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Wang X, Zhou C, Li Y, Yang H, Sun X, Li S, Li J. Sex-dependent associations of serum BDNF, glycolipid metabolism and cognitive impairments in Parkinson's disease with depression: a comprehensive analysis. J Neural Transm (Vienna) 2024; 131:1047-1057. [PMID: 38967809 DOI: 10.1007/s00702-024-02802-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 06/25/2024] [Indexed: 07/06/2024]
Abstract
Brain-derived neurotrophic factor (BDNF) and glycolipid metabolism have been implicated in cognitive impairments and depression among Parkinson's disease (PD). However, the role of sex differences in this relationship remains elusive. This study aimed to investigate the potential sex differences in the link between serum BDNF levels, glycolipid metabolism and cognitive performance among depressive PD patients. PD patients comprising 108 individuals with depression and 108 without depression were recruited for this study. Cognitive function was assessed using the Montreal Cognitive Assessment Beijing version (MOCA-BJ). The severity of depressive symptoms was assessed using the Hamilton Depression Rating Scale (HAMD-17), while motor symptoms were evaluated using the Revised Hoehn and Yahr rating scale (H-Y) and the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III). Laboratory testing and enzyme-linked immunosorbent assay (ELISA) are used to measure serum levels of glycolipid metabolism and BDNF. Females showed superior performance in delayed recall (all p < 0.05), male PD patients exhibited higher scores in naming tasks compared to females in non-depression group. There was no sex differences in serum BDNF levels between depression and non-depression groups. Liner regression analysis indicated BDNF as an independent risk factor for language deficits in male PD patients with depression (p < 0.05), while cholesterol (CHOL) emerged as a cognitive influencing factor, particularly in delayed recall among male PD patients with depression (p < 0.05). Our study reveals extensive cognitive impairments in PD patients with depression. Moreover, BDNF and CHOL may contribute to the pathological mechanisms underlying cognitive deficits, particularly in male patients with depression.
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Affiliation(s)
- Xinxu Wang
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
- Brain Assessment & Intervention Laboratory, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Chi Zhou
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
- Tongling Third People's Hospital, Tongling, 244000, China
| | - Yanzhe Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
- Brain Assessment & Intervention Laboratory, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Hechao Yang
- Brain Assessment & Intervention Laboratory, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
- Department of Psychiatry, Tianjin Huanhu Hospital, Tianjin, 300222, China
| | - Xiaoxiao Sun
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Shen Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China.
- Brain Assessment & Intervention Laboratory, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China.
| | - Jie Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China.
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Salfi F, Toro S, Saporito G, Sucapane P, Marano M, Montaruli G, Cacchio A, Ferrara M, Pistoia F. Facial emotion recognition and judgment of affective scenes in Parkinson's disease. Heliyon 2024; 10:e32947. [PMID: 38975139 PMCID: PMC11226888 DOI: 10.1016/j.heliyon.2024.e32947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 07/09/2024] Open
Abstract
Emotional dysfunctions in Parkinson's disease (PD) remain a controversial issue. While previous investigations showed compromised recognition of expressive faces in PD, no studies evaluated potential deficits in recognizing the emotional valence of affective scenes. This study aimed to investigate both facial emotion recognition performance and the ability to judge affective scenes in PD patients. Forty PD patients (mean age ± SD: 64.50 ± 8.19 years; 27 men) and forty healthy subjects (64.95 ± 8.25 years; 27 men) were included. Exclusion criteria were previous psychiatric disorders, previous Deep Brain Stimulation, and cognitive impairment. Participants were evaluated through the Ekman 60-Faces test and the International Affective Picture System. The accuracy in recognizing the emotional valence of facial expressions and affective scenes was compared between groups using linear mixed models. Pearson's correlation was performed to test the association between accuracy measures. The groups did not differ in sex, age, education, and Mini-Mental State Examination scores. Patients showed a lower recognition accuracy of facial expressions (68.54 % ± 15.83 %) than healthy participants (78.67 % ± 12.04 %; p < 0.001). Specifically, the PD group was characterized by lower recognition of faces expressing fear, sadness, and anger than the control group (all p < 0.020). No difference was detected for faces expressing disgust, surprise, and happiness (all p ≥ 0.25). Furthermore, patients showed lower accuracy in recognizing the emotional valence of affective scenes (66.75 % ± 14.59 %) than healthy subjects (74.83 % ± 12.65 %; p = 0.010). Pearson's correlations indicated that higher accuracy in recognizing the emotional facial expressions was associated with higher accuracy in classifying the valence of affective scenes in patients (r = 0.57, p < 0.001) and control participants (r = 0.57, p < 0.001). Our study suggested maladaptive affective processing in PD, leading patients to misinterpret both facial expressions and the emotional valence of complex evocative scenes.
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Affiliation(s)
- Federico Salfi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy
| | - Stefano Toro
- Research Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, Università Campus Bio-Medico di Roma, Via Alvaro Del Portillo 21, 00128, Rome, Italy
| | - Gennaro Saporito
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy
| | - Patrizia Sucapane
- Parkinson's and Movement Disorder Center, Neurology Unit, San Salvatore Hospital, Via Lorenzo Natali 1, 67100, L'Aquila, Italy
| | - Massimo Marano
- Research Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, Università Campus Bio-Medico di Roma, Via Alvaro Del Portillo 21, 00128, Rome, Italy
| | - Gianluca Montaruli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy
| | - Angelo Cacchio
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy
| | - Francesca Pistoia
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy
- Parkinson's and Movement Disorder Center, Neurology Unit, San Salvatore Hospital, Via Lorenzo Natali 1, 67100, L'Aquila, Italy
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Burgio F, Menardi A, Benavides-Varela S, Danesin L, Giustiniani A, Van den Stock J, De Mitri R, Biundo R, Meneghello F, Antonini A, Vallesi A, de Gelder B, Semenza C. Facial emotion recognition in individuals with mild cognitive impairment: An exploratory study. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2024:10.3758/s13415-024-01160-5. [PMID: 38316707 DOI: 10.3758/s13415-024-01160-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/10/2024] [Indexed: 02/07/2024]
Abstract
Understanding facial emotions is fundamental to interact in social environments and modify behavior accordingly. Neurodegenerative processes can progressively transform affective responses and affect social competence. This exploratory study examined the neurocognitive correlates of face recognition, in individuals with two mild cognitive impairment (MCI) etiologies (prodromal to dementia - MCI, or consequent to Parkinson's disease - PD-MCI). Performance on the identification and memorization of neutral and emotional facial expressions was assessed in 31 individuals with MCI, 26 with PD-MCI, and 30 healthy controls (HC). Individuals with MCI exhibited selective impairment in recognizing faces expressing fear, along with difficulties in remembering both neutral and emotional faces. Conversely, individuals with PD-MCI showed no differences compared with the HC in either emotion recognition or memory. In MCI, no significant association emerged between the memory for facial expressions and cognitive difficulties. In PD-MCI, regression analyses showed significant associations with higher-level cognitive functions in the emotional memory task, suggesting the presence of compensatory mechanisms. In a subset of participants, voxel-based morphometry revealed that the performance on emotional tasks correlated with regional changes in gray matter volume. The performance in the matching of negative expressions was predicted by volumetric changes in brain areas engaged in face and emotional processing, in particular increased volume in thalamic nuclei and atrophy in the right parietal cortex. Future studies should leverage on neuroimaging data to determine whether differences in emotional recognition are mediated by pathology-specific atrophic patterns.
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Affiliation(s)
| | - Arianna Menardi
- Department of Neuroscience, University of Padova, 35128, Padova, Italy
- Padova Neuroscience Center, University of Padova, 35129, Padova, Italy
| | - Silvia Benavides-Varela
- Padova Neuroscience Center, University of Padova, 35129, Padova, Italy
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | | | | | - Jan Van den Stock
- Department of Neuroscience, Leuven Brain Institute, KU Leuven, 3000, Leuven, Belgium
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, 3000, Leuven, Belgium
| | | | - Roberta Biundo
- Department of General Psychology (DPG), University of Padua, 35131, Padua, Italy
- Study Center for Neurodegeneration (CESNE), University of Padua, 35131, Padua, Italy
| | - Francesca Meneghello
- Unità Operativa Complessa Cure Primarie Distretto 3 Mirano-Dolo, Aulss 3, Serenissima, Italy
| | - Angelo Antonini
- Parkinson's Disease and Movement Disorders Unit, Department of Neuroscience, Centre for Rare Neurological Diseases (ERN-RND), University of Padova, Padova, Italy
| | - Antonino Vallesi
- Department of Neuroscience, University of Padova, 35128, Padova, Italy
- Padova Neuroscience Center, University of Padova, 35129, Padova, Italy
| | - Beatrice de Gelder
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, 6200, MD, Maastricht, the Netherlands
| | - Carlo Semenza
- Department of Neuroscience, University of Padova, 35128, Padova, Italy
- Padova Neuroscience Center, University of Padova, 35129, Padova, Italy
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Trompeta C, Gasca-Salas C, Pineda-Pardo JA, Guida P, Cohn M, Mata-Marín D, Monje MH, López-Aguirre M, Obeso I, Sánchez Ferro Á. Longitudinal assessment of social cognition in de novo Parkinson's disease patients and its relationship with dopaminergic innervation. Behav Brain Res 2023; 454:114654. [PMID: 37659457 DOI: 10.1016/j.bbr.2023.114654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/10/2023] [Accepted: 08/29/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND Social Cognition (SC) has been scarcely studied in Parkinson's disease (PD), and findings in early disease are controversial. SC encompasses different capacities such as facial emotion recognition (FER); Theory of Mind (ToM), the ability to understand other people's intentions (cognitive-ToM) and emotions (affective-ToM); and self-monitoring, the ability to regulate one's own behavior in social contexts. A relationship between dopaminergic deficit and SC in PD has been suggested. OBJECTIVES To prospectively assess, over a two-year period, SC in newly diagnosed drug-naïve, cognitively normal and non-depressed PD patients. Furthermore, we aimed to evaluate the relationship between SC and Fluorodopa (Positron Emission Tomography) Ki uptake, which is a marker of dopaminergic depletion. METHODS We compared SC performance between 25 de novo PD patients and 20 healthy controls (HC), and within-patients at baseline and two-year follow-up. The SC assessment included FER, ToM, as well as self-monitoring measures. The relationship between SC and dopaminergic innervation was also assessed in patients. RESULTS SC scores did not differ between PD and HC groups at baseline, nor between baseline and follow-up evaluation in PD. A significant positive correlation between self-monitoring and Fluorodopa Ki uptake in the left pallidum in PD patients was found at baseline. At follow-up, ToM (stories) positively correlated with Fluorodopa Ki uptake in the right thalamus and the left putamen. CONCLUSION SC appears to be preserved in de novo PD and remains stable in the short-term. Although more evidence is needed, our results support a relationship between dopamine innervation in subcortical regions and SC.
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Affiliation(s)
- Clara Trompeta
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain; PhD Program in Health Sciences, University of Alcala de Henares Alcalá de Henares, Madrid 28054, Spain
| | - Carmen Gasca-Salas
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain; Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain; University CEU-San Pablo, Madrid, Spain.
| | - José A Pineda-Pardo
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain
| | - Pasqualina Guida
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain; PhD Program in Neuroscience, Autónoma de Madrid University-Cajal Institute, Madrid 28029, Spain
| | | | - David Mata-Marín
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain; PhD Program in Neuroscience, Autónoma de Madrid University-Cajal Institute, Madrid 28029, Spain
| | - Mariana Hg Monje
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain
| | - Miguel López-Aguirre
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain; PhD Program in Physics, Complutense University of Madrid, Madrid, Spain
| | - Ignacio Obeso
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain; Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | - Álvaro Sánchez Ferro
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain
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Suslow T, Lemster A, Koelkebeck K, Kersting A. Interpersonal problems and recognition of facial emotions in healthy individuals. Front Psychiatry 2023; 14:1139051. [PMID: 37139331 PMCID: PMC10149975 DOI: 10.3389/fpsyt.2023.1139051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/31/2023] [Indexed: 05/05/2023] Open
Abstract
Background Recognition of emotions in faces is important for successful social interaction. Results from previous research based on clinical samples suggest that difficulties in identifying threat-related or negative emotions can go along with interpersonal problems. The present study examined whether associations between interpersonal difficulties and emotion decoding ability can be found in healthy individuals. Our analysis was focused on two main dimensions of interpersonal problems: agency (social dominance) and communion (social closeness). Materials and methods We constructed an emotion recognition task with facial expressions depicting six basic emotions (happiness, surprise, anger, disgust, sadness, and fear) in frontal and profile view, which was administered to 190 healthy adults (95 women) with a mean age of 23.9 years (SD = 3.8) along with the Inventory of Interpersonal Problems, measures of negative affect and verbal intelligence. The majority of participants were university students (80%). Emotion recognition accuracy was assessed using unbiased hit rates. Results Negative correlations were observed between interpersonal agency and recognition of facial anger and disgust that were independent of participants' gender and negative affect. Interpersonal communion was not related to recognition of facial emotions. Discussion Poor identification of other people's facial signals of anger and disgust might be a factor contributing to interpersonal problems with social dominance and intrusiveness. Anger expressions signal goal obstruction and proneness to engage in conflict whereas facial disgust indicates a request to increase social distance. The interpersonal problem dimension of communion appears not to be linked to the ability to recognize emotions from facial expressions.
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Affiliation(s)
- Thomas Suslow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
- *Correspondence: Thomas Suslow,
| | - Alexander Lemster
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Katja Koelkebeck
- Department of Psychiatry and Psychotherapy, LVR-Hospital Essen, Institute and Hospital of the University of Duisburg-Essen, Essen, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
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Steinbach MJ, Campbell RW, DeVore BB, Harrison DW. Laterality in Parkinson's disease: A neuropsychological review. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:126-140. [PMID: 33844619 DOI: 10.1080/23279095.2021.1907392] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
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.
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Facial emotion perception and recognition deficits in acute ischemic stroke. J Clin Neurosci 2022; 106:219-225. [DOI: 10.1016/j.jocn.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/29/2022] [Accepted: 10/01/2022] [Indexed: 11/11/2022]
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Crossed functional specialization between the basal ganglia and cerebellum during vocal emotion decoding: Insights from stroke and Parkinson’s disease. COGNITIVE, AFFECTIVE, & BEHAVIORAL NEUROSCIENCE 2022; 22:1030-1043. [PMID: 35474566 PMCID: PMC9458588 DOI: 10.3758/s13415-022-01000-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 11/08/2022]
Abstract
There is growing evidence that both the basal ganglia and the cerebellum play functional roles in emotion processing, either directly or indirectly, through their connections with cortical and subcortical structures. However, the lateralization of this complex processing in emotion recognition remains unclear. To address this issue, we investigated emotional prosody recognition in individuals with Parkinson’s disease (model of basal ganglia dysfunction) or cerebellar stroke patients, as well as in matched healthy controls (n = 24 in each group). We analysed performances according to the lateralization of the predominant brain degeneration/lesion. Results showed that a right (basal ganglia and cerebellar) hemispheric dysfunction was likely to induce greater deficits than a left one. Moreover, deficits following left hemispheric dysfunction were only observed in cerebellar stroke patients, and these deficits resembled those observed after degeneration of the right basal ganglia. Additional analyses taking disease duration / time since stroke into consideration revealed a worsening of performances in patients with predominantly right-sided lesions over time. These results point to the differential, but complementary, involvement of the cerebellum and basal ganglia in emotional prosody decoding, with a probable hemispheric specialization according to the level of cognitive integration.
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Chuang YH, Tan CH, Su HC, Chien CY, Sung PS, Lee TL, Yu RL. Hypomimia May Influence the Facial Emotion Recognition Ability in Patients with Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2022; 12:185-197. [PMID: 34569974 DOI: 10.3233/jpd-212830] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hypomimia is a clinical feature of Parkinson's disease (PD). Based on the embodied simulation theory, the impairment of facial mimicry may worsen facial emotion recognition; however, the empirical results are inconclusive. OBJECTIVE We aimed to explore the worsening of emotion recognition by hypomimia. We further explored the relationship between the hypomimia, emotion recognition, and social functioning. METHODS A total of 114 participants were recruited. The patients with PD and normal controls (NCs) were matched for demographic characteristics. All the participants completed the Mini-Mental State Examination and the Chinese Multi-modalities Emotion Recognition Test. In addition to the above tests, the patients were assessed with the Movement Disorder Society-Unified Parkinson's Disease Rating Scale and Parkinson's Disease Social Functioning Scale (PDSFS). RESULTS Patients with PD with hypomimia had worse recognition of disgust than NCs (p = 0.018). The severity of hypomimia was predictive of the recognition of disgust (β= -0.275, p = 0.028). Facial emotion recognition was predictive of the PDSFS score of PD patients (β= 0.433, p = 0.001). We also found that recognizing disgust could mediate the relationship between hypomimia and the PDSFS score (β= 0.264, p = 0.045). CONCLUSION Patients with hypomimia had the worst disgust facial recognition. Hypomimia may affect the social function of PD patients, which is related to recognizing the expression of disgust. Emotion recognition training may improve the social function of patients with PD.
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Affiliation(s)
- Yu-Han Chuang
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Hsiang Tan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hui-Chen Su
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Yao Chien
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Pi-Shan Sung
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tsung-Lin Lee
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Rwei-Ling Yu
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Bernardinis M, Atashzar SF, Patel RV, Jog MS. Abnormal Vision-Based Displacement Perception in Parkinson's Disease. Front Neurosci 2021; 15:676469. [PMID: 34393703 PMCID: PMC8359811 DOI: 10.3389/fnins.2021.676469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/02/2021] [Indexed: 11/30/2022] Open
Abstract
In this work, we investigate the effect of Parkinson’s disease (PD), and common corresponding therapies on vision-based perception of motion, a critical perceptual ability required for performing a wide range of activities of daily livings. While PD has been recognized as mainly a motor disorder, sensory manifestation of PD can also play a major role in the resulting disability. In this paper, for the first time, the effect of disease duration and common therapies on vision-based perception of displacement were investigated. The study is conducted in a movement-independent manner, to reject the shadowing effects and isolate the targeted perceptual disorder to the maximum possible extent. Data was collected using a computerized graphical tool on 37 PD patients [6 early-stage de novo, 25 mid-stage using levodopa therapy, six later-stage using deep brain stimulation (DBS)] and 15 control participants. Besides the absolute measurement of perception through a psychometric analysis on two tested position reference magnitudes, we also investigated the linearity in perception using Weber’s fraction. The results showed that individuals with PD displayed significant perceptual impairments compared to controls, though early-stage patients were not impaired. Mid-stage patients displayed impairments at the greater of the two tested reference magnitudes, while late-stage patients were impaired at both reference magnitudes. Levodopa and DBS use did not cause statistically significant differences in absolute displacement perception. The findings suggest abnormal visual processing in PD increasing with disease development, perhaps contributing to sensory-based impairments of PD such as bradykinesia, visuospatial deficits, and abnormal object recognition.
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Affiliation(s)
- Matthew Bernardinis
- School of Biomedical Engineering, Western University, London, ON, Canada.,Canadian Surgical Technologies and Advanced Robotics, London Health Sciences Centre (LHSC), London, ON, Canada.,London Movement Disorders Centre, LHSC, London, ON, Canada
| | - S Farokh Atashzar
- Electrical and Computer Engineering, Mechanical and Aerospace Engineering, New York University (NYU), New York, NY, United States
| | - Rajni V Patel
- School of Biomedical Engineering, Western University, London, ON, Canada.,Canadian Surgical Technologies and Advanced Robotics, London Health Sciences Centre (LHSC), London, ON, Canada.,Department of Clinical Neurological Sciences and Electrical and Computer Engineering, Western University, London, ON, Canada
| | - Mandar S Jog
- School of Biomedical Engineering, Western University, London, ON, Canada.,London Movement Disorders Centre, LHSC, London, ON, Canada.,Department of Clinical Neurological Sciences and Electrical and Computer Engineering, Western University, London, ON, Canada
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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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Czernecki V, Benchetrit E, Houot M, Pineau F, Mangone G, Corvol JC, Vidailhet M, Levy R. Social cognitive impairment in early Parkinson's disease: A novel "mild impairment"? Parkinsonism Relat Disord 2021; 85:117-121. [PMID: 33812772 DOI: 10.1016/j.parkreldis.2021.02.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/23/2020] [Accepted: 02/15/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Social cognition (SC) deficit has recently been described in the early stages of Parkinson's disease (PD), but findings remain unclear. Our objective was to determine the frequency of SC impairment in newly-diagnosed PD patients and whether it is independent of Mild Cognitive Impairment (MCI). METHODS We enrolled 109 patients with idiopathic PD diagnosed within the previous four years (ICEBERG cohort) and 39 healthy participants. SC was evaluated using the Mini-Social Cognition and Emotional Assessment (Mini-SEA) that allows a multi-domain assessment of SC. Relationships between SC and clinical characteristics, global cognitive efficiency, mood, anxiety, apathy and impulse control disorders, were also evaluated. RESULTS 30% of patients had significant socio-emotional impairment. Moreover, SC deficit in isolation was 3.5 times more frequent than MCI in isolation (20.2% vs 5.5% respectively). Both emotion identification and Theory of Mind were impaired compared to healthy participants. No effect of age, level of education, disease severity, dopamine replacement therapy, or global cognitive efficiency were found. Only scores on the Frontal Assessment Battery were correlated with SC abilities. CONCLUSION SC impairment is frequent in early PD and should be given more consideration. It often occurs in the absence of any other cognitive disorder and may represent the most common neuropsychological deficit in early-stage PD. In line with the definition of PD-MCI criteria, we consider the addition of a sixth MCI sub-type termed "Mild Social Cognition Impairment (MSCI)". Further studies are required to validate the addition of this new MCI domain.
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Affiliation(s)
- Virginie Czernecki
- Sorbonne Université, Inserm, CNRS, Institut du Cerveau - Paris Brain Institute - ICM, Paris, France; Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France.
| | - Eve Benchetrit
- Clinical Investigation Center for Neurosciences, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
| | - Marion Houot
- Clinical Investigation Center for Neurosciences, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France; Institute of Memory and Alzheimer's Disease (IM2A), Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France; Centre of Excellence of Neurodegenerative Disease (CoEN), Pitié-Salpêtrière Hospital, Paris, France
| | - Fanny Pineau
- Clinical Investigation Center for Neurosciences, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France; Institute of Memory and Alzheimer's Disease (IM2A), Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
| | - Graziella Mangone
- Sorbonne Université, Inserm, CNRS, Institut du Cerveau - Paris Brain Institute - ICM, Paris, France; Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France; Clinical Investigation Center for Neurosciences, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
| | - Jean-Christophe Corvol
- Sorbonne Université, Inserm, CNRS, Institut du Cerveau - Paris Brain Institute - ICM, Paris, France; Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France; Clinical Investigation Center for Neurosciences, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
| | - Marie Vidailhet
- Sorbonne Université, Inserm, CNRS, Institut du Cerveau - Paris Brain Institute - ICM, Paris, France; Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France; Clinical Investigation Center for Neurosciences, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
| | - Richard Levy
- Sorbonne Université, Inserm, CNRS, Institut du Cerveau - Paris Brain Institute - ICM, Paris, France; Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France; Institute of Memory and Alzheimer's Disease (IM2A), Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
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13
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Mood and emotional disorders associated with parkinsonism, Huntington disease, and other movement disorders. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:175-196. [PMID: 34389117 DOI: 10.1016/b978-0-12-822290-4.00015-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This chapter provides a review of mood, emotional disorders, and emotion processing deficits associated with diseases that cause movement disorders, including Parkinson's disease, Lewy body dementia, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, frontotemporal dementia with parkinsonism, Huntington's disease, essential tremor, dystonia, and tardive dyskinesia. For each disorder, a clinical description of the common signs and symptoms, disease progression, and epidemiology is provided. Then the mood and emotional disorders associated with each of these diseases are described and discussed in terms of clinical presentation, incidence, prevalence, and alterations in quality of life. Alterations of emotion communication, such as affective speech prosody and facial emotional expression, associated with these disorders are also discussed. In addition, if applicable, deficits in gestural and lexical/verbal emotion are reviewed. Throughout the chapter, the relationships among mood and emotional disorders, alterations of emotional experiences, social communication, and quality of life, as well as treatment, are emphasized.
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Crispino P, Gino M, Barbagelata E, Ciarambino T, Politi C, Ambrosino I, Ragusa R, Marranzano M, Biondi A, Vacante M. Gender Differences and Quality of Life in Parkinson's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E198. [PMID: 33383855 PMCID: PMC7795924 DOI: 10.3390/ijerph18010198] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/05/2020] [Accepted: 12/26/2020] [Indexed: 12/15/2022]
Abstract
Parkinson's disease has been found to significantly affect health-related quality of life. The gender differences of the health-related quality of life of subjects with Parkinson's disease have been observed in a number of studies. These differences have been reported in terms of the age at onset, clinical manifestations, and response to therapy. In general, women with Parkinson's disease showed more positive disease outcomes with regard to emotion processing, non-motor symptoms, and cognitive functions, although women report more Parkinson's disease-related clinical manifestations. Female gender predicted poor physical functioning and socioemotional health-related quality of life, while male gender predicted the cognitive domain of health-related quality of life. Some studies reported gender differences in the association between health-related quality of life and non-motor symptoms. Depression and fatigue were the main causes of poorer health-related quality of life in women, even in the early stages of Parkinson's disease. The aim of this review was to collect the best available evidence on gender differences in the development of Parkinson's disease symptoms and health-related quality of life.
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Affiliation(s)
- Pietro Crispino
- Internal Medicine Department, Lagonegro Hospital, 85042 Lagonegro (PZ), Italy;
| | - Miriam Gino
- Department of Internal Medicine, Rivoli Hospital, 10098 Rivoli (TO), Italy;
| | - Elena Barbagelata
- Department of Internal Medicine, ASL 4 Chiavarese, Sestri Levante Hospital, 16039 Sestri Levante (GE), Italy;
| | - Tiziana Ciarambino
- Department of Medical, Surgical, Neurological, Metabolic and Geriatrics Sciences, Marcianise Hospital, ASL Caserta, University of Campania “L. Vanvitelli”, 81025 Naples, Italy;
| | - Cecilia Politi
- Department of Internal Medicine, Veneziale Hospital, 86170 Isernia, Italy;
| | | | - Rosalia Ragusa
- Health Technology Assessment Committee, University Hospital G. Rodolico, 95123 Catania, Italy;
| | - Marina Marranzano
- Department of Medical, Surgical and Advanced Sciences, University of Catania, 95123 Catania, Italy;
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy;
| | - Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy;
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15
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Johnson C, Langbehn KE, Long JD, Moser D, Cross S, Gutmann L, Nopoulos PC, van der Plas E. Encoding of facial expressions in individuals with adult-onset myotonic dystrophy type 1. J Clin Exp Neuropsychol 2020; 42:932-940. [PMID: 33028165 PMCID: PMC7676461 DOI: 10.1080/13803395.2020.1826410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 09/13/2020] [Indexed: 10/23/2022]
Abstract
Introduction: Emotional issues are often reported among individuals with myotonic dystrophy type 1 (DM1) and some studies have suggested that deficits in ability to quickly encode emotions may contribute to these problems. However, poor performance on emotion encoding tasks could also be explained by a more general cognitive deficit (Full Scale IQ [FSIQ]), rather than a specific deficit in emotional processing. Since individuals with DM1 are known to exhibit difficulties in general cognitive abilities, it is important to account for FSIQ when evaluating emotion encoding. The aim of this study was to compare emotion encoding abilities between individuals with and without DM1, while adjusting for the impact of general cognitive abilities (FSIQ). Methods: The sample included 35 individuals with adult-onset DM1 and 54 unaffected adults who completed assessments of emotion encoding abilities (Ekman faces test) and general cognitive abilities (Wechsler Adult Intelligence Scale-IV). Performance on the emotion encoding task was operationalized as proportion correct and response time. Group differences in proportion correct were evaluated with generalized linear regression, while linear regression models were used to determine the effect of group on response time. Models were adjusted for age, sex, and FSIQ. The false discovery rate (FDR) was applied to control false positives due to multiple comparisons (pfdr ). Results: No significant group differences were observed for emotion encoding abilities (all pfdr > 0.13). FSIQ was significantly associated with proportion correct and with response time (all pfdr < 0.05). Conclusions: Emotion encoding appears intact in individuals with DM1 and variation in the ability to encode facial expressions was associated with FSIQ. Further research is required to address the relationship between general cognitive abilities and emotion encoding abilities among DM1 patients.
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Affiliation(s)
- Claire Johnson
- Department of Psychiatry, University of Iowa Hospitals & Clinics, Iowa City IA, USA
| | - Kathleen E. Langbehn
- Department of Psychiatry, University of Iowa Hospitals & Clinics, Iowa City IA, USA
| | - Jeff D. Long
- Department of Psychiatry, University of Iowa Hospitals & Clinics, Iowa City IA, USA
| | - David Moser
- Department of Psychiatry, University of Iowa Hospitals & Clinics, Iowa City IA, USA
| | - Stephen Cross
- Department of Psychiatry, University of Iowa Hospitals & Clinics, Iowa City IA, USA
| | - Laurie Gutmann
- Department of Neurology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Peggy C. Nopoulos
- Department of Psychiatry, University of Iowa Hospitals & Clinics, Iowa City IA, USA
| | - Ellen van der Plas
- Department of Psychiatry, University of Iowa Hospitals & Clinics, Iowa City IA, USA
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Effects of Subthalamic Nucleus Deep Brain Stimulation on Facial Emotion Recognition in Parkinson's Disease: A Critical Literature Review. Behav Neurol 2020; 2020:4329297. [PMID: 32724481 PMCID: PMC7382738 DOI: 10.1155/2020/4329297] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/12/2020] [Indexed: 01/04/2023] Open
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective therapy for Parkinson's disease (PD). Nevertheless, DBS has been associated with certain nonmotor, neuropsychiatric effects such as worsening of emotion recognition from facial expressions. In order to investigate facial emotion recognition (FER) after STN DBS, we conducted a literature search of the electronic databases MEDLINE and Web of science. In this review, we analyze studies assessing FER after STN DBS in PD patients and summarize the current knowledge of the effects of STN DBS on FER. The majority of studies, which had clinical and methodological heterogeneity, showed that FER is worsening after STN DBS in PD patients, particularly for negative emotions (sadness, fear, anger, and tendency for disgust). FER worsening after STN DBS can be attributed to the functional role of the STN in limbic circuits and the interference of STN stimulation with neural networks involved in FER, including the connections of the STN with the limbic part of the basal ganglia and pre- and frontal areas. These outcomes improve our understanding of the role of the STN in the integration of motor, cognitive, and emotional aspects of behaviour in the growing field of affective neuroscience. Further studies using standardized neuropsychological measures of FER assessment and including larger cohorts are needed, in order to draw definite conclusions about the effect of STN DBS on emotional recognition and its impact on patients' quality of life.
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17
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Mattavelli G, Barvas E, Longo C, Zappini F, Ottaviani D, Malaguti MC, Pellegrini M, Papagno C. Facial expressions recognition and discrimination in Parkinson's disease. J Neuropsychol 2020; 15:46-68. [PMID: 32319735 DOI: 10.1111/jnp.12209] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 10/03/2020] [Indexed: 12/29/2022]
Abstract
Emotion processing impairment is a common non-motor symptom in Parkinson's Disease (PD). Previous literature reported conflicting results concerning, in particular, the performance for different emotions, the relation with cognitive and neuropsychiatric symptoms and the affected stage of processing. This study aims at assessing emotion recognition and discrimination in PD. Recognition of six facial expressions was studied in order to clarify its relationship with motor, cognitive and neuropsychiatric symptoms. Sensitivity in discriminating happy and fearful faces was investigated to address controversial findings on impairment in early stages of emotion processing. To do so, seventy PD patients were tested with the Ekman 60 Faces test and compared with 46 neurologically unimpaired participants. Patients' performances were correlated with clinical scales and neuropsychological tests. A subsample of 25 PD patients and 25 control participants were also tested with a backward masking paradigm for sensitivity in happiness and fear discrimination. Results showed that PD patients were impaired in facial emotion recognition, especially for fearful expressions. The performance correlated with perceptual, executive and general cognitive abilities, but facial expression recognition deficits were present even in cognitively unimpaired patients. In contrast, patients' sensitivity in backward masking tasks was not reduced as compared to controls. Taken together our data demonstrate that facial emotion recognition, and fear expression in particular, is critically affected by neurodegeneration in PD and related to cognitive abilities; however, it appears before other cognitive impairments. Preserved performances in discriminating shortly presented facial expressions, suggest unimpaired early stages of emotion processing.
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Affiliation(s)
| | - Edoardo Barvas
- CeRiN, Centro di Riabilitazione Neurocognitiva, CIMeC, Università di Trento, Rovereto, Italy
| | - Chiara Longo
- CeRiN, Centro di Riabilitazione Neurocognitiva, CIMeC, Università di Trento, Rovereto, Italy
| | - Francesca Zappini
- CeRiN, Centro di Riabilitazione Neurocognitiva, CIMeC, Università di Trento, Rovereto, Italy
| | - Donatella Ottaviani
- Unità Operativa di Neurologia, Ospedale Santa Maria del Carmine, Azienda Provinciale per i Servizi Sanitari, Rovereto, Italy
| | | | - Maria Pellegrini
- Dipartimento di Scienze Neurologiche, Ospedale Santa Chiara, Trento, Italy
| | - Costanza Papagno
- CeRiN, Centro di Riabilitazione Neurocognitiva, CIMeC, Università di Trento, Rovereto, Italy.,Dipartimento di Psicologia, Università degli studi di Milano-Bicocca, Milano, Italy
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18
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Guo J, Ma Y, Liu Z, Wang F, Hou X, Chen J, Hong Y, Xu S, Liu X. Performance of facial expression classification tasks in patients with obstructive sleep apnea. J Clin Sleep Med 2020; 16:523-530. [PMID: 32003740 DOI: 10.5664/jcsm.8256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES People show a facial recognition speed advantage, termed positive classification advantage (PCA), when judging whether a facial expression is happy compared to angry or sad. This study investigated emotional face recognition by patients with obstructive sleep apnea (OSA) with impaired neurocognition. METHODS Thirty-four patients with OSA and 26 healthy control patients who underwent 1 night of polysomnographic evaluation before recruitment were asked to complete an emotion recognition task. Accuracy rates and reaction times were recorded and analyzed using repeated-measures analysis of variance. RESULTS When participants were asked to classify positive (happy) versus negative (sad) emotional expressions, the phenomenon of PCA disappeared. Importantly, however, compared with the control patients who showed PCA, patients with OSA identified sad faces faster but were similar in processing happy faces. CONCLUSIONS In accordance with previous studies that showed depressive emotion in patients with OSA, our results indicate that patients with OSA show negative bias in facial expression recognition, which might lead to decline in ability of social communication.
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Affiliation(s)
- Junfeng Guo
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Department of Rehabilitation, Weihai Municipal Hospital, Shandong University, Shandong, China
| | - Yingjuan Ma
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Zhenhua Liu
- Center of Sleep Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Fumin Wang
- Center of Sleep Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Xunyao Hou
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Jian Chen
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Yan Hong
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Song Xu
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Xueping Liu
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
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Abstract
BACKGROUND Individuals with Parkinson disease (PD) display cognitive dysfunction. However, few studies have investigated how facial and musical emotion recognition are affected in individuals with PD. OBJECTIVE To explore the relationship between facial and musical emotion recognition and executive functions in Chinese individuals with PD. METHODS We showed 40 Chinese individuals with PD and 40 Chinese healthy controls 24 black-and-white portraits and 24 musical excerpts that were designed to express happiness, sadness, fear, and anger. Then, we used four tests to assess the participants' executive functions, including the Trail Making Test (TMT), Clock Drawing Test (CDT), semantic Verbal Fluency Test (VFT), and Digit Span Test (DST). RESULTS The PD group showed significant impairment in recognizing anger from facial expressions, although their emotion recognition from musical excerpts was similar to that of the control group. Recognition of an angry face was significantly correlated to scores on the TMT and DST. Recognition of happy music was significantly correlated to the Hamilton Rating Scale for Depression score, whereas recognition of angry music was significantly correlated to musical knowledge background. Recognition of happy, sad, or angry music was significantly correlated to tests of executive function, whereas recognition of fearful music was not. CONCLUSIONS The PD group showed impaired recognition of angry faces, which may be related to executive dysfunction. However, the PD group did not show any difficulties in recognizing emotions in music. This dissociation indicates that the mechanisms underlying the recognition of emotions in faces and music are partly independent.
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20
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Vogel A, Jørgensen K, Larsen IU. Normative data for Emotion Hexagon test and frequency of impairment in behavioral variant frontotemporal dementia, Alzheimer's disease and Huntington's disease. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:127-132. [PMID: 32058804 DOI: 10.1080/23279095.2020.1720686] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Social cognitive functions such as Theory of Mind, empathy and emotion recognition can be impaired in dementia spectrum disorders, especially in diseases with prominent frontal dysfunction. The Emotion Hexagon test (EHT) is a short test of basic emotion recognition. As with other social cognitive tests, normative data for this test is sparse. The aim of this study was to present regression-based normative data for the EHT. Further, we wished to investigate the frequency of impairment in patients with the behavioral variant of frontotemporal dementia (bvFTD, N = 11), Alzheimer's disease (AD, N = 44) and Huntington's disease (HD, N = 52) when using regression-based normative data. The results documented that age (but not gender or education) had a significant effect on EHT score. The effect of age had numerical impact on expected scores in persons older than 60 years. Normative data (including percentile estimates) are presented. The EHT is sensitive to impairment in both bvFTD and HD, where more than 80% of patients had lower scores than expected. In both groups, 54% of patients fell below the 5th percentile-estimate, and in HD 65% fell below the 10th percentile-estimate. In the AD group 25% fell below the 10th percentile-estimate, and 14% fell below the 5th percentile-estimate. In conclusion, very low scores are typically associated with HD and bvFTD, but very poor performances can also be found in other diseases such like AD. Hopefully, the normative data presented and the documentation of their validity in clinical practice is a useful tool for clinicians.
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Affiliation(s)
- Asmus Vogel
- Department of Neurology, Danish Dementia Research Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Kasper Jørgensen
- Department of Neurology, Danish Dementia Research Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ida Unmack Larsen
- Department of Neurology, Danish Dementia Research Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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21
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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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22
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Wagenbreth C, Kuehne M, Heinze HJ, Zaehle T. Deep Brain Stimulation of the Subthalamic Nucleus Influences Facial Emotion Recognition in Patients With Parkinson's Disease: A Review. Front Psychol 2019; 10:2638. [PMID: 31849760 PMCID: PMC6901782 DOI: 10.3389/fpsyg.2019.02638] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 11/08/2019] [Indexed: 12/17/2022] Open
Abstract
Parkinson’s disease (PD) is a neurodegenerative disorder characterized by motor symptoms following dopaminergic depletion in the substantia nigra. Besides motor impairments, however, several non-motor detriments can have the potential to considerably impact subjectively perceived quality of life in patients. Particularly emotion recognition of facial expressions has been shown to be affected in PD, and especially the perception of negative emotions like fear, anger, or disgust is impaired. While emotion processing generally refers to automatic implicit as well as conscious explicit processing, the focus of most previous studies in PD was on explicit recognition of emotions only, while largely ignoring implicit processing deficits. Deep brain stimulation of the subthalamic nucleus (STN-DBS) is widely accepted as a therapeutic measure in the treatment of PD and has been shown to advantageously influence motor problems. Among various concomitant non-motor effects of STN-DBS, modulation of facial emotion recognition under subthalamic stimulation has been investigated in previous studies with rather heterogeneous results. Although there seems to be a consensus regarding the processing of disgust, which significantly deteriorates under STN stimulation, findings concerning emotions like fear or happiness report heterogeneous data and seem to depend on various experimental settings and measurements. In the present review, we summarized previous investigations focusing on STN-DBS influence on recognition of facial emotional expressions in patients suffering from PD. In a first step, we provide a synopsis of disturbances and problems in facial emotion processing observed in patients with PD. Second, we present findings of STN-DBS influence on facial emotion recognition and especially highlight different impacts of stimulation on implicit and explicit emotional processing.
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Affiliation(s)
- Caroline Wagenbreth
- Department of Neurology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Maria Kuehne
- Department of Neurology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Hans-Jochen Heinze
- Department of Neurology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Tino Zaehle
- Department of Neurology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
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Bek J, Poliakoff E, Lander K. Measuring emotion recognition by people with Parkinson's disease using eye-tracking with dynamic facial expressions. J Neurosci Methods 2019; 331:108524. [PMID: 31747554 DOI: 10.1016/j.jneumeth.2019.108524] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 10/23/2019] [Accepted: 11/16/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Motion is an important cue to emotion recognition, and it has been suggested that we recognize emotions via internal simulation of others' expressions. There is a reduction of facial expression in Parkinson's disease (PD), which may influence the ability to use motion to recognise emotions in others. However, the majority of previous work in PD has used only static expressions. Moreover, few studies have used eye-tracking to explore emotion processing in PD. NEW METHOD We measured accuracy and eye movements in people with PD and healthy controls when identifying emotions from both static and dynamic facial expressions. RESULTS The groups did not differ overall in emotion recognition accuracy, but motion significantly increased recognition only in the control group. Participants made fewer and longer fixations when viewing dynamic expressions, and interest area analysis revealed increased gaze to the mouth region and decreased gaze to the eyes for dynamic stimuli, although the latter was specific to the control group. COMPARISON WITH EXISTING METHODS Ours is the first study to directly compare recognition of static and dynamic emotional expressions in PD using eye-tracking, revealing subtle differences between groups that may otherwise be undetected. CONCLUSIONS It is feasible and informative to use eye-tracking with dynamic expressions to investigate emotion recognition in PD. Our findings suggest that people with PD may differ from healthy older adults in how they utilise motion during facial emotion recognition. Nonetheless, gaze patterns indicate some effects of motion on emotional processing, highlighting the need for further investigation in this area.
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Affiliation(s)
- Judith Bek
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK.
| | - Ellen Poliakoff
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK.
| | - Karen Lander
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK.
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Tsatali M, Overton PG, Vivas AB. Self-reported and experimentally induced self-disgust is heightened in Parkinson's disease: Contribution of behavioural symptoms. PLoS One 2019; 14:e0223663. [PMID: 31618239 PMCID: PMC6799866 DOI: 10.1371/journal.pone.0223663] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 09/25/2019] [Indexed: 12/14/2022] Open
Abstract
Parkinson’s disease (PD) is associated with deficits in the recognition and expression of basic emotions, although self-reported levels of the self-conscious emotions shame and embarrassment are higher. However, one self-conscious emotion—self-disgust–which has been shown to have a negative impact on psychological wellbeing, has not been investigated in PD before. Here we employed self-report measures of self-conscious emotions, and an emotion induction paradigm involving images of the self, and narrated personal vignettes of instances when patients with PD (and controls) found themselves disgusting. We found that self-reported and induced levels of self-disgust were higher in PD patients than in matched controls, and that trait self-disgust was specifically related to disorders of impulse control in PD patients. Given the link between self-disgust and impaired psychological wellbeing, and the prevalence of anxiety and depression in PD, self-disgust might make a useful therapeutic target for psychological interventions in the condition.
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Affiliation(s)
- Marianna Tsatali
- South East European Research Center, SEERC, Thessaloniki, Greece
| | - Paul G. Overton
- Psychology Department, University of Sheffield, Sheffield, United Kingdom
| | - Ana B. Vivas
- Psychology Department, The University of Sheffield International Faculty, City College, Thessaloniki, Greece
- * E-mail:
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Deep Brain Stimulation of the Subthalamic Nucleus Selectively Modulates Emotion Recognition of Facial Stimuli in Parkinson's Patients. J Clin Med 2019; 8:jcm8091335. [PMID: 31466414 PMCID: PMC6781243 DOI: 10.3390/jcm8091335] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 08/23/2019] [Accepted: 08/27/2019] [Indexed: 01/05/2023] Open
Abstract
: Background: Diminished emotion recognition is a known symptom in Parkinson (PD) patients and subthalamic nucleus deep brain stimulation (STN-DBS) has been shown to further deteriorate the processing of especially negative emotions. While emotion recognition generally refers to both, implicit and explicit processing, demonstrations of DBS-influences on implicit processing are sparse. In the present study, we assessed the impact of STN-DBS on explicit and implicit processing for emotional stimuli. METHODS Under STN-DBS ON and OFF, fourteen PD patients performed an implicit as well as an explicit emotional processing task. To assess implicit emotional processing, patients were tested with a lexical decision task (LTD) combined with an affective priming paradigm, which provides emotional content through the facial eye region. To assess explicit emotional processing, patients additionally explicitly rated the emotional status of eyes and words used in the implicit task. RESULTS DBS affected explicit emotional processing more than implicit processing with a more pronounced effect on error rates than on reaction speed. STN-DBS generally worsened implicit and explicit processing for disgust stimulus material but improved explicit processing of fear stimuli. CONCLUSIONS This is the first study demonstrating influences of STN-DBS on explicit and implicit emotion processing in PD patients. While STN stimulation impeded the processing of disgust stimuli, it improved explicit discrimination of fear stimuli.
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26
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Costabile T, Capretti V, Abate F, Liguori A, Paciello F, Pane C, De Rosa A, Peluso S, De Michele G, Filla A, Saccà F. Emotion Recognition and Psychological Comorbidity in Friedreich's Ataxia. THE CEREBELLUM 2019; 17:336-345. [PMID: 29327279 DOI: 10.1007/s12311-018-0918-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Friedreich's ataxia (FRDA) is an autosomal recessive disease presenting with ataxia, corticospinal signs, peripheral neuropathy, and cardiac abnormalities. Little effort has been made to understand the psychological and emotional burden of the disease. The aim of our study was to measure patients' ability to recognize emotions using visual and non-verbal auditory hints, and to correlate this ability with psychological, neuropsychological, and neurological variables. We included 20 patients with FRDA, and 20 age, sex, and education matched healthy controls (HC). We measured emotion recognition using the Geneva Emotion Recognition Test (GERT). Neuropsychological status was assessed measuring memory, executive functions, and prosopagnosia. Psychological tests were Patient Health Questionnaire-9 (PHQ-9), State Trait Anxiety Inventory-state/-trait (STAI-S/-T), and Structured Clinical Interview for DSM Disorders II. FRDA patients scored worse at the global assessment and showed impaired immediate visuospatial memory and executive functions. Patients presented lower STAI-S scores, and similar scores at the STAI-T, and PHQ-9 as compared to HC. Three patients were identified with personality disorders. Emotion recognition was impaired in FRDA with 29% reduction at the total GERT score (95% CI - 44.8%, - 12.6%; p < 0.001; Cohen's d = 1.2). Variables associated with poor GERT scores were the 10/36 spatial recall test, the Ray Auditory Verbal Learning Test, the Montreal Cognitive Assessment, and the STAI-T (R2 = 0.906; p < 0.001). FRDA patients have impaired emotion recognition that may be secondary to neuropsychological impairment. Depression and anxiety were not higher in FRDA as compared to HC and should not be considered as part of the disease.
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Affiliation(s)
- Teresa Costabile
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University "Federico II", Via Pansini, 5, 80131, Naples, NA, Italy
| | - Veronica Capretti
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University "Federico II", Via Pansini, 5, 80131, Naples, NA, Italy
| | - Filomena Abate
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University "Federico II", Via Pansini, 5, 80131, Naples, NA, Italy
| | - Agnese Liguori
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University "Federico II", Via Pansini, 5, 80131, Naples, NA, Italy
| | - Francesca Paciello
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University "Federico II", Via Pansini, 5, 80131, Naples, NA, Italy
| | - Chiara Pane
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University "Federico II", Via Pansini, 5, 80131, Naples, NA, Italy
| | - Anna De Rosa
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University "Federico II", Via Pansini, 5, 80131, Naples, NA, Italy
| | - Silvio Peluso
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University "Federico II", Via Pansini, 5, 80131, Naples, NA, Italy
| | - Giuseppe De Michele
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University "Federico II", Via Pansini, 5, 80131, Naples, NA, Italy
| | - Alessandro Filla
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University "Federico II", Via Pansini, 5, 80131, Naples, NA, Italy
| | - Francesco Saccà
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University "Federico II", Via Pansini, 5, 80131, Naples, NA, Italy.
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27
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Coundouris SP, Adams AG, Grainger SA, Henry JD. Social perceptual function in parkinson's disease: A meta-analysis. Neurosci Biobehav Rev 2019; 104:255-267. [PMID: 31336113 DOI: 10.1016/j.neubiorev.2019.07.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/16/2019] [Accepted: 07/18/2019] [Indexed: 12/20/2022]
Abstract
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.
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Affiliation(s)
| | | | - Sarah A Grainger
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Julie D Henry
- School of Psychology, University of Queensland, Brisbane, Australia
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28
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Maremmani C, Monastero R, Orlandi G, Salvadori S, Pieroni A, Baschi R, Pecori A, Dolciotti C, Berchina G, Rovini E, Cuddemi F, Cavallo F. Objective assessment of blinking and facial expressions in Parkinson's disease using a vertical electro-oculogram and facial surface electromyography. Physiol Meas 2019; 40:065005. [PMID: 31018181 DOI: 10.1088/1361-6579/ab1c05] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Hypomimia is a common and early symptom of Parkinson's disease (PD), which reduces the ability of PD patients to manifest emotions. Currently, it is visually evaluated by the neurologist during neurological examinations for PD diagnosis, as described in task 3.2 of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Since such an evaluation is semi-quantitative and affected by inter-variability, this paper aims to measure the physiological parameters related to eye blink and facial expressions extracted from a vertical electro-oculogram (VEOG) and facial surface electromyography (fsEMG) to differentiate PD patients from healthy control subjects (HCs). APPROACH The spontaneous eye blink rate-minute (sEBR), its maximum amplitude (BMP), and facial cutaneous muscle activity were measured in 24 PD patients and 24 HCs while the subjects looked at a visual-tester composed of three main parts: static vision, dynamic vision and reading silently. Specificity and sensitivity for each parameter were calculated. MAIN RESULTS The VEOG and the fsEMG allowed the identification of some parameters related to eye blink and facial expressions (i.e. sEBR, BMP, frontal and peribuccal muscular activities), being able to distinguish between PD patients and HCs with high sensitivity and specificity. SIGNIFICANCE The demonstration that the combination of parameters related to eye blink and facial expressions can discriminate (with high accuracy) between PD patients versus HCs, thus resulting in a useful tool to support the neurologist in objective assessment of hypomimia for improving PD diagnosis.
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Affiliation(s)
- Carlo Maremmani
- Unità Operativa di Neurologia, Laboratorio Congiunto di Neuro-Biorobotica, Ospedale delle Apuane, Azienda USL Toscana Nord Ovest, Massa, Italia
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29
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Harper SA, Dowdell BT, Kim JH, Pollock BS, Ridgel AL. Non-Motor Symptoms after One Week of High Cadence Cycling in Parkinson's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2104. [PMID: 31197095 PMCID: PMC6616554 DOI: 10.3390/ijerph16122104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/10/2019] [Accepted: 06/12/2019] [Indexed: 12/23/2022]
Abstract
The objective was to investigate if high cadence cycling altered non-motor cognition and depression symptoms in individuals with Parkinson's disease (PD) and whether exercise responses were influenced by brain-derived neurotrophic factor (BDNF) Val66Met polymorphism. Individuals with idiopathic PD who were ≥50 years old and free of surgical procedures for PD were recruited. Participants were assigned to either a cycling (n = 20) or control (n = 15) group. The cycling group completed three sessions of high cadence cycling on a custom motorized stationary ergometer. The primary outcome was cognition (attention, executive function, and emotion recognition were assessed via WebNeuro® and global cognition via Montreal Cognitive Assessment). Depression symptoms were assessed via Beck Depression Inventory-II. There was a main effect of time for emotional recognition (p = 0.048), but there were no other changes in cognition or depression symptoms. Regardless of intervention or Val66Met polymorphism, high cadence cycling does not alter cognition or depression symptoms after three sessions in one week.
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Affiliation(s)
- Sara A Harper
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL 35205, USA.
- Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL 35205, USA.
| | - Bryan T Dowdell
- Exercise Physiology Department, Kent State University, Kent, OH 44240, USA.
| | - Jin Hyun Kim
- Exercise Physiology Department, Kent State University, Kent, OH 44240, USA.
| | - Brandon S Pollock
- Department of Exercise Science, Walsh University, North Canton, OH 44720, USA.
| | - Angela L Ridgel
- Exercise Physiology Department, Kent State University, Kent, OH 44240, USA.
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30
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Kang J, Derva D, Kwon DY, Wallraven C. Voluntary and spontaneous facial mimicry toward other's emotional expression in patients with Parkinson's disease. PLoS One 2019; 14:e0214957. [PMID: 30973893 PMCID: PMC6459535 DOI: 10.1371/journal.pone.0214957] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/23/2019] [Indexed: 01/31/2023] Open
Abstract
A "masked face", that is, decreased facial expression is considered as one of the cardinal symptoms among individuals with Parkinson's disease (PD). Both spontaneous and voluntary mimicry toward others' emotional expressions is essential for both social communication and emotional sharing with others. Despite many studies showing impairments in facial movements in PD in general, it is still unclear whether voluntary, spontaneous, or both types of mimicry are affected and how the impairments affect the patients' quality of life. We investigated to verify whether impairments in facial movements happen for spontaneous as well as for voluntary expressions by quantitatively comparing muscle activations using surface electromyography. Dynamic facial expressions of Neutral, Anger, Joy, and Sad were presented during recordings in corrugator and zygomatic areas. In the spontaneous condition, participants were instructed to simply watch clips, whereas in the voluntary condition they were instructed to actively mimic the stimuli. We found that PD patients showed decreased mimicry in both spontaneous and voluntary conditions compared to a matched control group, although movement patterns in each emotion were similar in the two groups. Moreover, whereas the decrease in mimicry correlated with the decrease not in a health-related quality of life index (PDQ), it did so in a more subjective measurement of general quality of life index (SWB). The correlation between facial mimicry and subjective well-being index suggests that the 'masked face' symptom deteriorates patients' quality of life in a complex way affecting social and psychological aspects, which in turn may be linked to the increased depression risk among individuals with PD.
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Affiliation(s)
- June Kang
- Korea University, Department of Brain and Cognitive Engineering, Seoul, South Korea
- Empathy Research Institute, Seoul, South Korea
| | - Dilara Derva
- Korea University, Department of Brain and Cognitive Engineering, Seoul, South Korea
| | - Do-Young Kwon
- Korea University Ansan hospital, Department of Neurology, Ansan City, South Korea
| | - Christian Wallraven
- Korea University, Department of Brain and Cognitive Engineering, Seoul, South Korea
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31
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A survey on computer-assisted Parkinson's Disease diagnosis. Artif Intell Med 2019; 95:48-63. [DOI: 10.1016/j.artmed.2018.08.007] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 06/14/2018] [Accepted: 08/25/2018] [Indexed: 12/28/2022]
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32
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Benzagmout M, Boujraf S, Alami B, Amadou HA, El Hamdaoui H, Bennani A, Jaafari M, Rammouz I, Maaroufi M, Magoul R, Boussaoud D. Emotion processing in Parkinson's disease: a blood oxygenation level-dependent functional magnetic resonance imaging study. Neural Regen Res 2019; 14:666-672. [PMID: 30632507 PMCID: PMC6352597 DOI: 10.4103/1673-5374.247470] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Mohammed Benzagmout
- Laboratory of Clinical Neuroscience, Faculty of Medicine; Department of Neurosurgery, University Hospital of Fez; Laboratory of Neuroendocrinology and Nutritional and Climatic Environment, Faculty of Sciences Dhar El Mahraz, Fez, Morocco
| | - Saïd Boujraf
- Laboratory of Clinical Neuroscience, Faculty of Medicine; Department of Biophysics and Clinical MRI Methods, Faculty of Medicine; Department of Radiology and Clinical Imaging, University Hospital of Fez, Fez, Morocco
| | - Badreeddine Alami
- Laboratory of Clinical Neuroscience, Faculty of Medicine; Department of Biophysics and Clinical MRI Methods, Faculty of Medicine; Department of Radiology and Clinical Imaging, University Hospital of Fez, Fez, Morocco
| | - Hassane Ali Amadou
- Laboratory of Clinical Neuroscience, Faculty of Medicine; Department of Neurosurgery, University Hospital of Fez, Fez, Morocco
| | - Halima El Hamdaoui
- Laboratory of Clinical Neuroscience, Faculty of Medicine; Department of Biophysics and Clinical MRI Methods, Faculty of Medicine, Fez, Morocco
| | - Amine Bennani
- Laboratory of Clinical Neuroscience, Faculty of Medicine, Fez, Morocco
| | - Mounir Jaafari
- Laboratory of Clinical Neuroscience, Faculty of Medicine; Department of Psychiatry, University Hospital of Fez, Fez, Morocco
| | - Ismail Rammouz
- Laboratory of Clinical Neuroscience, Faculty of Medicine; Department of Psychiatry, University Hospital of Fez, Fez, Morocco
| | - Mustapha Maaroufi
- Laboratory of Clinical Neuroscience, Faculty of Medicine; Department of Radiology and Clinical Imaging, University Hospital of Fez, Fez, Morocco
| | - Rabia Magoul
- Laboratory of Neuroendocrinology and Nutritional and Climatic Environment, Faculty of Sciences Dhar El Mahraz, Fez, Morocco
| | - Driss Boussaoud
- Laboratory of Clinical Neuroscience, Faculty of Medicine, Fez, Morocco; Aix Marseille Université, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, France
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33
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Yu RL, Chen PS, Tu SC, Tsao WC, Tan CH. Emotion-Specific Affective Theory of Mind Impairment in Parkinson's Disease. Sci Rep 2018; 8:16043. [PMID: 30375420 PMCID: PMC6207749 DOI: 10.1038/s41598-018-33988-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 10/06/2018] [Indexed: 11/22/2022] Open
Abstract
The neuropathology of Parkinson’s disease (PD) involves the frontal-subcortical circuit, an area responsible for processing affective theory of mind (ToM). Patients with PD are expected to experience deficits in the affective ToM. This study aims to investigate whether the ability to infer emotion in others is affected in either young-onset Parkinson’s disease (YOPD) or middle-onset PD (MOPD) patients and to test whether the impairments in affective ToM are associated with the motor symptoms. The affective ToM, global mental abilities, and clinical symptoms were assessed in a total of 107 MOPD, 30 YOPD, and 30 normal controls (NCs). The MOPD patients exhibited deficits in affective ToM to the negative and neutral valences, when compared to the participants in the NCs and YOPD group. By conducting gender-stratified analysis, the deficits in affective ToM was only found in female participants. After adjusting for demographic variables, the multiple linear regression model revealed that affective ToM predicted motor symptoms, especially in female MOPD patients. The present study may aid in the development of medical care programs by advocating for a more comprehensive therapeutic plan that includes continuous disease progression monitoring and social skills training for female MOPD patients or their caregivers.
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Affiliation(s)
- Rwei-Ling Yu
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Po See Chen
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shao-Ching Tu
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Chia Tsao
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hsiang Tan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. .,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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34
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Guo L, Normando EM, Shah PA, De Groef L, Cordeiro MF. Oculo-visual abnormalities in Parkinson's disease: Possible value as biomarkers. Mov Disord 2018; 33:1390-1406. [DOI: 10.1002/mds.27454] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 05/16/2018] [Accepted: 05/18/2018] [Indexed: 12/16/2022] Open
Affiliation(s)
- Li Guo
- Glaucoma and Retinal Degenerative Disease Research Group, Institute of Ophthalmology; University College London; London UK
| | - Eduardo M. Normando
- Glaucoma and Retinal Degenerative Disease Research Group, Institute of Ophthalmology; University College London; London UK
- Western Eye Hospital, Imperial College Healthcare National Health Service Trust; London UK
- Imperial College Ophthalmology Research Group, Department of Surgery and Cancer, Imperial College London; London UK
| | - Parth Arvind Shah
- Glaucoma and Retinal Degenerative Disease Research Group, Institute of Ophthalmology; University College London; London UK
| | - Lies De Groef
- Glaucoma and Retinal Degenerative Disease Research Group, Institute of Ophthalmology; University College London; London UK
- Neural Circuit Development and Regeneration Research Group, Department of Biology; University of Leuven; Leuven Belgium
| | - M. Francesca Cordeiro
- Glaucoma and Retinal Degenerative Disease Research Group, Institute of Ophthalmology; University College London; London UK
- Western Eye Hospital, Imperial College Healthcare National Health Service Trust; London UK
- Imperial College Ophthalmology Research Group, Department of Surgery and Cancer, Imperial College London; London UK
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35
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Hemispheric specialization of the basal ganglia during vocal emotion decoding: Evidence from asymmetric Parkinson's disease and 18FDG PET. Neuropsychologia 2018; 119:1-11. [DOI: 10.1016/j.neuropsychologia.2018.07.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/10/2018] [Accepted: 07/19/2018] [Indexed: 11/15/2022]
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36
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Hirai M, Sakurada T, Muramatsu SI. Face-to-trait inferences in patients with Parkinson's disease. J Clin Exp Neuropsychol 2018; 41:170-178. [PMID: 30198816 DOI: 10.1080/13803395.2018.1513452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Introduction: Parkinson's disease is a progressive neurological disorder characterized by the preferential loss of dopaminergic neurons in the substantia nigra, which project to the striatum. The disease is characterized by prominent motor symptoms, which are its cardinal features. Consequently, Parkinson's disease has been primarily considered a disorder of movement. However, increasing evidence has indicated that Parkinson's disease affects not only the motor domain but also the cognitive domain. Increasing evidence indicates that patients with Parkinson's disease have an impaired ability to recognize emotional facial expressions. Recent studies have reported that other socially relevant information from faces, including face-to-trait inferences for traits such as dominance, competence, and trustworthiness, may be processed in subcortical regions, including the amygdala and caudate nucleus. However, the mechanism underlying the processing of face-to-trait inferences for these traits in patients with Parkinson's disease is still unknown. This study aimed to assess the face-to-trait inference ability in patients with Parkinson's disease. Method: Face-to-trait inference ability was assessed using a forced-choice method in patients with Parkinson's disease and age- and sex-matched healthy controls. Results: Overall correct face-to-trait inferences occurred significantly less frequently in the Parkinson's disease group than in the control group. Further analysis revealed a significant interaction between groups and the extent to which facial features were exaggerated. Conclusions: The present results suggest that the sensitivity of face-to-trait processing was linear in the Parkinson's disease group but not in the healthy controls. These deficits may have resulted from dysfunction in subcortical regions, which may also lead to impairment in other social inferential abilities in patients with Parkinson's disease.
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Affiliation(s)
- Masahiro Hirai
- a Center for Development of Advanced Medical Technology , Jichi Medical University , Tochigi , Japan.,b Centre for Brain & Cognitive Development, Birkbeck , University of London , London , UK
| | - Takeshi Sakurada
- a Center for Development of Advanced Medical Technology , Jichi Medical University , Tochigi , Japan.,c Department of Neurosurgery , Jichi Medical University , Tochigi , Japan
| | - Shin-Ichi Muramatsu
- d Division of Neurology , Jichi Medical University , Tochigi , Japan.,e Center for Gene & Cell Therapy, The Institute of Medical Science , The University of Tokyo , Tokyo , Japan
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Martinez M, Multani N, Anor CJ, Misquitta K, Tang-Wai DF, Keren R, Fox S, Lang AE, Marras C, Tartaglia MC. Emotion Detection Deficits and Decreased Empathy in Patients with Alzheimer's Disease and Parkinson's Disease Affect Caregiver Mood and Burden. Front Aging Neurosci 2018; 10:120. [PMID: 29740312 PMCID: PMC5928197 DOI: 10.3389/fnagi.2018.00120] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 04/06/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Changes in social cognition occur in patients with Alzheimer’s disease (AD) and Parkinson’s disease (PD) and can be caused by several factors, including emotion recognition deficits and neuropsychiatric symptoms (NPS). The aims of this study were to investigate: (1) group differences on emotion detection between patients diagnosed with AD or PD and their respective caregivers; (2) the association of emotion detection with empathetic ability and NPS in individuals with AD or PD; (3) caregivers’ depression and perceived burden in relation to patients’ ability to detect emotions, empathize with others, presence of NPS; and (4) caregiver’s awareness of emotion detection deficits in patients with AD or Parkinson. Methods: In this study, patients with probable AD (N = 25) or PD (N = 17), and their caregivers (N = 42), performed an emotion detection task (The Awareness of Social Inference Test—Emotion Evaluation Test, TASIT-EET). Patients underwent cognitive assessment, using the Behavioral Neurology Assessment (BNA). In addition, caregivers completed questionnaires to measure empathy (Interpersonal Reactivity Index, IRI) and NPS (Neuropsychiatric Inventory, NPI) in patients and self-reported on depression (Geriatric Depression Scale, GDS) and burden (Zarit Burden Interview, ZBI). Caregivers were also interviewed to measure dementia severity (Clinical Dementia Rating (CDR) Scale) in patients. Results: The results suggest that individuals with AD and PD are significantly worse at recognizing emotions than their caregivers. Moreover, caregivers failed to recognize patients’ emotion recognition deficits and this was associated with increased caregiver burden and depression. Patients’ emotion recognition deficits, decreased empathy and NPS were also related to caregiver burden and depression. Conclusions: Changes in emotion detection and empathy in individuals with AD and PD has implications for caregiver burden and depression and may be amenable to interventions with both patients and caregivers.
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Affiliation(s)
- Maria Martinez
- Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network Memory Clinic, Toronto, ON, Canada
| | - Namita Multani
- Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network Memory Clinic, Toronto, ON, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Cassandra J Anor
- Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network Memory Clinic, Toronto, ON, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Karen Misquitta
- Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network Memory Clinic, Toronto, ON, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - David F Tang-Wai
- Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network Memory Clinic, Toronto, ON, Canada
| | - Ron Keren
- Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network Memory Clinic, Toronto, ON, Canada.,Department of Psychiatry, University Health Network, Toronto, ON, Canada
| | - Susan Fox
- Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network Memory Clinic, Toronto, ON, Canada.,Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Anthony E Lang
- Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network Memory Clinic, Toronto, ON, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.,Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Connie Marras
- Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network Memory Clinic, Toronto, ON, Canada.,Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Maria C Tartaglia
- Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network Memory Clinic, Toronto, ON, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
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Argaud S, Vérin M, Sauleau P, Grandjean D. Facial emotion recognition in Parkinson's disease: A review and new hypotheses. Mov Disord 2018; 33:554-567. [PMID: 29473661 PMCID: PMC5900878 DOI: 10.1002/mds.27305] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 12/21/2017] [Accepted: 12/22/2017] [Indexed: 02/02/2023] Open
Abstract
Parkinson's disease is a neurodegenerative disorder classically characterized by motor symptoms. Among them, hypomimia affects facial expressiveness and social communication and has a highly negative impact on patients' and relatives' quality of life. Patients also frequently experience nonmotor symptoms, including emotional-processing impairments, leading to difficulty in recognizing emotions from faces. Aside from its theoretical importance, understanding the disruption of facial emotion recognition in PD is crucial for improving quality of life for both patients and caregivers, as this impairment is associated with heightened interpersonal difficulties. However, studies assessing abilities in recognizing facial emotions in PD still report contradictory outcomes. The origins of this inconsistency are unclear, and several questions (regarding the role of dopamine replacement therapy or the possible consequences of hypomimia) remain unanswered. We therefore undertook a fresh review of relevant articles focusing on facial emotion recognition in PD to deepen current understanding of this nonmotor feature, exploring multiple significant potential confounding factors, both clinical and methodological, and discussing probable pathophysiological mechanisms. This led us to examine recent proposals about the role of basal ganglia-based circuits in emotion and to consider the involvement of facial mimicry in this deficit from the perspective of embodied simulation theory. We believe our findings will inform clinical practice and increase fundamental knowledge, particularly in relation to potential embodied emotion impairment in PD. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Soizic Argaud
- Behavior and Basal Ganglia Research Unit (EA4712)University of Rennes 1RennesFrance
- Neuroscience of Emotion and Affective Dynamics laboratory, Department of Psychology and Educational SciencesUniversity of GenevaGenevaSwitzerland
| | - Marc Vérin
- Behavior and Basal Ganglia Research Unit (EA4712)University of Rennes 1RennesFrance
- Department of NeurologyRennes University HospitalRennesFrance
| | - Paul Sauleau
- Behavior and Basal Ganglia Research Unit (EA4712)University of Rennes 1RennesFrance
- Department of NeurophysiologyRennes University HospitalRennesFrance
| | - Didier Grandjean
- Neuroscience of Emotion and Affective Dynamics laboratory, Department of Psychology and Educational SciencesUniversity of GenevaGenevaSwitzerland
- Swiss Center for Affective SciencesCampus BiotechGenevaSwitzerland
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39
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Clark US, Sweet LH, Morgello S, Philip NS, Cohen RA. High early life stress and aberrant amygdala activity: risk factors for elevated neuropsychiatric symptoms in HIV+ adults. Brain Imaging Behav 2018; 11:649-665. [PMID: 27011015 DOI: 10.1007/s11682-016-9542-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Relative to HIV-negative adults, HIV+ adults report elevated levels of early life stress (ELS). In non-HIV samples, high ELS has been linked to abnormalities in brain structure and function, as well as increased risk of neuropsychiatric symptoms. Yet, little is known about the neural effects of high ELS, and their relation to elevated neuropsychiatric symptoms, in HIV+ adults. Recent studies have revealed combined effects of HIV and high ELS on amygdala morphometry. Aberrant amygdala activity is prominently implicated in studies of neuropsychiatric symptomology in non-HIV samples. Hence, this preliminary study examined: 1) the combined effects of HIV and high ELS on amygdala activity, and 2) the relation between amygdala activity and neuropsychiatric symptoms in HIV+ adults. We included 28 HIV+ adults and 25 demographically-matched HIV-negative control (HC) adults. ELS exposure was quantified using a retrospective ELS questionnaire, which defined four groups: HIV+ Low-ELS (N = 15); HIV+ High-ELS (N = 13); HC Low-ELS (N = 16); and HC High-ELS (N = 9). Participants completed a battery of neuropsychiatric measures. BOLD fMRI assessed amygdala reactivity during explicit observation of fearful/angry faces. High-ELS participants demonstrated reduced levels of amygdala reactivity relative to Low-ELS participants. HIV+ High-ELS participants reported higher levels of neuropsychiatric symptoms than all other groups. In the HIV+ group, lower amygdala responses were associated with higher neuropsychiatric symptoms, particularly depression, anxiety, and alexithymia. Collectively, these results suggest that high ELS exposure is a significant risk factor for neuropsychiatric symptoms in HIV+ adults. Furthermore, our results implicate ELS-related abnormalities in amygdala activity in the etiology of neuropsychiatric symptoms in HIV+ adults.
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Affiliation(s)
- Uraina S Clark
- Department of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1052, New York, NY, 10029, USA.
| | - Lawrence H Sweet
- Department of Psychology, University of Georgia, Athens, GA, USA
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Susan Morgello
- Department of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1052, New York, NY, 10029, USA
| | - Noah S Philip
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Providence VA Medical Center, Providence, RI, USA
| | - Ronald A Cohen
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Departments of Aging and Geriatric Research, Neurology, and Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
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Camalier CR, McHugo M, Zald DH, Neimat JS. 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. ACTA ACUST UNITED AC 2018; 6. [PMID: 29657957 PMCID: PMC5897106 DOI: 10.4172/2329-6895.1000377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
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.
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Affiliation(s)
- Corrie R Camalier
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA.,Laboratory of Neuropsychology, National Institute of Mental Health (NIMH), Bethesda, MD, USA
| | - Maureen McHugo
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - David H Zald
- Departments of Psychology, Psychiatry and Behavioral Sciences, Vanderbilt University Nashville, TN, USA
| | - Joseph S Neimat
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
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Rymarczyk K, Żurawski Ł, Jankowiak-Siuda K, Szatkowska I. Neural Correlates of Facial Mimicry: Simultaneous Measurements of EMG and BOLD Responses during Perception of Dynamic Compared to Static Facial Expressions. Front Psychol 2018; 9:52. [PMID: 29467691 PMCID: PMC5807922 DOI: 10.3389/fpsyg.2018.00052] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 01/12/2018] [Indexed: 11/13/2022] Open
Abstract
Facial mimicry (FM) is an automatic response to imitate the facial expressions of others. However, neural correlates of the phenomenon are as yet not well established. We investigated this issue using simultaneously recorded EMG and BOLD signals during perception of dynamic and static emotional facial expressions of happiness and anger. During display presentations, BOLD signals and zygomaticus major (ZM), corrugator supercilii (CS) and orbicularis oculi (OO) EMG responses were recorded simultaneously from 46 healthy individuals. Subjects reacted spontaneously to happy facial expressions with increased EMG activity in ZM and OO muscles and decreased CS activity, which was interpreted as FM. Facial muscle responses correlated with BOLD activity in regions associated with motor simulation of facial expressions [i.e., inferior frontal gyrus, a classical Mirror Neuron System (MNS)]. Further, we also found correlations for regions associated with emotional processing (i.e., insula, part of the extended MNS). It is concluded that FM involves both motor and emotional brain structures, especially during perception of natural emotional expressions.
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Affiliation(s)
- Krystyna Rymarczyk
- Department of Experimental Psychology, Institute of Cognitive and Behavioural Neuroscience, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Łukasz Żurawski
- Laboratory of Psychophysiology, Department of Neurophysiology, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Warsaw, Poland
| | - Kamila Jankowiak-Siuda
- Department of Experimental Psychology, Institute of Cognitive and Behavioural Neuroscience, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Iwona Szatkowska
- Laboratory of Psychophysiology, Department of Neurophysiology, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Warsaw, Poland
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42
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Heller J, Mirzazade S, Romanzetti S, Habel U, Derntl B, Freitag NM, Schulz JB, Dogan I, Reetz K. Impact of gender and genetics on emotion processing in Parkinson's disease - A multimodal study. NEUROIMAGE-CLINICAL 2018; 18:305-314. [PMID: 29876251 PMCID: PMC5987844 DOI: 10.1016/j.nicl.2018.01.034] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 01/25/2018] [Accepted: 01/28/2018] [Indexed: 01/07/2023]
Abstract
Understanding of the phenotypic heterogeneity of Parkinson's disease is needed. Gender and genetics determine manifestation and progression of Parkinson's disease. Altered emotion processing in Parkinson's disease is specific to male patients. This is influenced by endocrinal and genetic factors in both genders. This finding may impact the diagnosis and treatment of emerging clinical features.
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Key Words
- BAI, Beck anxiety inventory
- BDI-II, Beck depression inventory version II
- BFRT, Benton facial recognition test
- BOLD, blood‑oxygen-level dependent
- COMT, catechol-O-methyltransferase
- EPI, echo planar imaging
- Emotion
- Functional magnetic resonance imaging (fMRI)
- GM, gray matter
- Gender
- Genetics
- H&Y, Hoehn and Yahr rating scale
- HC, healthy controls
- LEDD, levodopa equivalence daily dose
- MCI, mild cognitive impairment
- MMSE, Mini-Mental State Examination
- MRI, magnetic resonance imaging
- MoCA, Montreal Cognitive Assessment
- NMS, non-motor symptoms
- PD, Parkinson's disease
- Parkinson's disease (PD)
- UPDRS, Unified Parkinson's disease rating scale
- VBM, voxel-based morphometry
- fMRI, functional magnetic resonance imaging
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Affiliation(s)
- Julia Heller
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Germany
| | - Shahram Mirzazade
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Germany
| | - Sandro Romanzetti
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Brain Structure-Function Relationships: Decoding the Human Brain at Systemic Levels, Forschungszentrum Jülich GmbH and RWTH Aachen University, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, University of Tübingen, Osianderstraße 24, Tübingen, Germany
| | - Nils M Freitag
- II. Institute of Physics B and JARA-FIT, RWTH Aachen University, Otto-Blumenthal-Straße, Aachen, Germany
| | - Jörg B Schulz
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Germany
| | - Imis Dogan
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Germany.
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Nozima AMM, Demos B, Souza WCD. Ausência de Prejuízo no Reconhecimento de Expressões Faciais entre Indivíduos com Parkinson. PSICOLOGIA: TEORIA E PESQUISA 2018. [DOI: 10.1590/0102.3772e3421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
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.
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Del-Monte J, Bayard S, Graziani P, Gély-Nargeot MC. Cognitive, Emotional, and Auto-Activation Dimensions of Apathy in Parkinson's Disease. Front Behav Neurosci 2017; 11:230. [PMID: 29209182 PMCID: PMC5702439 DOI: 10.3389/fnbeh.2017.00230] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 11/07/2017] [Indexed: 02/02/2023] Open
Abstract
Apathy is one of the most frequent non-motor manifestations in Parkinson's disease (PD) that can lead to a whole range of deleterious outcomes. In 2006, Levy and Dubois proposed a model that distinguishes three different apathy aetiologies in PD divided into three subtypes of disrupted processing: “emotional-affective,” “cognitive,” and “auto-activation.” These three dimensions associated with dopamine depletion present in the pathology would lead to the emergence of apathy in PD. The aim of this mini-review was to describe and discuss studies that have explore links between apathy and the three subtypes of disrupted processing proposed by Levy and Dubois (2006) and as well as the links between these dimensions and dopamine depletion in Parkinson's disease. The lack of consensus regarding the emotional-affective correlates of apathy and the lack of evidence supporting the hypothesis of the auto-activation deficit, do not clearly confirm the validity of Levy and Dubois's model. Furthermore, the suggested association between dopaminergic depletion and apathy must also be clarified.
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Affiliation(s)
- Jonathan Del-Monte
- Social Psychology Laboratory EA 849, Aix-Marseille and Nîmes Universities, Nîmes, France
| | - Sophie Bayard
- Epsylon, Laboratory Dynamic of Human Abilities & Health Behaviors, Department of Sport Sciences, Psychology and Medicine, Montpellier University, Montpellier, France
| | - Pierluigi Graziani
- Social Psychology Laboratory EA 849, Aix-Marseille and Nîmes Universities, Nîmes, France
| | - Marie C Gély-Nargeot
- Epsylon, Laboratory Dynamic of Human Abilities & Health Behaviors, Department of Sport Sciences, Psychology and Medicine, Montpellier University, Montpellier, France
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45
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Moonen AJH, Wijers A, Dujardin K, Leentjens AFG. Neurobiological correlates of emotional processing in Parkinson's disease: A systematic review of experimental studies. J Psychosom Res 2017; 100:65-76. [PMID: 28789795 DOI: 10.1016/j.jpsychores.2017.07.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/17/2017] [Accepted: 07/17/2017] [Indexed: 01/18/2023]
Abstract
Deficits in emotional processing in patients with Parkinson's disease (PD) have received increasing interest over the past decades. In this systematic review, we present the results of 18 behavioral studies that have examined the neurobiological base of emotional processing in PD. Multiple aspects of emotional processing have been studied, using a variety of research methods. Deficits in PD are mainly related to autonomic and perceptive processing of intense emotional stimuli, which is accompanied by structural and functional neurobiological abnormalities in predominantly ventral regions of affective neurocircuitry. These structures are more strongly dependent on dopaminergic neurotransmission than the dorsal structures of affective neurocircuitry, which are more related to the cognitive and regulatory aspects of emotion and appear to remain largely intact in PD patients. Considering the importance of active dopaminergic neurotransmission, PD can serve as a prolific model for studying the neurobiological correlates of normal human emotional behavior as well as psychiatric disorders such as anxiety, depression, and apathy. Moreover, the fact that PD patients are able to cognitively regulate or modulate their emotional responses despite reduced dopamine supplies, can have important implications for the treatment of affective disorders not only in PD patients but in the general population likewise.
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Affiliation(s)
- Anja J H Moonen
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Anke Wijers
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Kathy Dujardin
- CHU Lille, Neurology and Movement Disorders, F-59000 Lille, France
| | - Albert F G Leentjens
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands
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46
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Trinkler I, Devignevielle S, Achaibou A, Ligneul RV, Brugières P, Cleret de Langavant L, De Gelder B, Scahill R, Schwartz S, Bachoud-Lévi AC. Embodied emotion impairment in Huntington's Disease. Cortex 2017; 92:44-56. [DOI: 10.1016/j.cortex.2017.02.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 02/08/2017] [Accepted: 02/22/2017] [Indexed: 12/24/2022]
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47
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Kalampokini S, Lyros E, Luley M, Schöpe J, Spiegel J, Bürmann J, Dillmann U, Fassbender K, Unger MM. Facial emotion recognition in Parkinson's disease: Association with age and olfaction. J Clin Exp Neuropsychol 2017. [PMID: 28637374 DOI: 10.1080/13803395.2017.1341470] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The ability to recognize facial emotion expressions has been reported to be impaired in Parkinson's disease (PD), yet previous studies showed inconsistent findings. The aim of this study was to further investigate facial emotion recognition (FER) in PD patients and its association with demographic and clinical parameters (including motor and nonmotor symptoms). METHOD Thirty-four nondemented PD patients and 24 age- and sex-matched healthy controls (HC) underwent clinical neurological and neuropsychological assessment, standardized olfactory testing with Sniffin' Sticks, and the Ekman 60 Faces Emotion Recognition Test. RESULTS PD patients had a significantly lower score on the total FER task than HC (p = .006), even after controlling for the potential confounding factors depression and apathy. The PD group had a specific impairment in the recognition of surprise (p = .007). The recognition of anger approached statistical significance (p = .07). Increasing chronological age and age at disease onset were associated with worse performance on the FER task in PD patients. Olfactory function along with PD diagnosis predicted worse FER performance within all study participants. CONCLUSION Facial emotion recognition and especially the recognition of surprise are significantly impaired in PD patients compared with age- and sex-matched HC. The association of FER with age and olfactory function is endorsed by common structures that undergo neurodegeneration in PD. The relevance of FER in social interaction stresses the clinical relevance and the need for further investigation in this field. Future studies should also determine whether impaired FER is already present in premotor stages of PD.
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Affiliation(s)
- S Kalampokini
- a Department of Neurology , University Hospital of Saarland , Homburg , Germany
| | - E Lyros
- a Department of Neurology , University Hospital of Saarland , Homburg , Germany
| | - M Luley
- a Department of Neurology , University Hospital of Saarland , Homburg , Germany
| | - J Schöpe
- b Institute for Medical Biometry, Epidemiology and Medical Informatics , Saarland University , Homburg , Germany
| | - J Spiegel
- a Department of Neurology , University Hospital of Saarland , Homburg , Germany
| | - J Bürmann
- a Department of Neurology , University Hospital of Saarland , Homburg , Germany
| | - U Dillmann
- a Department of Neurology , University Hospital of Saarland , Homburg , Germany
| | - K Fassbender
- a Department of Neurology , University Hospital of Saarland , Homburg , Germany
| | - M M Unger
- a Department of Neurology , University Hospital of Saarland , Homburg , Germany
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48
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Mioni G, Grondin S, Meligrana L, Perini F, Bartolomei L, Stablum F. Effects of happy and sad facial expressions on the perception of time in Parkinson's disease patients with mild cognitive impairment. J Clin Exp Neuropsychol 2017; 40:123-138. [PMID: 28532288 DOI: 10.1080/13803395.2017.1324021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Parkinson's disease (PD) is a movement disorder caused by deterioration of the dopaminergic system. Previous studies have demonstrated temporal as well as emotional facial recognition impairment in PD patients. Moreover, it has been demonstrated that emotional facial expressions alter temporal judgments. In the present study, we investigate the magnitude of temporal distortions caused by the presentation of emotional facial expressions (happiness, sadness, and neutral) in PD patients with mild cognitive impairment (PD-MCI) and controls. METHOD Seventeen older adults with PD-MCI and 22 healthy older adults took part in the present study. Participants were tested with a time bisection task with standard intervals lasting 400 ms and 1600 ms. Moreover, a complete neuropsychological evaluation was conducted to characterize the sample. RESULTS Differences between groups were observed indicating a general underestimation of time in PD-MCI patients. Temporal impairments in PD-MCI patients seem to be caused mainly by a dysfunction at the level of reference memory. The effect of emotional facial expressions on time perception was evident in both PD patients and controls, with an overestimation of perceived duration when happiness was presented and an underestimation when sadness was presented. CONCLUSION Overall, our results indicate that reduced cognitive abilities might be responsible for the lower temporal ability observed in PD-MCI patients. Moreover, similar effects of emotional stimuli were observed in both PD-MCI patients and controls.
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Affiliation(s)
- Giovanna Mioni
- a Dipartimento di Psicologia Generale , Università di Padova , Padova , Italy
| | - Simon Grondin
- b École de Psychologie , Université Laval , Québec , Canada
| | - Lucia Meligrana
- c U.O. Neurologia , Ospedale San Bortolo , Vicenza , Italy.,d U.O. Psicologia Ospedaliera , Ospedale San Bortolo , Vicenza , Italy
| | | | | | - Franca Stablum
- a Dipartimento di Psicologia Generale , Università di Padova , Padova , Italy
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Beyond emotion recognition deficits: A theory guided analysis of emotion processing in Huntington’s disease. Neurosci Biobehav Rev 2017; 73:276-292. [DOI: 10.1016/j.neubiorev.2016.11.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 10/21/2016] [Accepted: 11/03/2016] [Indexed: 11/22/2022]
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