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García I, Martínez O, López-Paz JF, García M, Espinosa-Blanco P, Rodríguez AA, Pallarès-Sastre M, Ruiz de Lazcano A, Amayra I. Social cognition in DMD and BMD dystrophinopathies: A cross-sectional preliminary study. Clin Neuropsychol 2024; 38:219-234. [PMID: 37081823 DOI: 10.1080/13854046.2023.2202332] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 04/07/2023] [Indexed: 04/22/2023]
Abstract
Objective: The dystrophinopathies called Duchenne and Becker muscular dystrophies (DMD/BMD) are rare, progressive, incurable, and life-limiting paediatric-onset neuromuscular diseases. These diseases have long been associated with specific neuropsychological deficits. However, the performance of these patients in the social cognition domain has not been properly investigated. Thus, the main objective of this study was to compare the performance on social cognition between DMD/BMD patients and healthy age-matched boys. Method: This cross-sectional study included 20 DMD/BMD children and adolescents and 20 healthy controls. The protocol included the Social Perception Domain of the NEPSY-II, the Reading the Mind in the Eyes Test - Child and Happé's Strange Stories test. General intelligence was controlled to eliminate the possible influence of covariables. All the assessments were performed remotely. Results: Most social cognition tasks were worse in patients with DMD/BMD than in matched healthy controls. These differences remained even after controlling for the general intelligence variable, with the exception of Total Disgust Errors (F = 1.462, p = .234, η2p= .038) and Verbal task (F = 1.820, p = .185, η2p= .047) scores from the NEPSY-II. Conclusions: This is the first study to demonstrate that the neuropsychological domain of social cognition is impaired in DMD/BMD patients, independent of the level of general intelligence. Screening assessments in DMD/BMD patients should be promoted to allow social cognition difficulties to be detected at an early stage to enhance patients' quality of life and social development.
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Affiliation(s)
- Irune García
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Oscar Martínez
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Juan Francisco López-Paz
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Maitane García
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Patricia Espinosa-Blanco
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Alicia Aurora Rodríguez
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Mercè Pallarès-Sastre
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Aitana Ruiz de Lazcano
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Imanol Amayra
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
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Rizzo G, Martino D, Avanzino L, Avenanti A, Vicario CM. Social cognition in hyperkinetic movement disorders: a systematic review. Soc Neurosci 2023; 18:331-354. [PMID: 37580305 DOI: 10.1080/17470919.2023.2248687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 07/10/2023] [Accepted: 08/09/2023] [Indexed: 08/16/2023]
Abstract
Numerous lines of research indicate that our social brain involves a network of cortical and subcortical brain regions that are responsible for sensing and controlling body movements. However, it remains unclear whether movement disorders have a systematic impact on social cognition. To address this question, we conducted a systematic review examining the influence of hyperkinetic movement disorders (including Huntington disease, Tourette syndrome, dystonia, and essential tremor) on social cognition. Following the PRISMA guidelines and registering the protocol in the PROSPERO database (CRD42022327459), we analyzed 50 published studies focusing on theory of mind (ToM), social perception, and empathy. The results from these studies provide evidence of impairments in ToM and social perception in all hyperkinetic movement disorders, particularly during the recognition of negative emotions. Additionally, individuals with Huntington's Disease and Tourette syndrome exhibit empathy disorders. These findings support the functional role of subcortical structures (such as the basal ganglia and cerebellum), which are primarily responsible for movement disorders, in deficits related to social cognition.
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Affiliation(s)
- Gaetano Rizzo
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e degli studi culturali, Università di Messina, Messina, Italy
| | - Davide Martino
- Department of Clinical Neurosciences, Hotchkiss Brain Institute, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Laura Avanzino
- Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy
| | - Alessio Avenanti
- Centro studi e ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia "Renzo Canestrari", Campus di Cesena, Alma Mater Studiorum Università di Bologna, Cesena, Italy
- Centro de Investigación en Neuropsicología y Neurociencias Cognitivas, Universidad Católica del Maule, Talca, Chile
| | - Carmelo Mario Vicario
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e degli studi culturali, Università di Messina, Messina, Italy
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Klingner CM, Guntinas-Lichius O. Facial expression and emotion. Laryngorhinootologie 2023; 102:S115-S125. [PMID: 37130535 PMCID: PMC10171334 DOI: 10.1055/a-2003-5687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Human facial expressions are unique in their ability to express our emotions and communicate them to others. The mimic expression of basic emotions is very similar across different cultures and has also many features in common with other mammals. This suggests a common genetic origin of the association between facial expressions and emotion. However, recent studies also show cultural influences and differences. The recognition of emotions from facial expressions, as well as the process of expressing one's emotions facially, occurs within an extremely complex cerebral network. Due to the complexity of the cerebral processing system, there are a variety of neurological and psychiatric disorders that can significantly disrupt the coupling of facial expressions and emotions. Wearing masks also limits our ability to convey and recognize emotions through facial expressions. Through facial expressions, however, not only "real" emotions can be expressed, but also acted ones. Thus, facial expressions open up the possibility of faking socially desired expressions and also of consciously faking emotions. However, these pretenses are mostly imperfect and can be accompanied by short-term facial movements that indicate the emotions that are actually present (microexpressions). These microexpressions are of very short duration and often barely perceptible by humans, but they are the ideal application area for computer-aided analysis. This automatic identification of microexpressions has not only received scientific attention in recent years, but its use is also being tested in security-related areas. This article summarizes the current state of knowledge of facial expressions and emotions.
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Affiliation(s)
- Carsten M Klingner
- Hans Berger Department of Neurology, Jena University Hospital, Germany
- Biomagnetic Center, Jena University Hospital, Germany
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Silva Neto JAD, Afonso SLA, Souza WCD. A Utilização da Imitação Facial em Tarefas de Reconhecimento de Expressões Emocionais. PSICOLOGIA: CIÊNCIA E PROFISSÃO 2023. [DOI: 10.1590/1982-3703003249386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Resumo A imitação facial é um comportamento involuntário capaz de facilitar a transmissão de informações não verbais relevantes em diferentes contextos sociais. Este estudo teve por objetivo analisar a capacidade de reconhecimento de expressões emocionais enquanto o observador tensiona a própria face ou imita a face-alvo. A hipótese utilizada foi a de que indivíduos que tensionam a própria face terão menor probabilidade de acertos na execução das tarefas de reconhecimento de expressões emocionais e aqueles que imitam a expressão terão uma maior probabilidade de acertos na execução das mesmas tarefas. A amostra foi composta por 30 participantes, divididos em dois grupos experimentais: o Grupo Imitação (GI) e o Grupo Ruído (GR), ambos com 18 participantes do sexo feminino e 12 do sexo masculino. O experimento consistiu em apresentar fotos de atores expressando facialmente uma emoção básica por 10 segundos. Neste período, os participantes deveriam, então, observar ou intervir facialmente, imitando ou tensionando a própria face (de acordo com o grupo alocado, Imitação ou Ruído). Após os 10 segundos executando a instrução (observar, imitar ou interferir), o participante deveria responder - entre as opções alegria, tristeza, nojo, raiva, surpresa e medo - a emoção correspondente à imagem. Os resultados apresentaram diferenças significativas quando comparadas as tarefas de tensionar ou imitar a face-alvo, sugerindo que a alteração da própria face do observador pode influenciar durante o desempenho de uma tarefa de reconhecimento de emoções em faces.
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Abdollah Zadegan S, Coco HM, Reddy KS, Anderson KM, Teixeira AL, Stimming EF. Frequency and Pathophysiology of Apathy in Huntington Disease: A Systematic Review and Meta-Analysis. J Neuropsychiatry Clin Neurosci 2022; 35:121-132. [PMID: 36353818 DOI: 10.1176/appi.neuropsych.20220033] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Apathy is a common behavioral symptom of Huntington disease (HD). This systematic review describes current evidence on the pathophysiology, assessment, and frequency of apathy in HD. METHODS This systematic review was conducted in accordance with PRISMA guidelines. Using a comprehensive search strategy, the investigators searched the MEDLINE, Embase, and PsycINFO databases. All studies that evaluated apathy in HD patients with a valid scale and reported apathy frequency or scores were included. Apathy scores were analyzed by mean or standardized mean differences in accordance with Cochrane guidelines. RESULTS A total of 1,085 records were screened and 80 studies were ultimately included. The Problem Behaviors Assessment-Short was the most frequently used apathy assessment tool. Apathy frequency generally ranged from 10%-33% in premanifest HD to 24%-76% in manifest HD. A meta-analysis of 5,311 records of patients with premanifest HD showed significantly higher apathy scores, with a standardized mean difference of 0.41 (CI=0.29-0.52; p<0.001). A comparison of 1,247 patients showed significantly higher apathy scores in manifest than premanifest HD, with a mean difference of 1.87 (CI=1.48-2.26; p<0.001). There was evidence of involvement of various cortical and subcortical brain regions in HD patients with apathy. CONCLUSIONS Apathy was more frequent among individuals with premanifest HD compared with those in a control group and among individuals with manifest HD compared with those with premanifest HD. Considering the complexity and unique pattern of development in neurodegenerative disease, further studies are required to explore the pathophysiology of apathy in HD.
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Affiliation(s)
- Shayan Abdollah Zadegan
- Department of Neurology (Zadegan, Furr Stimming), Huntington's Disease Society of America Center of Excellence (Zadegan, Anderson, Teixeira, Furr Stimming), McGovern Medical School (Coco, Reddy), Department of Psychiatry and Behavioral Sciences (Anderson, Teixeira), all at the University of Texas Health Science Center at Houston
| | - Hannah M Coco
- Department of Neurology (Zadegan, Furr Stimming), Huntington's Disease Society of America Center of Excellence (Zadegan, Anderson, Teixeira, Furr Stimming), McGovern Medical School (Coco, Reddy), Department of Psychiatry and Behavioral Sciences (Anderson, Teixeira), all at the University of Texas Health Science Center at Houston
| | - Kirthan S Reddy
- Department of Neurology (Zadegan, Furr Stimming), Huntington's Disease Society of America Center of Excellence (Zadegan, Anderson, Teixeira, Furr Stimming), McGovern Medical School (Coco, Reddy), Department of Psychiatry and Behavioral Sciences (Anderson, Teixeira), all at the University of Texas Health Science Center at Houston
| | - Kendra M Anderson
- Department of Neurology (Zadegan, Furr Stimming), Huntington's Disease Society of America Center of Excellence (Zadegan, Anderson, Teixeira, Furr Stimming), McGovern Medical School (Coco, Reddy), Department of Psychiatry and Behavioral Sciences (Anderson, Teixeira), all at the University of Texas Health Science Center at Houston
| | - Antonio L Teixeira
- Department of Neurology (Zadegan, Furr Stimming), Huntington's Disease Society of America Center of Excellence (Zadegan, Anderson, Teixeira, Furr Stimming), McGovern Medical School (Coco, Reddy), Department of Psychiatry and Behavioral Sciences (Anderson, Teixeira), all at the University of Texas Health Science Center at Houston
| | - Erin Furr Stimming
- Department of Neurology (Zadegan, Furr Stimming), Huntington's Disease Society of America Center of Excellence (Zadegan, Anderson, Teixeira, Furr Stimming), McGovern Medical School (Coco, Reddy), Department of Psychiatry and Behavioral Sciences (Anderson, Teixeira), all at the University of Texas Health Science Center at Houston
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Gallezot C, Riad R, Titeux H, Lemoine L, Montillot J, Sliwinski A, Bagnou JH, Cao XN, Youssov K, Dupoux E, Bachoud Levi AC. Emotion expression through spoken language in Huntington Disease. Cortex 2022; 155:150-161. [DOI: 10.1016/j.cortex.2022.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/18/2022] [Accepted: 05/29/2022] [Indexed: 11/26/2022]
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Eddy CM, Rickards H. Social cognition and quality of life in Huntington's disease. Front Psychiatry 2022; 13:963457. [PMID: 36090376 PMCID: PMC9449535 DOI: 10.3389/fpsyt.2022.963457] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
Individuals with Huntington's disease (HD) and their close others report difficulties with social interaction, and previous studies have shown that the areas of quality of life detrimentally impacted by HD include social and emotional domains. However, despite the finding that people with HD often exhibit difficulties on standard tests of social cognition, the relationship between such impairments and patients' everyday life has remained largely unexplored. We used a range of tasks assessing empathy, emotion recognition and Theory of Mind, to investigate whether patients' performance may predict quality of life within the social and emotional domains, while also accounting for broader cognitive function, behavioural changes, motor symptoms, disease stage and functional capacity. Poorer social functioning was predicted specifically by a reduced tendency to attribute intentionality while viewing social animations, in addition to emotional blunting and apathy, while role limitations due to emotional problems were predicted by personal distress, irritability and aspects of executive function. These findings highlight the potential impact of Theory of Mind impairment on quality of life in HD, and suggest that enhanced assessment of social cognition will offer unique insight into patients' social function and related wellbeing.
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Affiliation(s)
- Clare M Eddy
- BSMHFT National Centre for Mental Health, Birmingham, United Kingdom.,Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Hugh Rickards
- BSMHFT National Centre for Mental Health, Birmingham, United Kingdom.,Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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8
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Kalkers K, Schols JMGA, van Zwet EW, Roos RAC. Falls, Fear of Falling, and Preventive Measures in Huntington's Disease: The Perspectives of Individuals with Huntington's Disease and Caregivers in Long-Term Care. J Huntingtons Dis 2021; 10:493-503. [PMID: 34719503 DOI: 10.3233/jhd-210493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Falls are common in Huntington's disease (HD), which can have serious consequences and may therefore lead to fear of falling (FoF). There is little knowledge about falls or FoF in individuals with HD or about formal and informal caregivers' fear about falls in individuals with HD. OBJECTIVE To explore prevalence of falls, FoF and fall preventive measures both those applied and those not included in managing falls in individuals with HD and their formal and informal caregivers, and to identify the relationship between FoF and, anxiety, awareness and cognitive functioning respectively. METHODS In a multi-center observational cross-sectional study, care-independent and -dependent individuals with HD and their formal and informal caregivers were recruited from six Dutch nursing homes specialized in HD. The participants were assessed by means of questionnaires enquiring about falls, FoF, awareness of fall risk, cognition, anxiety and fall preventive measures. RESULTS For all included 158 individuals with HD, the fall prevalence over the last 30 days was 28.8%. The prevalence of FoF in individuals with HD, formal caregivers and informal caregivers was 47.6%, 25.6%, and 63.5%, respectively, for care-independent individuals with HD and 46.9%, 26.3%, and 62.0%, respectively, for care-dependent individuals with HD. Anticipatory awareness of fall risks and gender are predictors of FoF in care-independent individuals with HD, though not in the care-dependent group. A combination of fall preventive measures is used in most individuals with HD. CONCLUSION Fall prevalence is high and FoF is common in individuals with HD and their caregivers. Gender and anticipatory awareness are risk factors for FoF. In addition to the use of individual multifactorial fall prevention strategies, it is important to support both formal and informal caregivers in coping with falls.
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Affiliation(s)
- Kristel Kalkers
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Mijzo, Raamsdonksveer, The Netherlands
| | - Jos M G A Schols
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Erik W van Zwet
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Raymund A C Roos
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
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9
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Brewer R, Murphy J, Bird G. Atypical interoception as a common risk factor for psychopathology: A review. Neurosci Biobehav Rev 2021; 130:470-508. [PMID: 34358578 PMCID: PMC8522807 DOI: 10.1016/j.neubiorev.2021.07.036] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/09/2021] [Accepted: 07/31/2021] [Indexed: 02/06/2023]
Abstract
The inadequacy of a categorial approach to mental health diagnosis is now well-recognised, with many authors, diagnostic manuals and funding bodies advocating a dimensional, trans-diagnostic approach to mental health research. Variance in interoception, the ability to perceive one's internal bodily state, is reported across diagnostic boundaries, and is associated with atypical functioning across symptom categories. Drawing on behavioural and neuroscientific evidence, we outline current research on the contribution of interoception to numerous cognitive and affective abilities (in both typical and clinical populations), and describe the interoceptive atypicalities seen in a range of psychiatric conditions. We discuss the role that interoception may play in the development and maintenance of psychopathology, as well as the ways in which interoception may differ across clinical presentations. A number of important areas for further research on the role of interoception in psychopathology are highlighted.
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Affiliation(s)
- Rebecca Brewer
- Department of Psychology, Royal Holloway, University of London, United Kingdom
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom.
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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10
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Emotional Processing and Experience in Amyotrophic Lateral Sclerosis: A Systematic and Critical Review. Brain Sci 2021; 11:brainsci11101356. [PMID: 34679420 PMCID: PMC8534224 DOI: 10.3390/brainsci11101356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022] Open
Abstract
Even though increasing literature describes changes in emotional processing in Amyotrophic Lateral Sclerosis (ALS), efforts to summarize relevant findings are lacking in the field. A systematic literature review was performed to provide a critical and up-to-date account of emotional abilities in ALS. References were identified by searches of PubMed, Web of Science and Scopus (1980–2021, English literature), with the following key terms: (“Amyotrophic Lateral Sclerosis” or “Primary Lateral Sclerosis” or “Motor Neuron”) and “Emotion*” and (“Processing” or “Attribution” or “Elaboration” or “Perception” or “Recognition”). Studies concerning only caregivers, pseudobulbar affect, and social cognition were excluded. Forty-one articles were included, all concerning ALS, and seven topics were identified: Emotion recognition, Emotional responsiveness, Emotional reactivity, Faces approachability rating, Valence rating, Memory for emotional materials and Alexithymia. The majority of these aspects have only been sparsely addressed. The evidence confirms altered emotional processing in ALS. The most consistent findings regard the recognition of facial expressions for negative emotions, but also alterations in the subjective responsiveness to emotional stimuli (arousal, valence and approachability), in psychophysiological and cerebral reactivity and in emotional memory, together with alexithymia traits, were reported. According to this evidence, emotional abilities should be included in the clinical assessment and therapeutic interventions.
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Problems with Social Cognition and Decision-Making in Huntington's Disease: Why Is it Important? Brain Sci 2021; 11:brainsci11070838. [PMID: 34202701 PMCID: PMC8301991 DOI: 10.3390/brainsci11070838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/11/2021] [Accepted: 06/18/2021] [Indexed: 01/21/2023] Open
Abstract
Huntington’s disease starts slowly and progresses over a 15–20 year period. Motor changes begin subtly, often going unnoticed by patients although they are typically visible to those close to them. At this point, it is the early non-motor problems of HD that arguably cause the most functional impairment. Approximately 65% of gene carriers will experience a reduction in their occupational level, and just under half will feel unable to manage their finances independently before a clinical diagnosis is made. Understanding what drives this impairment in activities of daily living is the key to helping people with HD to live more independently for longer, especially in early disease. Early cognitive decline is likely to play a contributory factor although few studies have looked directly at this relationship. Recently, it has been shown that along with the well documented dysexecutive syndrome seen in HD, changes in social cognition and decision-making are more common than previously thought. Furthermore, some of the early neuropathological and neurochemical changes seen in HD disrupt networks known to be involved in social functioning. In this review, we explore how HD changes the way individuals interact in a social world. Specifically, we summarise the literature on both classical and social decision-making (value-based decision-making in a social context) along with studies of theory of mind, empathy, alexithymia, and emotion recognition in HD. The literature specific to HD is discussed and supported by evidence from similar neurodegenerative disorders and healthy individuals to propose future directions and potential therapeutic avenues to be explored.
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12
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Marshall CR, Hardy CJD, Russell LL, Bond RL, Sivasathiaseelan H, Greaves C, Moore KM, Agustus JL, van Leeuwen JEP, Wastling SJ, Rohrer JD, Kilner JM, Warren JD. The functional neuroanatomy of emotion processing in frontotemporal dementias. Brain 2020; 142:2873-2887. [PMID: 31321407 PMCID: PMC7959336 DOI: 10.1093/brain/awz204] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 05/08/2019] [Accepted: 05/12/2019] [Indexed: 11/13/2022] Open
Abstract
Impaired processing of emotional signals is a core feature of frontotemporal dementia syndromes, but the underlying neural mechanisms have proved challenging to characterize and measure. Progress in this field may depend on detecting functional changes in the working brain, and disentangling components of emotion processing that include sensory decoding, emotion categorization and emotional contagion. We addressed this using functional MRI of naturalistic, dynamic facial emotion processing with concurrent indices of autonomic arousal, in a cohort of patients representing all major frontotemporal dementia syndromes relative to healthy age-matched individuals. Seventeen patients with behavioural variant frontotemporal dementia [four female; mean (standard deviation) age 64.8 (6.8) years], 12 with semantic variant primary progressive aphasia [four female; 66.9 (7.0) years], nine with non-fluent variant primary progressive aphasia [five female; 67.4 (8.1) years] and 22 healthy controls [12 female; 68.6 (6.8) years] passively viewed videos of universal facial expressions during functional MRI acquisition, with simultaneous heart rate and pupillometric recordings; emotion identification accuracy was assessed in a post-scan behavioural task. Relative to healthy controls, patient groups showed significant impairments (analysis of variance models, all P < 0.05) of facial emotion identification (all syndromes) and cardiac (all syndromes) and pupillary (non-fluent variant only) reactivity. Group-level functional neuroanatomical changes were assessed using statistical parametric mapping, thresholded at P < 0.05 after correction for multiple comparisons over the whole brain or within pre-specified regions of interest. In response to viewing facial expressions, all participant groups showed comparable activation of primary visual cortex while patient groups showed differential hypo-activation of fusiform and posterior temporo-occipital junctional cortices. Bi-hemispheric, syndrome-specific activations predicting facial emotion identification performance were identified (behavioural variant, anterior insula and caudate; semantic variant, anterior temporal cortex; non-fluent variant, frontal operculum). The semantic and non-fluent variant groups additionally showed complex profiles of central parasympathetic and sympathetic autonomic involvement that overlapped signatures of emotional visual and categorization processing and extended (in the non-fluent group) to brainstem effector pathways. These findings open a window on the functional cerebral mechanisms underpinning complex socio-emotional phenotypes of frontotemporal dementia, with implications for novel physiological biomarker development.
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Affiliation(s)
- Charles R Marshall
- Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.,Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.,Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
| | - Christopher J D Hardy
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Lucy L Russell
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Rebecca L Bond
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Harri Sivasathiaseelan
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Caroline Greaves
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Katrina M Moore
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Jennifer L Agustus
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Janneke E P van Leeuwen
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Stephen J Wastling
- Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - James M Kilner
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
| | - Jason D Warren
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
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Williams JHG, Huggins CF, Zupan B, Willis M, Van Rheenen TE, Sato W, Palermo R, Ortner C, Krippl M, Kret M, Dickson JM, Li CSR, Lowe L. A sensorimotor control framework for understanding emotional communication and regulation. Neurosci Biobehav Rev 2020; 112:503-518. [PMID: 32070695 PMCID: PMC7505116 DOI: 10.1016/j.neubiorev.2020.02.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/22/2020] [Accepted: 02/11/2020] [Indexed: 12/12/2022]
Abstract
Our research team was asked to consider the relationship of the neuroscience of sensorimotor control to the language of emotions and feelings. Actions are the principal means for the communication of emotions and feelings in both humans and other animals, and the allostatic mechanisms controlling action also apply to the regulation of emotional states by the self and others. We consider how motor control of hierarchically organised, feedback-based, goal-directed action has evolved in humans, within a context of consciousness, appraisal and cultural learning, to serve emotions and feelings. In our linguistic analysis, we found that many emotion and feelings words could be assigned to stages in the sensorimotor learning process, but the assignment was often arbitrary. The embodied nature of emotional communication means that action words are frequently used, but that the meanings or senses of the word depend on its contextual use, just as the relationship of an action to an emotion is also contextually dependent.
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Affiliation(s)
- Justin H G Williams
- University of Aberdeen, Institute of Medical Sciences, Foresterhill, AB25 2ZD, Scotland, United Kingdom.
| | - Charlotte F Huggins
- University of Aberdeen, Institute of Medical Sciences, Foresterhill, AB25 2ZD, Scotland, United Kingdom
| | - Barbra Zupan
- Central Queensland University, School of Health, Medical and Applied Sciences, Bruce Highway, Rockhampton, QLD 4702, Australia
| | - Megan Willis
- Australian Catholic University, School of Psychology, ARC Centre for Excellence in Cognition and its Disorders, Sydney, NSW 2060, Australia
| | - Tamsyn E Van Rheenen
- University of Melbourne, Melbourne Neuropsychiatry Centre, Department of Psychiatry, 161 Barry Street, Carlton, VIC 3053, Australia
| | - Wataru Sato
- Kyoto University, Kokoro Research Centre, 46 Yoshidashimoadachicho, Sakyo Ward, Kyoto, 606-8501, Japan
| | - Romina Palermo
- University of Western Australia, School of Psychological Science, Perth, WA, 6009, Australia
| | - Catherine Ortner
- Thompson Rivers University, Department of Psychology, 805 TRU Way, Kamloops, BC V2C 0C8, Canada
| | - Martin Krippl
- Otto von Guericke University Magdeburg, Faculty of Natural Sciences, Department of Psychology, Universitätsplatz 2, Magdeburg, 39106, Germany
| | - Mariska Kret
- Leiden University, Cognitive Psychology, Pieter de la Court, Waassenaarseweg 52, Leiden, 2333 AK, the Netherlands
| | - Joanne M Dickson
- Edith Cowan University, Psychology Department, School of Arts and Humanities, 270 Joondalup Dr, Joondalup, WA 6027, Australia
| | - Chiang-Shan R Li
- Yale University, Connecticut Mental Health Centre, S112, 34 Park Street, New Haven, CT 06519-1109, USA
| | - Leroy Lowe
- Neuroqualia, Room 229A, Forrester Hall, 36 Arthur Street, Truro, Nova Scotia, B2N 1X5, Canada
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14
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Lenzoni S, Bozzoni V, Burgio F, de Gelder B, Wennberg A, Botta A, Pegoraro E, Semenza C. Recognition of emotions conveyed by facial expression and body postures in myotonic dystrophy (DM). Cortex 2020; 127:58-66. [PMID: 32169676 DOI: 10.1016/j.cortex.2020.02.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 10/04/2019] [Accepted: 02/07/2020] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Neuromuscular diseases may be of neuropsychological interest insofar as they may affect representations based on embodied cognition theories. Previous studies have shown impaired ability to recognize facial emotions and an association between facial emotion recognition and visuospatial abilities in myotonic dystrophy type 1 (DM1) patients. Here we examined the ability of both DM1 and DM2 patients to recognize emotions expressed by body postures and its relation, and their association with cognitive performance. METHODS Participants included 34 DM1 patients, 8 DM2 patients, and 24 healthy control subjects. Emotional recognition ability was assessed through two computerized matching tasks (face and bodies). A neuropsychological battery was used to measure cognition in three domains and global cognition. We used univariate and adjusted linear regression models to investigate the association between cognition and emotion recognition performance. RESULTS DM patients (combined DM1 and DM2) performed worse on emotional facial expression (p = .006) and body posture (p = .004) accuracy measures than healthy controls. In linear regression models, DM patients' facial expression accuracy was associated with executive function (p = .013) and visuospatial (p < .001) z-scores. Body posture accuracy was associated with visuospatial (p = .001) and memory (p = .012) z-scores. There were no associations among controls or between cognition and reaction time. DISCUSSION These findings suggest that impaired emotional recognition among DM patients is also extended to emotions conveyed by body postures. Consistent with embodied cognition theories, people affected in their body and its movement may have impaired sensorimotor representation in ways that have yet to be fully understood.
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Affiliation(s)
- Sabrina Lenzoni
- Department of Neurosciences (Padova Neuroscience Center), Università degli Studi di Padova, Italy.
| | - Virginia Bozzoni
- Department of Neurosciences (Padova Neuroscience Center), Università degli Studi di Padova, Italy.
| | | | | | - Alexandra Wennberg
- Department of Neurosciences (Padova Neuroscience Center), Università degli Studi di Padova, Italy.
| | - Annalisa Botta
- Department of Biomedicine and Prevention, Medical Genetics Section, University of Rome Tor Vergata, Rome, Italy.
| | - Elena Pegoraro
- Department of Neurosciences (Padova Neuroscience Center), Università degli Studi di Padova, Italy.
| | - Carlo Semenza
- Department of Neurosciences (Padova Neuroscience Center), Università degli Studi di Padova, Italy; IRCCS San Camillo Hospital, Venice, Italy.
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15
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Farina E, Borgnis F, Pozzo T. Mirror neurons and their relationship with neurodegenerative disorders. J Neurosci Res 2020; 98:1070-1094. [DOI: 10.1002/jnr.24579] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 12/12/2022]
Affiliation(s)
| | | | - Thierry Pozzo
- INSERM UMR1093‐CAPS, Université Bourgogne Franche‐Comté Dijon France
- IT@UniFe Center for Translational Neurophysiology Istituto Italiano di Tecnologia Ferrara Italy
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16
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Storbeck F, Schlegelmilch K, Streitberger KJ, Sommer W, Ploner CJ. Delayed recognition of emotional facial expressions in Bell's palsy. Cortex 2019; 120:524-531. [DOI: 10.1016/j.cortex.2019.07.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 05/19/2019] [Accepted: 07/25/2019] [Indexed: 12/25/2022]
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17
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Pick E, Kleinbub JR, Mannarini S, Palmieri A. Empathy In Neurodegenerative Diseases: A Systematic Review. Neuropsychiatr Dis Treat 2019; 15:3287-3304. [PMID: 31819455 PMCID: PMC6878921 DOI: 10.2147/ndt.s225920] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 10/31/2019] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Empathy, in its affective and cognitive components, is a crucial interpersonal ability. It is broadly studied in the field of psychopathology, whereas its study in the neurodegenerative diseases is relatively recent. Existing literature, though, focused on a reduced subset of considered diseases, which often found a compromise in empathy abilities. Organized knowledge about a more comprehensive set of diseases is lacking. METHOD The present PRISMA systematic review was aimed at collecting the current available literature concerning empathic alterations in adult patients affected by neurodegenerative diseases. It considered the different empathy components, evaluated existing patterns, the impact on patients' lives, and treatment considerations. RESULTS Overall, the 32 retrieved studies describe a spread deterioration of empathic abilities in patients, with each disease displaying its own pattern of empathy functioning. Literature in this field is fragmented and of heterogeneous quality, and further studies are warranted to increase evidence of many preliminary results. DISCUSSION In conclusion, we highlight the crucial importance of acknowledging empathy deficits in these diseases, showing their repercussion on both patients' and caregivers' quality of life, the establishment of a functional doctor-patient relationship, and the development of efficacious psychological intervention. These clinical approaches can be enriched by the knowledge of the spared abilities of patients affected by neurodegenerative diseases.
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Affiliation(s)
- Emanuele Pick
- Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padova, Italy
| | - Johann R Kleinbub
- Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padova, Italy
| | - Stefania Mannarini
- Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padova, Italy.,Interdepartmental Center for Family Research, University of Padova, Padova, Italy
| | - Arianna Palmieri
- Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy
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18
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Kordsachia CC, Labuschagne I, Andrews SC, Stout JC. Diminished facial EMG responses to disgusting scenes and happy and fearful faces in Huntington's disease. Cortex 2018; 106:185-199. [PMID: 30005370 DOI: 10.1016/j.cortex.2018.05.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 04/20/2018] [Accepted: 05/27/2018] [Indexed: 11/30/2022]
Abstract
Huntington's disease (HD) is a neurodegenerative disorder associated with impaired facial emotion recognition and altered subjective experience of emotion. These impairments likely result from the effects of the disease on underlying neurobiological mechanisms. Studies using self-report to examine emotional experiences have been ambiguous regarding whether experiences are diminished or exaggerated, possibly due to cognitive impairment and lack of insight in HD. To infer affective states more objectively and overcome the limitations of self-report, we used facial EMG to measure muscle responses to emotionally-evocative scenes. Further, we examined muscle responses to emotionally-expressive faces, because facial mimicry is thought to facilitate emotion recognition and social affiliation. Twenty-three HD participants (late pre-manifest and early symptomatic) were compared to twenty-five healthy controls in a scene condition and a face condition. EMG activity was measured from facial muscles associated with expressing particular emotions: 1) corrugator supercilii for anger, 2) frontalis for fear, 3) levator labii for disgust, and 4) both zygomaticus major and orbicularis oculi for happiness. Compared to controls, HD participants showed diminished responses to disgusting scenes, and to happy and fearful faces. Our findings provide evidence for a loss of disgust experience in HD. Further, consistent with the alleged affiliative function of facial mimicry, diminished mimicry responses may be relevant to social-emotional changes in HD. Our findings help understand the neural mechanisms underlying emotion processing impairments in HD.
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Affiliation(s)
- Catarina C Kordsachia
- Monash Institute of Cognitive and Clinical Neurosciences (MICCN), School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Izelle Labuschagne
- Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Fitzroy, Melbourne, Australia
| | - Sophie C Andrews
- Monash Institute of Cognitive and Clinical Neurosciences (MICCN), School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Julie C Stout
- Monash Institute of Cognitive and Clinical Neurosciences (MICCN), School of Psychological Sciences, Monash University, Melbourne, Australia.
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19
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Garces D, El Massioui N, Lamirault C, Riess O, Nguyen HP, Brown BL, Doyère V. The Alteration of Emotion Regulation Precedes the Deficits in Interval Timing in the BACHD Rat Model for Huntington Disease. Front Integr Neurosci 2018; 12:14. [PMID: 29867384 PMCID: PMC5954136 DOI: 10.3389/fnint.2018.00014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/05/2018] [Indexed: 11/13/2022] Open
Abstract
Huntington disease (HD) is an autosomal dominantly inherited, progressive neurodegenerative disorder which is accompanied by executive dysfunctions and emotional alteration. The aim of the present study was to assess the impact of emotion/stress on on-going highly demanding cognitive tasks, i.e., temporal processing, as a function of age in BACHD rats (a “full length” model of HD). Middle-aged (4–6 months) and old (10–12 months) rats were first trained on a 2 vs. 8-s temporal discrimination task, and then exposed to a series of bisection tests under normal and stressful (10 mild unpredictable foot-shocks) conditions. The animals were then trained on a peak interval task, in which reinforced fixed-interval (FI) 30-s trials were randomly intermixed with non-reinforced probe trials. After training, the effect of stress upon time perception was again assessed. Sensitivity to foot-shocks was also assessed independently. The results show effects of both age and genotype, with largely greater effects in old BACHD animals. The older BACHD animals had impaired learning in both tasks, but reached equivalent levels of performance as WT animals at the end of training in the temporal discrimination task, while remaining impaired in the peak interval task. Whereas sensitivity to foot-shock did not differ between BACHD and WT rats, delivery of foot-shocks during the test sessions had a disruptive impact on temporal behavior in WT animals, an effect which increased with age. In contrast, BACHD rats, independent of age, did not show any significant disruption under stress. In conclusion, BACHD rats showed a disruption in temporal learning in late symptomatic animals. Age-related modification in stress-induced impairment of temporal control of behavior was also observed, an effect which was greatly reduced in BACHD animals, thus confirming previous results suggesting reduced emotional reactivity in HD animals. The results suggest a staggered onset in cognitive and emotional alterations in HD, with emotional alteration being the earliest, possibly related to different time courses of degeneration in cortico-striatal and amygdala circuits.
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Affiliation(s)
- Daniel Garces
- The Graduate Center, City University of New York, New York, NY, United States
| | - Nicole El Massioui
- Institut des Neurosciences Paris-Saclay (Neuro-PSI), Université Paris Sud, CNRS, Université Paris-Saclay, Orsay, France
| | - Charlotte Lamirault
- Institut des Neurosciences Paris-Saclay (Neuro-PSI), Université Paris Sud, CNRS, Université Paris-Saclay, Orsay, France
| | - Olaf Riess
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.,Center for Rare Diseases, University of Tübingen, Tübingen, Germany
| | - Huu P Nguyen
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.,Center for Rare Diseases, University of Tübingen, Tübingen, Germany.,Department of Human Genetics, Ruhr University Bochum, Bochum, Germany
| | - Bruce L Brown
- The Graduate Center, City University of New York, New York, NY, United States.,Queens College, City University of New York, New York, NY, United States
| | - Valérie Doyère
- Institut des Neurosciences Paris-Saclay (Neuro-PSI), Université Paris Sud, CNRS, Université Paris-Saclay, Orsay, France
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20
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Motor signatures of emotional reactivity in frontotemporal dementia. Sci Rep 2018; 8:1030. [PMID: 29348485 PMCID: PMC5773553 DOI: 10.1038/s41598-018-19528-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 01/04/2018] [Indexed: 11/18/2022] Open
Abstract
Automatic motor mimicry is essential to the normal processing of perceived emotion, and disrupted automatic imitation might underpin socio-emotional deficits in neurodegenerative diseases, particularly the frontotemporal dementias. However, the pathophysiology of emotional reactivity in these diseases has not been elucidated. We studied facial electromyographic responses during emotion identification on viewing videos of dynamic facial expressions in 37 patients representing canonical frontotemporal dementia syndromes versus 21 healthy older individuals. Neuroanatomical associations of emotional expression identification accuracy and facial muscle reactivity were assessed using voxel-based morphometry. Controls showed characteristic profiles of automatic imitation, and this response predicted correct emotion identification. Automatic imitation was reduced in the behavioural and right temporal variant groups, while the normal coupling between imitation and correct identification was lost in the right temporal and semantic variant groups. Grey matter correlates of emotion identification and imitation were delineated within a distributed network including primary visual and motor, prefrontal, insular, anterior temporal and temporo-occipital junctional areas, with common involvement of supplementary motor cortex across syndromes. Impaired emotional mimesis may be a core mechanism of disordered emotional signal understanding and reactivity in frontotemporal dementia, with implications for the development of novel physiological biomarkers of socio-emotional dysfunction in these diseases.
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