant effect on fear prosody expression. Pearson's correlation analysis revealed significant correlations between performance on emotional prosody recognition tests and performance on emotional prosody expression tests in both the pre-DBS PD and post-DBS PD groups.

CONCLUSION

Shortly after STN DBS, the ability to recognize emotional prosody was not altered, but fear expression was impaired. We identified associations between abnormalities in emotional prosody recognition and expression deficits both before and after STN DBS, indicating that the processes involved in recognizing and expressing emotional prosody may share a common system.

Speech dysprosody but no music 'dysprosody' in Parkinson's disease

Parkinson's disease is characterized not only by bradykinesia, rigidity, and tremor, but also by impairments of expressive and receptive linguistic prosody. The facilitating effect of music with a salient beat on patients' gait suggests that it might have a similar effect on vocal behavior, however it is currently unknown whether singing is affected by the disease. In the present study, fifteen Parkinson patients were compared with fifteen healthy controls during the singing of familiar melodies and improvised melodic continuations. While patients' speech could reliably be distinguished from that of healthy controls matched for age and gender, purely on the basis of aural perception, no significant differences in singing were observed, either in pitch, pitch range, pitch variability, and tempo, or in scale tone distribution, interval size or interval variability. The apparent dissociation of speech and singing in Parkinson's disease suggests that music could be used to facilitate expressive linguistic prosody.

Strength Is in Numbers: Can Concordant Artificial Listeners Improve Prediction of Emotion from Speech?

Humans can communicate their emotions by modulating facial expressions or the tone of their voice. Albeit numerous applications exist that enable machines to read facial emotions and recognize the content of verbal messages, methods for speech emotion recognition are still in their infancy. Yet, fast and reliable applications for emotion recognition are the obvious advancement of present ‘intelligent personal assistants’, and may have countless applications in diagnostics, rehabilitation and research. Taking inspiration from the dynamics of human group decision-making, we devised a novel speech emotion recognition system that applies, for the first time, a semi-supervised prediction model based on consensus. Three tests were carried out to compare this algorithm with traditional approaches. Labeling performances relative to a public database of spontaneous speeches are reported. The novel system appears to be fast, robust and less computationally demanding than traditional methods, allowing for easier implementation in portable voice-analyzers (as used in rehabilitation, research, industry, etc.) and for applications in the research domain (such as real-time pairing of stimuli to participants’ emotional state, selective/differential data collection based on emotional content, etc.).

Perception of Communicative and Non-communicative Motion-Defined Gestures in Parkinson's Disease

OBJECTIVES

Parkinson's disease (PD) is associated with deficits in social cognition and visual perception, but little is known about how the disease affects perception of socially complex biological motion, specifically motion-defined communicative and non-communicative gestures. We predicted that individuals with PD would perform more poorly than normal control (NC) participants in discriminating between communicative and non-communicative gestures, and in describing communicative gestures. We related the results to the participants' gender, as there are gender differences in social cognition in PD.

METHODS

The study included 23 individuals with PD (10 men) and 24 NC participants (10 men) matched for age and education level. Participants viewed point-light human figures that conveyed communicative and non-communicative gestures and were asked to describe each gesture while discriminating between the two gesture types.

RESULTS

PD as a group were less accurate than NC in describing non-communicative but not communicative gestures. Men with PD were impaired in describing and discriminating between communicative as well as non-communicative gestures.

CONCLUSIONS

The present study demonstrated PD-related impairments in perceiving and inferring the meaning of biological motion gestures. Men with PD may have particular difficulty in understanding the communicative gestures of others in interpersonal exchanges.

Advanced Parkinson disease patients have impairment in prosody processing

BACKGROUND

The ability to recognize and interpret emotions in others is a crucial prerequisite of adequate social behavior. Impairments in emotion processing have been reported from the early stages of Parkinson's disease (PD). This study aims to characterize emotion recognition in advanced Parkinson's disease (APD) candidates for deep-brain stimulation and to compare emotion recognition abilities in visual and auditory domains.

METHOD

APD patients, defined as those with levodopa-induced motor complications (N = 42), and healthy controls (N = 43) matched by gender, age, and educational level, undertook the Comprehensive Affect Testing System (CATS), a battery that evaluates recognition of seven basic emotions (happiness, sadness, anger, fear, surprise, disgust, and neutral) on facial expressions and four emotions on prosody (happiness, sadness, anger, and fear). APD patients were assessed during the "ON" state. Group performance was compared with independent-samples t tests.

RESULTS

Compared to controls, APD had significantly lower scores on the discrimination and naming of emotions in prosody, and visual discrimination of neutral faces, but no significant differences in visual emotional tasks.

CONCLUSION

The contrasting performance in emotional processing between visual and auditory stimuli suggests that APD candidates for surgery have either a selective difficulty in recognizing emotions in prosody or a general defect in prosody processing. Studies investigating early-stage PD, and the effect of subcortical lesions in prosody processing, favor the latter interpretation. Further research is needed to understand these deficits in emotional prosody recognition and their possible contribution to later behavioral or neuropsychiatric manifestations of PD.

Understanding the Influence of Parkinson Disease on Adolf Hitler's Decision-Making during World War II

Parkinson disease (PD) is a common neurodegenerative disorder characterized by the presence of Lewy bodies and a reduction in the number of dopaminergic neurons in the substantia nigra of the basal ganglia. Common symptoms of PD include a reduction in control of voluntary movements, rigidity, and tremors. Such symptoms are marked by a severe deterioration in motor function. The causes of PD in many cases are unknown. PD has been found to be prominent in several notable people, including Adolf Hitler, the Chancellor of Germany and Führer of Nazi Germany during World War II. It is believed that Adolf Hitler suffered from idiopathic PD throughout his life. However, the effect of PD on Adolf Hitler's decision making during World War II is largely unknown. Here we examine the potential role of PD in shaping Hitler's personality and influencing his decision-making. We purport that Germany's defeat in World War II was influenced by Hitler's questionable and risky decision-making and his inhumane and callous personality, both of which were likely affected by his condition. Likewise his paranoid disorder marked by intense anti-Semitic beliefs influenced his treatment of Jews and other non-Germanic peoples. We also suggest that the condition played an important role in his eventual political decline.

Working memory and facial expression recognition in patients with Parkinson's disease

Facial expression recognition impairment has been reported in Parkinson's disease. While some authors have referred to specific emotional disabilities, others view them as secondary to executive deficits frequently described in the disease, such as working memory. The present study aims to analyze the relationship between working memory and facial expression recognition abilities in Parkinson's disease. We observed 50 patients with Parkinson's disease and 49 healthy controls by means of an n-back procedure with four types of stimuli: emotional facial expressions, gender, spatial locations, and non-sense syllables. Other executive and visuospatial neuropsychological tests were also administered. Results showed that Parkinson's disease patients with high levels of disability performed worse than healthy individuals on the emotional facial expression and spatial location tasks. Moreover, spatial location task performance was correlated with executive neuropsychological scores, but emotional facial expression was not. Thus, working memory seems to be altered in Parkinson's disease, particularly in tasks that involve the appreciation of spatial relationships in stimuli. Additionally, non-executive, facial emotional recognition difficulty seems to be present and related to disease progression.

Proficiency in positive vs. negative emotion identification and subjective well-being among long-term married elderly couples

Evidence is accruing that positive emotions play a crucial role in shaping a healthy interpersonal climate. Inspired by this research, the current investigation sought to shed light on the link between proficiency in identifying positive vs. negative emotions and a close partner's well-being. To this end, we conducted two studies with neurologically intact elderly married couples (Study 1) and an age-matched clinical sample, comprising married couples in which one spouse had been diagnosed with Parkinson's Disease (Study 2), which tends to hinder emotional expressivity. To assess proficiency in identifying emotions from whole body postures, we had participants in both studies complete a pointlight walker task, featuring four actors (two male, two female) expressing one positive (i.e., happiness) and three negative (i.e., sadness, anger, fear) basic emotions. Participants also filled out measures of subjective well-being. Among Study 1's neurologically intact spouses, greater expertise in identifying positive (but not negative) emotions was linked to greater partner life satisfaction (but not hedonic balance). Spouses of PD patients exhibited increased proficiency in identifying positive emotions relative to controls, possibly reflective of compensatory mechanisms. Complementarily, relative to controls, spouses of PD patients exhibited reduced proficiency in identifying negative emotions and a tendency to underestimate their intensity. Importantly, all of these effects attenuated with longer years from PD onset. Finally, there was evidence that it was increased partner expertise in identifying negative (rather than positive) emotional states that predicted greater life satisfaction levels among the PD patients and their spouses. Our results thus suggest that positive vs. negative emotions may play distinct roles in close relationship dynamics as a function of neurological status and disability trajectory.

Selective attention and facial expression recognition in patients with Parkinson's disease

Parkinson's disease (PD) has been associated with facial expression recognition difficulties. However, this impairment could be secondary to the one produced in other cognitive processes involved in recognition, such as selective attention. This study investigates the influence of two selective attention components (inhibition and visual search) on facial expression recognition in PD. We compared facial expression and non-emotional stimuli recognition abilities of 51 patients and 51 healthy controls, by means of an adapted Stroop task, and by "The Face in the Crowd" paradigm, which assess Inhibition and Visual Search abilities, respectively. Patients scored worse than controls in both tasks with facial expressions, but not with the other nonemotional stimuli, indicating specific emotional recognition impairment, not dependent on selective attention abilities. This should be taken into account in patients' neuropsychological assessment given the relevance of emotional facial expression for social communication in everyday settings.

On the analysis of EEG power, frequency and asymmetry in Parkinson's disease during emotion processing

OBJECTIVE

While Parkinson's disease (PD) has traditionally been described as a movement disorder, there is growing evidence of disruption in emotion information processing associated with the disease. The aim of this study was to investigate whether there are specific electroencephalographic (EEG) characteristics that discriminate PD patients and normal controls during emotion information processing.

METHOD

EEG recordings from 14 scalp sites were collected from 20 PD patients and 30 age-matched normal controls. Multimodal (audio-visual) stimuli were presented to evoke specific targeted emotional states such as happiness, sadness, fear, anger, surprise and disgust. Absolute and relative power, frequency and asymmetry measures derived from spectrally analyzed EEGs were subjected to repeated ANOVA measures for group comparisons as well as to discriminate function analysis to examine their utility as classification indices. In addition, subjective ratings were obtained for the used emotional stimuli.

RESULTS

Behaviorally, PD patients showed no impairments in emotion recognition as measured by subjective ratings. Compared with normal controls, PD patients evidenced smaller overall relative delta, theta, alpha and beta power, and at bilateral anterior regions smaller absolute theta, alpha, and beta power and higher mean total spectrum frequency across different emotional states. Inter-hemispheric theta, alpha, and beta power asymmetry index differences were noted, with controls exhibiting greater right than left hemisphere activation. Whereas intra-hemispheric alpha power asymmetry reduction was exhibited in patients bilaterally at all regions. Discriminant analysis correctly classified 95.0% of the patients and controls during emotional stimuli.

CONCLUSION

These distributed spectral powers in different frequency bands might provide meaningful information about emotional processing in PD patients.