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Álvarez-Fernández S, Andrade-González N, Simal P, Matias-Guiu JA, Gómez-Escalonilla C, Rodriguez-Jimenez R, Stiles BJ, Lahera G. Emotional processing in patients with single brain damage in the right hemisphere. BMC Psychol 2023; 11:8. [PMID: 36635763 PMCID: PMC9837967 DOI: 10.1186/s40359-022-01033-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/26/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The interest in the relationship between brain damage and social cognition has increased in recent years. The objectives of the present study were the following: (1) to evaluate and compare emotional facial recognition and subjective emotional experience in patients who have suffered a single ischemic stroke in the right hemisphere (RH) and in healthy people, (2) to analyze the relationship between both variables in both groups of subjects, and (3) to analyze the association between the cerebral location of the stroke and these two variables. METHODS Emotional facial recognition and the subjective emotional experience of 41 patients who had suffered a single ischemic stroke in the RH and 45 volunteers without previous cerebrovascular pathology were evaluated. RESULTS Brain damaged patients performed lower in facial emotional recognition and had a less intense subjective emotional response to social content stimuli compared to healthy subjects. Likewise, among patients with RH ischemic stroke, we observed negative associations between facial recognition of surprise and reactivity to unpleasant images, and positive associations between recognition of disgust and reactivity to pleasant images. Finally, patients with damage in the caudate nucleus of the RH presented a deficit in the recognition of happiness and sadness, and those with damage in the frontal lobe exhibited a deficit in the recognition of surprise, compared to those injured in other brain areas. CONCLUSIONS Emotional facial recognition and subjective emotional experience are affected in patients who have suffered a single ischemic stroke in the RH. Professionals caring for stroke patients should improve their understanding of the general condition of affected persons and their environment, assess for risk of depression, and facilitate their adaptation to work, family, and social environments.
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Affiliation(s)
| | - Nelson Andrade-González
- grid.7159.a0000 0004 1937 0239Psychiatry and Mental Health Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain ,grid.464699.00000 0001 2323 8386Faculty of Medicine, Alfonso X el Sabio University, Villanueva de La Cañada, Madrid, Spain
| | - Patricia Simal
- grid.411068.a0000 0001 0671 5785Stroke Unit, Neurology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Jordi A. Matias-Guiu
- grid.411068.a0000 0001 0671 5785Stroke Unit, Neurology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Carlos Gómez-Escalonilla
- grid.411068.a0000 0001 0671 5785Stroke Unit, Neurology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Roberto Rodriguez-Jimenez
- grid.4795.f0000 0001 2157 7667Complutense University of Madrid, Madrid, Spain ,grid.144756.50000 0001 1945 5329Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain ,grid.469673.90000 0004 5901 7501CIBERSAM, Madrid, Spain
| | - Bryan J. Stiles
- grid.10698.360000000122483208Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Guillermo Lahera
- grid.7159.a0000 0004 1937 0239Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain ,IRyCIS, CIBERSAM, Madrid, Spain ,Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
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Psychiatric sequelae of stroke affecting the non-dominant cerebral hemisphere. J Neurol Sci 2021; 430:120007. [PMID: 34624794 DOI: 10.1016/j.jns.2021.120007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 01/08/2023]
Abstract
There are a plethora of cognitive sequelae in addition to neglect and extinction that arise with unilateral right hemispheric stroke (RHS). Cognitive deficits following non-dominant (right) hemisphere stroke are common with unilateral neglect and extinction being the most recognized examples. The severity of RHS is usually underestimated by the National Institutes of Health Stroke Scale (NIHSS), which in terms of lateralized right hemisphere cognitive deficits, tests only for visual inattention/extinction. They account for 2 out of 42 total possible points. Additional neuropsychiatric sequelae include but are not limited to deficiencies in affective prosody comprehension and production (aprosodias), understanding and expressing facial emotions, empathy, recognition of familiar faces, anxiety, mania, apathy, and psychosis. These sequelae have a profound impact on patients' quality of life; affecting communication, interpersonal relationships, and the ability to fulfill social roles. They also pose additional challenges to recovery. There is presently a gap in the literature regarding a cohesive overview of the significant cognitive sequelae following RHS. This paper serves as a narrative survey of the current understanding of the subject, with particular emphasis on neuropsychiatric poststroke syndromes not predominantly associated with left hemisphere lesions (LHL), bilateral lesions, hemiplegia, or paralysis. A more comprehensive understanding of the neuropsychological consequences of RHS extending beyond the typical associations of unilateral neglect and extinction may have important implications for clinical practice, including the ways in which clinicians approach diagnostics, treatment, and rehabilitation.
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Bennett DA. Methodology of the global and regional burden of stroke study. Neuroepidemiology 2012; 38:30-40. [PMID: 22212892 DOI: 10.1159/000334744] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 11/01/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Setting priorities for the prevention of stroke requires an empirical understanding of the pattern of disease burden and exposure to major risk factors. In this manuscript we aim to report the methodology of a systematic review of the epidemiological literature on stroke and how this information will be synthesized to produce updated estimates of the global burden of stroke. METHODS We will use multi-state models implemented in the software program DisMod III to estimate age-specific prevalence, incidence, and early case-fatality (defined as either 28-day, 30-day or 1-month case fatality) for stroke by the 21 global burden of disease (GBD) regions as well as by gender and pathological stroke type based on information obtained from a systematic review. We conducted a two-stage search strategy in order to identify studies published between 1980 and 2011 for the GBD stroke review. Eligible studies: (a) distinguished between stroke and transient ischaemic attack (TIA); (b) distinguished between 1st ever and recurrent stroke; (c) reported on age-specific rates; (d) if reported, provided survival status within 28 days, 30 days or 1 month of onset for fatal and nonfatal events; (e) specified methods for ascertaining stroke cases, and (f) described imaging modalities to determine stroke subtypes. Details of included studies were recorded on a detailed data extraction form by trained reviewers. We will gather information on demographics, natural history and clinical outcomes (e.g. Rankin scale, Glasgow Coma Scale), after stroke which will be used to facilitate the estimation of epidemiological parameters. Reporting and methodological quality was rated. Populations were coded as urban, rural, or combined and studies classified as national, subnational, healthcare system-based, or community level. Studies published in non-English languages were translated and coded centrally. DISCUSSION In international health research, there is a crucial need for accurate assessment of global health patterns. A thorough GBD reassessment of stroke will ensure that global health policy decisions are based on the most up-to-date, valid and reliable epidemiological information available.
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Affiliation(s)
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- Clinical Trials Service Unit, Richard Doll Building, Old Road Campus, Roosevelt Drive, Oxford OX3 7LF, UK. derrick.bennett @ ctsu.ox.ac.uk
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Rush BK, McNeil RB, Gamble DM, Luke SH, Richie AN, Albers CS, Brown RD, Brott TG, Meschia JF. Behavioral Symptoms in Long-Term Survivors of Ischemic Stroke. J Stroke Cerebrovasc Dis 2010; 19:326-32. [DOI: 10.1016/j.jstrokecerebrovasdis.2009.09.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 08/06/2009] [Accepted: 09/10/2009] [Indexed: 11/27/2022] Open
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Borod JC, Bloom RL, Brickman AM, Nakhutina L, Curko EA. Emotional processing deficits in individuals with unilateral brain damage. APPLIED NEUROPSYCHOLOGY 2003; 9:23-36. [PMID: 12173747 DOI: 10.1207/s15324826an0901_4] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This article presents a review of the neural mechanisms underlying emotional processing deficits (EPDs) in individuals with unilateral brain damage. First, key theoretical issues pertaining to the neuropsychology of emotion are presented. These include parameters of emotional processing, the componential approach, emotional domains, and hypotheses regarding hemispheric specialization for emotion. Second, the literature on hemispheric asymmetries for emotion is reviewed in terms of processing mode (perception and expression) and communication channel (facial, prosodic-intonational, and lexical-verbal). Studies involving normal adults and individuals with right- or left-sided brain damage are reviewed. Third, recent findings identifying the role of the right hemisphere in emotional processing are described. The article is concluded by aligning these new data with findings from the general literature, providing added support for the right-hemisphere emotion hypothesis.
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Affiliation(s)
- Joan C Borod
- Department of Neurology, Mount Sinai School of Medicine, New York, New York, USA [corrected].
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