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Rahamim N, Gilad R, Linkovski O, Bergman H, Avirame K, Foul YA, Eitan R. Validation of behavioral measures of social cognition in individuals diagnosed with schizophrenia. Front Psychol 2024; 15:1443145. [PMID: 39319067 PMCID: PMC11420990 DOI: 10.3389/fpsyg.2024.1443145] [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: 06/03/2024] [Accepted: 08/28/2024] [Indexed: 09/26/2024] Open
Abstract
Schizophrenia, a complex neuropsychiatric disorder, manifests severe impairments in social cognition, notably in Theory of Mind (ToM), empathy, and emotion recognition, which significantly influence social competence and overall functioning. These aspects are crucial for prognosis in individuals diagnosed with schizophrenia (SZ). This study validates a comics strip paradigm for ToM and empathy assessment, the Montreal Affective Voices (MAV) for measuring emotion recognition, and a Go-NoGo task for inhibition control estimation in individuals diagnosed with SZ, comparing their performance with healthy controls. SZ participants exhibited diminished abilities in the comics strip task, especially in ToM and empathy conditions, alongside challenges in identifying emotions from vocal cues in MAV. They responded slower and tended to be less accurate in the Go-NoGo task. The validated behavioral battery addresses the limitations of previous measures and emerges as a promising tool for future investigations into the neural systems underlying social cognition in schizophrenia. Such insights can lead to the development of long-needed treatment for negative symptoms and social dysfunctions in schizophrenia.
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Affiliation(s)
- Noa Rahamim
- The Edmond and Lily Safra Center for Brain Science, Hebrew University, Jerusalem, Israel
| | - Reut Gilad
- Psychiatric Division, Tel Aviv Sourasky Medical Center Ichilov, Tel Aviv, Israel
- The Jerusalem Mental Health Center, Jerusalem, Israel
| | - Omer Linkovski
- The Jerusalem Mental Health Center, Jerusalem, Israel
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Hagai Bergman
- The Edmond and Lily Safra Center for Brain Science, Hebrew University, Jerusalem, Israel
- Department of Medical Neurobiology, Institute of Medical Research Israel-Canada (IMRIC), Hadassah-Hebrew University Medical School, Jerusalem, Israel
| | - Keren Avirame
- Psychiatric Division, Tel Aviv Sourasky Medical Center Ichilov, Tel Aviv, Israel
| | - Yasmin Abo Foul
- Psychiatric Division, Tel Aviv Sourasky Medical Center Ichilov, Tel Aviv, Israel
| | - Renana Eitan
- Psychiatric Division, Tel Aviv Sourasky Medical Center Ichilov, Tel Aviv, Israel
- The Jerusalem Mental Health Center, Jerusalem, Israel
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2
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Hegde S, Gothwal M, Arumugham S, Yadav R, Pal P. Deficits in emotion perception and cognition in patients with parkinson's disease: A systematic review. Ann Indian Acad Neurol 2022; 25:367-375. [PMID: 35936598 PMCID: PMC9350746 DOI: 10.4103/aian.aian_573_21] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/03/2021] [Accepted: 01/16/2022] [Indexed: 12/02/2022] Open
Abstract
Non-motor symptoms (NMS) are common among Parkinson's disease (PD) patients and have a significant impact on quality of life. NMS such as deficits in emotion perception are gaining due focus in the recent times. As emotion perception and cognitive functions share certain common neural substrates, it becomes pertinent to evaluate existing emotion perception deficits in view of underlying cognitive deficits. The current systematic review aimed at examining studies on emotion perception PD in the last decade. We carried out a systematic review of 44 studies from the PubMed database. We reviewed studies examining emotion perception and associated cognitive deficits, especially executive function and visuospatial function in PD. This review also examines how early and advanced PD differ in emotion perception deficits and how the presence of common neuropsychiatric conditions such as anxiety, apathy, and depression as well as neurosurgical procedure such as deep brain stimulation affect emotion perception. The need for future research employing a comprehensive evaluation of neurocognitive functions and emotion perception is underscored as it has a significant bearing on planning holistic intervention strategies.
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3
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Vielle C, Montanari C, Pelloux Y, Baunez C. Evidence for a vocal signature in the rat and its reinforcing effects: a key role for the subthalamic nucleus. Proc Biol Sci 2021; 288:20212260. [PMID: 34905707 PMCID: PMC8670952 DOI: 10.1098/rspb.2021.2260] [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: 10/19/2021] [Accepted: 11/23/2021] [Indexed: 12/24/2022] Open
Abstract
Although rodents have a well-structured vocal form of communication, like humans and non-human primates, there is, to date, no evidence for a vocal signature in the well-known 50- and 22-kHz ultrasonic vocalizations (USVs) emitted by rats. Here, we show that rats can recognize the identity of the USV emitter since they choose to preferentially self-administer playback of 50-kHz USVs emitted by a stranger rat over those of their cagemate. In a second experiment, we show that only stranger, but not familiar, 50-kHz USVs reduce cocaine self-administration. Finally, to study the neurobiological substrate of these processes, we have shown that subthalamic nucleus (STN)-lesioned rats did not lever press much for any USV playback, whatever their emotional valence, nor did they seem able to differentiate familiar from stranger peer. Advocating for the existence of a vocal signature in rats, these results highlight the importance of ultrasonic communication in the socio-affective influence of behaviour, such as the influence of proximal social factors on drug consumption and confirm the role of the STN on this influence.
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Affiliation(s)
- Cassandre Vielle
- Institut de Neurosciences de la Timone, UMR 7289 CNRS and Aix-Marseille Université, 27 Boulevard Jean Moulin, Marseille 13005, France
| | - Christian Montanari
- Institut de Neurosciences de la Timone, UMR 7289 CNRS and Aix-Marseille Université, 27 Boulevard Jean Moulin, Marseille 13005, France
| | - Yann Pelloux
- Institut de Neurosciences de la Timone, UMR 7289 CNRS and Aix-Marseille Université, 27 Boulevard Jean Moulin, Marseille 13005, France
| | - Christelle Baunez
- Institut de Neurosciences de la Timone, UMR 7289 CNRS and Aix-Marseille Université, 27 Boulevard Jean Moulin, Marseille 13005, France
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4
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Vielle C, Montanari C, Pelloux Y, Baunez C. Evidence for a vocal signature in the rat and its reinforcing effects: a key role for the subthalamic nucleus. Proc Biol Sci 2021; 288:20212260. [PMID: 34905707 PMCID: PMC8670952 DOI: 10.1098/rspb.2021.2260 10.1098/rspb.2021.2260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/23/2021] [Indexed: 06/16/2024] Open
Abstract
Although rodents have a well-structured vocal form of communication, like humans and non-human primates, there is, to date, no evidence for a vocal signature in the well-known 50- and 22-kHz ultrasonic vocalizations (USVs) emitted by rats. Here, we show that rats can recognize the identity of the USV emitter since they choose to preferentially self-administer playback of 50-kHz USVs emitted by a stranger rat over those of their cagemate. In a second experiment, we show that only stranger, but not familiar, 50-kHz USVs reduce cocaine self-administration. Finally, to study the neurobiological substrate of these processes, we have shown that subthalamic nucleus (STN)-lesioned rats did not lever press much for any USV playback, whatever their emotional valence, nor did they seem able to differentiate familiar from stranger peer. Advocating for the existence of a vocal signature in rats, these results highlight the importance of ultrasonic communication in the socio-affective influence of behaviour, such as the influence of proximal social factors on drug consumption and confirm the role of the STN on this influence.
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Affiliation(s)
- Cassandre Vielle
- Institut de Neurosciences de la Timone, UMR 7289 CNRS and Aix-Marseille Université, 27 Boulevard Jean Moulin, Marseille 13005, France
| | - Christian Montanari
- Institut de Neurosciences de la Timone, UMR 7289 CNRS and Aix-Marseille Université, 27 Boulevard Jean Moulin, Marseille 13005, France
| | - Yann Pelloux
- Institut de Neurosciences de la Timone, UMR 7289 CNRS and Aix-Marseille Université, 27 Boulevard Jean Moulin, Marseille 13005, France
| | - Christelle Baunez
- Institut de Neurosciences de la Timone, UMR 7289 CNRS and Aix-Marseille Université, 27 Boulevard Jean Moulin, Marseille 13005, France
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5
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Upadhyayula PS, Rennert RC, Martin JR, Yue JK, Yang J, Gillis-Buck EM, Sidhu N, Cheung CK, Lee AT, Hoshide RR, Ciacci JD. Basal impulses: findings from the last twenty years on impulsivity and reward pathways using deep brain stimulation. J Neurosurg Sci 2020; 64:544-551. [PMID: 32972108 DOI: 10.23736/s0390-5616.20.04906-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Deep brain stimulation (DBS) is an important treatment modality for movement disorders. Its role in tasks and processes of higher cortical function continues to increase in importance and relevance. This systematic review investigates the impact of DBS on measures of impulsivity. EVIDENCE ACQUISITION A total of 45 studies were collated from PubMed (30 prospective, 8 animal, 4 questionnaire-based, and 3 computational models), excluding case reports and review articles. Two areas extensively studied are the subthalamic nucleus (STN) and nucleus accumbens (NAc). EVIDENCE SYNTHESIS While both are part of the basal ganglia, the STN and NAc have extensive connections to the prefrontal cortex, cingulate cortex, and limbic system. Therefore, understanding cause and treatment of impulsivity requires understanding motor pathways, learning, memory, and emotional processing. DBS of the STN and NAc shell can increase objective measures of impulsivity, as measured by reaction times or reward-based learning, independent from patient insight. The ability for DBS to treat impulse control disorders, and also cause and/or worsen impulsivity in Parkinson's disease, may be explained by the affected closely-related neuroanatomical areas with discrete and sometimes opposing functions. CONCLUSIONS As newer, more refined DBS technology emerges, large-scale prospective studies specifically aimed at treatment of impulsivity disorders are needed.
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Affiliation(s)
- Pavan S Upadhyayula
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - Robert C Rennert
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - Joel R Martin
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - John K Yue
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Jason Yang
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - Eva M Gillis-Buck
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Nikki Sidhu
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - Christopher K Cheung
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Anthony T Lee
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Reid R Hoshide
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - Joseph D Ciacci
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA -
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6
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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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7
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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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8
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Affective modulation of the associative-limbic subthalamic nucleus: deep brain stimulation in obsessive-compulsive disorder. Transl Psychiatry 2019; 9:73. [PMID: 30718450 PMCID: PMC6361948 DOI: 10.1038/s41398-019-0404-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 09/23/2018] [Accepted: 01/01/2019] [Indexed: 12/11/2022] Open
Abstract
Affective states underlie daily decision-making and pathological behaviours relevant to obsessive-compulsive disorders (OCD), mood disorders and addictions. Deep brain stimulation targeting the motor and associative-limbic subthalamic nucleus (STN) has been shown to be effective for Parkinson's disease (PD) and OCD, respectively. Cognitive and electrophysiological studies in PD showed responses of the motor STN to emotional stimuli, impairments in recognition of negative affective states and modulation of the intensity of subjective emotion. Here we studied whether the stimulation of the associative-limbic STN in OCD influences the subjective emotion to low-intensity positive and negative images and how this relates to clinical symptoms. We assessed 10 OCD patients with on and off STN DBS in a double-blind randomized manner by recording ratings of valence and arousal to low- and high-intensity positive and negative emotional images. STN stimulation increased positive ratings and decreased negative ratings to low-intensity positive and negative stimuli, respectively, relative to off stimulation. We also show that the change in severity of obsessive-compulsive symptoms pre- versus post-operatively interacts with both DBS and valence ratings. We show that stimulation of the associative-limbic STN might influence the negative cognitive bias in OCD and decreasing the negative appraisal of emotional stimuli with a possible relationship with clinical outcomes. That the effect is specific to low intensity might suggest a role of uncertainty or conflict related to competing interpretations of image intensity. These findings may have implications for the therapeutic efficacy of DBS.
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9
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Martínez-Fernández R, Kibleur A, Chabardès S, Fraix V, Castrioto A, Lhommée E, Moro E, Lescoules L, Pelissier P, David O, Krack P. Different effects of levodopa and subthalamic stimulation on emotional conflict in Parkinson's disease. Hum Brain Mapp 2018; 39:5014-5027. [PMID: 30259598 DOI: 10.1002/hbm.24341] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 07/02/2018] [Accepted: 07/22/2018] [Indexed: 12/17/2022] Open
Abstract
Parkinson's disease impairs the decoding of emotional stimuli reflecting alterations of the limbic cortico-subcortical network. The objective of this study was to assess and compare the behavioral and electrophysiological effects of both levodopa and subthalamic stimulation on emotional processing in Parkinson's disease. Operated patients (n =16) and matched healthy subjects performed an emotional Stroop task, in which the emotion expressed by a face must be recognized while ignoring an emotional distractive word and that includes a neutral control sub-task. Patients were tested in the four possible treatment conditions (off stim/off med; on stim/off med; off stim/on med; and on stim/on med). High-resolution electroencephalography was recorded while performing the task. Patients made significantly more mistakes in facial emotion recognition than healthy subjects (p < .005). Untreated patients performed worse in the emotional trials than in the control sub-task (p < .05). Fearful faces induced significantly slower reaction times than happy faces in patients (p = .0002), but not in the healthy subjects. The emotional Stroop effect with levodopa was significantly higher than with subthalamic stimulation when fearful faces were assessed (p = .0243). Conversely, treatments did not modulate the Stroop effect of the control sub-task. EEG demonstrated that, compared with the untreated state, levodopa but not subthalamic stimulation significantly increases the amplitude of the event-related potential N170 (p = .002 vs. p = .1, respectively), an electrophysiological biomarker of early aspects of facial processing. The activity of the N170 cortical sources within the right fusiform gyrus was increased by levodopa (p < .05) but not by stimulation. While levodopa normalizes the recognition of emotional facial expression and early EEG markers of emotional processing, subthalamic stimulation does not. Thus, operated patients require dopaminergic medication in addition to stimulation to treat emotional symptoms of Parkinson's disease.
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Affiliation(s)
- Raul Martínez-Fernández
- CINAC-Hospital Universitario HM Puerta del Sur, Móstoles, Universidad CEU San Pablo, Madrid, Spain.,Movement Disorders Unit, CHU Grenoble Alpes, Grenoble, France.,U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Astrid Kibleur
- U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Stéphan Chabardès
- U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France.,Neurosurgery Department, CHU Grenoble Alpes, Grenoble, France
| | - Valérie Fraix
- Movement Disorders Unit, CHU Grenoble Alpes, Grenoble, France.,U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Anna Castrioto
- Movement Disorders Unit, CHU Grenoble Alpes, Grenoble, France.,U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Eugénie Lhommée
- Movement Disorders Unit, CHU Grenoble Alpes, Grenoble, France.,U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Elena Moro
- Movement Disorders Unit, CHU Grenoble Alpes, Grenoble, France.,U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Lucas Lescoules
- U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Pierre Pelissier
- Movement Disorders Unit, CHU Grenoble Alpes, Grenoble, France.,U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Olivier David
- U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Paul Krack
- Movement Disorders Unit, CHU Grenoble Alpes, Grenoble, France.,U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France.,Neurosurgery Department, CHU Grenoble Alpes, Grenoble, France.,Division of Neurology, Department of Neuroscience, Geneva University Hospitals, Geneva, Switzerland
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Majdinasab F, Khatoonabadi A, Khoddami SM, Habibi A. The effect of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on the acoustic and prosodic features in patients with Parkinson's disease: A study protocol for the first trial on Iranian patients. Med J Islam Repub Iran 2017; 31:118. [PMID: 29951419 PMCID: PMC6014802 DOI: 10.14196/mjiri.31.118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Indexed: 11/27/2022] Open
Abstract
Background: The effect of subthalamic nucleus deep brain stimulation (STN-DBS) on the voice features in Parkinson's disease (PD) is controversial. No study has evaluated the voice features of PD underwent STN-DBS by the acoustic, perceptual, and patientbased assessments comprehensively. Furthermore, there is no study to investigate prosodic features before and after DBS in PD. The current study aimed to assess the efficacy of STN-DBS on the voice and prosodic features by acoustic, perceptual and self-reported evaluations in PD. Methods and Analysis: An experimental prospective cohort pretest-posttest group has been designed to survey patients with PD candidates for STN-DBS surgery. All participants will be evaluated by a speech and language pathologist before and after surgery in four different conditions as follow: pre-surgery: Medication On/ Medication Off; post-surgery: Stimulation On/ Stimulation Off. To compare pre-surgery and post-surgery conditions paired- samples T Test or Wilcoxon signed-rank test will be used. A 95% confidence interval (p value of <0.05) will be considered to be statistically significant. This study protocol is approved by the Ethical Committee of Teheran University of Medical Sciences, and the results of the study will be published in a peer-reviewed journal and presented at national congresses.
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Affiliation(s)
- Fatemeh Majdinasab
- Department of Speech Therapy, School of Rehabilitation, Teheran University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Khatoonabadi
- Department of Speech Therapy, School of Rehabilitation, Teheran University of Medical Sciences, Tehran, Iran
| | - Seyyedeh Maryam Khoddami
- Department of Speech Therapy, School of Rehabilitation, Teheran University of Medical Sciences, Tehran, Iran
| | - Amirhassan Habibi
- Department of Neurology, Iran University of Medical Sciences, Tehran, Iran
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11
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Frühholz S, Staib M. Neurocircuitry of impaired affective sound processing: A clinical disorders perspective. Neurosci Biobehav Rev 2017; 83:516-524. [PMID: 28919431 DOI: 10.1016/j.neubiorev.2017.09.009] [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] [Received: 01/18/2017] [Revised: 06/08/2017] [Accepted: 09/05/2017] [Indexed: 12/22/2022]
Abstract
Decoding affective meaning from sensory information is central to accurate and adaptive behavior in many natural and social contexts. Human vocalizations (speech and non-speech), environmental sounds (e.g. thunder, noise, or animal sounds) and human-produced sounds (e.g. technical sounds or music) can carry a wealth of important aversive, threatening, appealing, or pleasurable affective information that sometimes implicitly influences and guides our behavior. A deficit in processing such affective information is detrimental to adaptive environmental behavior, psychological well-being, and social interactive abilities. These deficits can originate from a diversity of psychiatric and neurological disorders, and are associated with neural dysfunctions across largely distributed brain networks. Recent neuroimaging studies in psychiatric and neurological patients outline the cortical and subcortical neurocircuitry of the complimentary and differential functional roles for affective sound processing. This points to and confirms a recently proposed distributed network rather than a single brain region underlying affective sound processing, and highlights the notion of a multi-functional process that can be differentially impaired in clinical disorders.
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Affiliation(s)
- Sascha Frühholz
- Department of Psychology, University of Zürich, Zürich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Center for Integrative Human Physiology (ZIHP), University of Zurich, Switzerland.
| | - Matthias Staib
- Department of Psychology, University of Zürich, Zürich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
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12
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Péron J, Renaud O, Haegelen C, Tamarit L, Milesi V, Houvenaghel JF, Dondaine T, Vérin M, Sauleau P, Grandjean D. Vocal emotion decoding in the subthalamic nucleus: An intracranial ERP study in Parkinson's disease. BRAIN AND LANGUAGE 2017; 168:1-11. [PMID: 28088666 DOI: 10.1016/j.bandl.2016.12.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 11/22/2016] [Accepted: 12/12/2016] [Indexed: 05/13/2023]
Abstract
Using intracranial local field potential (LFP) recordings in patients with Parkinson's disease (PD) undergoing deep brain stimulation (DBS), we explored the electrophysiological activity of the subthalamic nucleus (STN) in response to emotional stimuli in the auditory modality. Previous studies focused on the influence of visual stimuli. To this end, we recorded LFPs within the STN in response to angry, happy, and neutral prosodies in 13 patients with PD who had just undergone implantation of DBS electrodes. We observed specific modulation of the right STN in response to anger and happiness, as opposed to neutral prosody, occurring at around 200-300ms post-onset, and later at around 850-950ms post-onset for anger and at around 3250-3350ms post-onset for happiness. Taken together with previous reports of modulated STN activity in response to emotional visual stimuli, the present results appear to confirm that the STN is involved in emotion processing irrespective of stimulus valence and sensory modality.
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Affiliation(s)
- Julie Péron
- 'Neuroscience of Emotion and Affective Dynamics' Laboratory, Department of Psychology & Swiss Center for Affective Sciences, University of Geneva, 40 bd du Pont d'Arve, 1205 Geneva, Switzerland; Neuropsychology Unit, Department of Neurology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.
| | - Olivier Renaud
- Methodology and Data Analysis Unit, Department of Psychology, University of Geneva, 40 bd du Pont d'Arve, 1205 Geneva, Switzerland
| | - Claire Haegelen
- Neurosurgery Department, Pontchaillou Hospital, Rennes University Hospital, rue Henri Le Guilloux, 35033 Rennes, France; INSERM, LTSI U1099, Faculty of Medicine, CS 34317, University of Rennes I, F-35042 Rennes, France
| | - Lucas Tamarit
- Neuropsychology Unit, Department of Neurology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Valérie Milesi
- 'Neuroscience of Emotion and Affective Dynamics' Laboratory, Department of Psychology & Swiss Center for Affective Sciences, University of Geneva, 40 bd du Pont d'Arve, 1205 Geneva, Switzerland; Neuropsychology Unit, Department of Neurology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Jean-François Houvenaghel
- 'Behavior and Basal Ganglia' Research Unit (EA 4712), University of Rennes 1, Rennes University Hospital, rue Henri Le Guilloux, 35033 Rennes, France; Neurology Department, Pontchaillou Hospital, Rennes University Hospital, rue Henri Le Guilloux, 35033 Rennes, France
| | - Thibaut Dondaine
- 'Behavior and Basal Ganglia' Research Unit (EA 4712), University of Rennes 1, Rennes University Hospital, rue Henri Le Guilloux, 35033 Rennes, France; Neurology Department, Pontchaillou Hospital, Rennes University Hospital, rue Henri Le Guilloux, 35033 Rennes, France; Adult Psychiatry Department, Guillaume Régnier Hospital, 108 avenue du Général Leclerc, 35703 Rennes, France
| | - Marc Vérin
- 'Behavior and Basal Ganglia' Research Unit (EA 4712), University of Rennes 1, Rennes University Hospital, rue Henri Le Guilloux, 35033 Rennes, France; Neurology Department, Pontchaillou Hospital, Rennes University Hospital, rue Henri Le Guilloux, 35033 Rennes, France
| | - Paul Sauleau
- 'Behavior and Basal Ganglia' Research Unit (EA 4712), University of Rennes 1, Rennes University Hospital, rue Henri Le Guilloux, 35033 Rennes, France; Physiology Department, Pontchaillou Hospital, Rennes University Hospital, rue Henri Le Guilloux, 35033 Rennes, France
| | - Didier Grandjean
- 'Neuroscience of Emotion and Affective Dynamics' Laboratory, Department of Psychology & Swiss Center for Affective Sciences, University of Geneva, 40 bd du Pont d'Arve, 1205 Geneva, Switzerland; Neuropsychology Unit, Department of Neurology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
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Jin Y, Mao Z, Ling Z, Xu X, Zhang Z, Yu X. Altered emotional recognition and expression in patients with Parkinson's disease. Neuropsychiatr Dis Treat 2017; 13:2891-2902. [PMID: 29225467 PMCID: PMC5708195 DOI: 10.2147/ndt.s149227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) patients exhibit deficits in emotional recognition and expression abilities, including emotional faces and voices. The aim of this study was to explore emotional processing in pre-deep brain stimulation (pre-DBS) PD patients using two sensory modalities (visual and auditory). METHODS Fifteen PD patients who needed DBS surgery and 15 healthy, age- and gender-matched controls were recruited as participants. All participants were assessed by the Karolinska Directed Emotional Faces database 50 Faces Recognition test. Vocal recognition was evaluated by the Montreal Affective Voices database 50 Voices Recognition test. For emotional facial expression, the participants were asked to imitate five basic emotions (neutral, happiness, anger, fear, and sadness). The subjects were required to express nonverbal vocalizations of the five basic emotions. Fifteen Chinese native speakers were recruited as decoders. We recorded the accuracy of the responses, reaction time, and confidence level. RESULTS For emotional recognition and expression, the PD group scored lower on both facial and vocal emotional processing than did the healthy control group. There were significant differences between the two groups in both reaction time and confidence level. A significant relationship was also found between emotional recognition and emotional expression when considering all participants between the two groups together. CONCLUSION The PD group exhibited poorer performance on both the recognition and expression tasks. Facial emotion deficits and vocal emotion abnormalities were associated with each other. In addition, our data allow us to speculate that emotional recognition and expression may share a common system.
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Affiliation(s)
- Yazhou Jin
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Zhiqi Mao
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Zhipei Ling
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Xin Xu
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Zhiyuan Zhang
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Xinguang Yu
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
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14
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Jin Y, Mao Z, Ling Z, Xu X, Xie G, Yu X. Altered emotional prosody processing in patients with Parkinson's disease after subthalamic nucleus stimulation. Neuropsychiatr Dis Treat 2017; 13:2965-2975. [PMID: 29270014 PMCID: PMC5729839 DOI: 10.2147/ndt.s153505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Patients with Parkinson's disease (PD) exhibit deficits in recognizing and expressing vocal emotional prosody. The aim of this study was to explore emotional prosody processing in patients with PD shortly after subthalamic nucleus (STN) deep brain stimulation (DBS). METHODS Two groups of patients with PD (pre-DBS and post-DBS) and one healthy control (HC) group were recruited as participants. All participants (PD and HC) were assessed using the Montreal Affective Voices database 50 Voices Recognition test. All participants were asked to nonverbally express five basic emotions (happiness, anger, fear, sadness, and neutral) to test emotional prosody expression. Fifteen native Chinese speakers were recruited as raters. We recorded the accuracy rate, reaction time, confidence level, and two acoustic parameters (mean pitch and mean intensity). RESULTS The PD groups scored lower than the HC group in recognizing and expressing emotional prosody. STN DBS had no significant effect on the recognition of emotional prosody but had a significant effect on fear prosody expression. Pearson's correlation analysis revealed significant correlations between performance on emotional prosody recognition tests and performance on emotional prosody expression tests in both the pre-DBS PD and post-DBS PD groups. CONCLUSION Shortly after STN DBS, the ability to recognize emotional prosody was not altered, but fear expression was impaired. We identified associations between abnormalities in emotional prosody recognition and expression deficits both before and after STN DBS, indicating that the processes involved in recognizing and expressing emotional prosody may share a common system.
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Affiliation(s)
- Yazhou Jin
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Zhiqi Mao
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Zhipei Ling
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Xin Xu
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Guang Xie
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Xinguang Yu
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
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15
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Péron J, Frühholz S, Ceravolo L, Grandjean D. Structural and functional connectivity of the subthalamic nucleus during vocal emotion decoding. Soc Cogn Affect Neurosci 2015; 11:349-56. [PMID: 26400857 DOI: 10.1093/scan/nsv118] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 09/17/2015] [Indexed: 11/13/2022] Open
Abstract
Our understanding of the role played by the subthalamic nucleus (STN) in human emotion has recently advanced with STN deep brain stimulation, a neurosurgical treatment for Parkinson's disease and obsessive-compulsive disorder. However, the potential presence of several confounds related to pathological models raises the question of how much they affect the relevance of observations regarding the physiological function of the STN itself. This underscores the crucial importance of obtaining evidence from healthy participants. In this study, we tested the structural and functional connectivity between the STN and other brain regions related to vocal emotion in a healthy population by combining diffusion tensor imaging and psychophysiological interaction analysis from a high-resolution functional magnetic resonance imaging study. As expected, we showed that the STN is functionally connected to the structures involved in emotional prosody decoding, notably the orbitofrontal cortex, inferior frontal gyrus, auditory cortex, pallidum and amygdala. These functional results were corroborated by probabilistic fiber tracking, which revealed that the left STN is structurally connected to the amygdala and the orbitofrontal cortex. These results confirm, in healthy participants, the role played by the STN in human emotion and its structural and functional connectivity with the brain network involved in vocal emotions.
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Affiliation(s)
- Julie Péron
- Neuroscience of Emotion and Affective Dynamics laboratory, Department of Psychology and Swiss Centre for Affective Sciences, Campus Biotech, University of Geneva, Switzerland
| | - Sascha Frühholz
- Neuroscience of Emotion and Affective Dynamics laboratory, Department of Psychology and Swiss Centre for Affective Sciences, Campus Biotech, University of Geneva, Switzerland
| | - Leonardo Ceravolo
- Neuroscience of Emotion and Affective Dynamics laboratory, Department of Psychology and Swiss Centre for Affective Sciences, Campus Biotech, University of Geneva, Switzerland
| | - Didier Grandjean
- Neuroscience of Emotion and Affective Dynamics laboratory, Department of Psychology and Swiss Centre for Affective Sciences, Campus Biotech, University of Geneva, Switzerland
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16
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Speech prosody, reward, and the corticobulbar system: an integrative perspective. Behav Brain Sci 2015; 37:573-4; discussion 577-604. [PMID: 25514963 DOI: 10.1017/s0140525x13004214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Speech prosody is essential for verbal communication. In this commentary I provide an integrative overview, arguing that speech prosody is subserved by the same anatomical and neurochemical mechanisms involved in the processing of reward/affective outcomes.
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17
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McIntosh LG, Mannava S, Camalier CR, Folley BS, Albritton A, Konrad PE, Charles D, Park S, Neimat JS. Emotion recognition in early Parkinson's disease patients undergoing deep brain stimulation or dopaminergic therapy: a comparison to healthy participants. Front Aging Neurosci 2015; 6:349. [PMID: 25653616 PMCID: PMC4301000 DOI: 10.3389/fnagi.2014.00349] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 12/28/2014] [Indexed: 01/24/2023] Open
Abstract
Parkinson's disease (PD) is traditionally regarded as a neurodegenerative movement disorder, however, nigrostriatal dopaminergic degeneration is also thought to disrupt non-motor loops connecting basal ganglia to areas in frontal cortex involved in cognition and emotion processing. PD patients are impaired on tests of emotion recognition, but it is difficult to disentangle this deficit from the more general cognitive dysfunction that frequently accompanies disease progression. Testing for emotion recognition deficits early in the disease course, prior to cognitive decline, better assesses the sensitivity of these non-motor corticobasal ganglia-thalamocortical loops involved in emotion processing to early degenerative change in basal ganglia circuits. In addition, contrasting this with a group of healthy aging individuals demonstrates changes in emotion processing specific to the degeneration of basal ganglia circuitry in PD. Early PD patients (EPD) were recruited from a randomized clinical trial testing the safety and tolerability of deep brain stimulation (DBS) of the subthalamic nucleus (STN-DBS) in early-staged PD. EPD patients were previously randomized to receive optimal drug therapy only (ODT), or drug therapy plus STN-DBS (ODT + DBS). Matched healthy elderly controls (HEC) and young controls (HYC) also participated in this study. Participants completed two control tasks and three emotion recognition tests that varied in stimulus domain. EPD patients were impaired on all emotion recognition tasks compared to HEC. Neither therapy type (ODT or ODT + DBS) nor therapy state (ON/OFF) altered emotion recognition performance in this study. Finally, HEC were impaired on vocal emotion recognition relative to HYC, suggesting a decline related to healthy aging. This study supports the existence of impaired emotion recognition early in the PD course, implicating an early disruption of fronto-striatal loops mediating emotional function.
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Affiliation(s)
- Lindsey G McIntosh
- Department of Neurological Surgery, Vanderbilt University Medical Center Nashville, TN, USA ; Department of Psychology, Vanderbilt University Nashville, TN, USA
| | - Sishir Mannava
- Department of Neurological Surgery, Vanderbilt University Medical Center Nashville, TN, USA
| | - Corrie R Camalier
- Department of Neurological Surgery, Vanderbilt University Medical Center Nashville, TN, USA
| | | | - Aaron Albritton
- Department of Neurological Surgery, Vanderbilt University Medical Center Nashville, TN, USA
| | - Peter E Konrad
- Department of Neurological Surgery, Vanderbilt University Medical Center Nashville, TN, USA
| | - David Charles
- Department of Neurology, Vanderbilt University Medical Center Nashville, TN, USA
| | - Sohee Park
- Department of Psychology, Vanderbilt University Nashville, TN, USA
| | - Joseph S Neimat
- Department of Neurological Surgery, Vanderbilt University Medical Center Nashville, TN, USA
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18
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Guillory SA, Bujarski KA. Exploring emotions using invasive methods: review of 60 years of human intracranial electrophysiology. Soc Cogn Affect Neurosci 2014; 9:1880-9. [PMID: 24509492 PMCID: PMC4249472 DOI: 10.1093/scan/nsu002] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Revised: 01/07/2014] [Accepted: 01/10/2014] [Indexed: 01/01/2023] Open
Abstract
Over the past 60 years, human intracranial electrophysiology (HIE) has been used to characterize seizures in patients with epilepsy. Secondary to the clinical objectives, electrodes implanted intracranially have been used to investigate mechanisms of human cognition. In addition to studies of memory and language, HIE methods have been used to investigate emotions. The aim of this review is to outline the contribution of HIE (electrocorticography, single-unit recording and electrical brain stimulation) to our understanding of the neural representations of emotions. We identified 64 papers dating back to the mid-1950s which used HIE techniques to study emotional states. Evidence from HIE studies supports the existence of widely distributed networks in the neocortex, limbic/paralimbic regions and subcortical nuclei which contribute to the representation of emotional states. In addition, evidence from HIE supports hemispheric dominance for emotional valence. Furthermore, evidence from HIE supports the existence of overlapping neural areas for emotion perception, experience and expression. Lastly, HIE provides unique insights into the temporal dynamics of neural activation during perception, experience and expression of emotional states. In conclusion, we propose that HIE techniques offer important evidence which must be incorporated into our current models of emotion representation in the human brain.
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Affiliation(s)
- Sean A Guillory
- Psychological and Brain Sciences Department, Dartmouth College, Hanover, NH, USA and Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Krzysztof A Bujarski
- Psychological and Brain Sciences Department, Dartmouth College, Hanover, NH, USA and Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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19
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Sensory contribution to vocal emotion deficit in Parkinson's disease after subthalamic stimulation. Cortex 2014; 63:172-83. [PMID: 25282055 DOI: 10.1016/j.cortex.2014.08.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 07/20/2014] [Accepted: 08/23/2014] [Indexed: 11/21/2022]
Abstract
Subthalamic nucleus (STN) deep brain stimulation in Parkinson's disease induces modifications in the recognition of emotion from voices (or emotional prosody). Nevertheless, the underlying mechanisms are still only poorly understood, and the role of acoustic features in these deficits has yet to be elucidated. Our aim was to identify the influence of acoustic features on changes in emotional prosody recognition following STN stimulation in Parkinson's disease. To this end, we analysed the performances of patients on vocal emotion recognition in pre-versus post-operative groups, as well as of matched controls, entering the acoustic features of the stimuli into our statistical models. Analyses revealed that the post-operative biased ratings on the Fear scale when patients listened to happy stimuli were correlated with loudness, while the biased ratings on the Sadness scale when they listened to happiness were correlated with fundamental frequency (F0). Furthermore, disturbed ratings on the Happiness scale when the post-operative patients listened to sadness were found to be correlated with F0. These results suggest that inadequate use of acoustic features following subthalamic stimulation has a significant impact on emotional prosody recognition in patients with Parkinson's disease, affecting the extraction and integration of acoustic cues during emotion perception.
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20
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Liu Y, Li W, Tan C, Liu X, Wang X, Gui Y, Qin L, Deng F, Hu C, Chen L. Meta-analysis comparing deep brain stimulation of the globus pallidus and subthalamic nucleus to treat advanced Parkinson disease. J Neurosurg 2014; 121:709-18. [PMID: 24905564 DOI: 10.3171/2014.4.jns131711] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECT Deep brain stimulation (DBS) is the surgical procedure of choice for patients with advanced Parkinson disease (PD). The globus pallidus internus (GPi) and the subthalamic nucleus (STN) are commonly targeted by this procedure. The purpose of this meta-analysis was to compare the efficacy of DBS in each region. METHODS MEDLINE/PubMed, EMBASE, Web of Knowledge, and the Cochrane Library were searched for English-language studies published before April 2013. RESULTS of studies investigating the efficacy and clinical outcomes of DBS of the GPi and STN for PD were analyzed. RESULTS Six eligible trials containing a total of 563 patients were included in the analysis. Deep brain stimulation of the GPi or STN equally improved motor function, measured by the Unified Parkinson's Disease Rating Scale Section III (UPDRSIII) (motor section, for patients in on- and off-medication phases), within 1 year postsurgery. The change score for the on-medication phase was 0.68 (95% CI - 2.12 to 3.47, p > 0.05; 5 studies, 518 patients) and for the off-medication phase was 1.83 (95% CI - 3.12 to 6.77, p > 0.05; 5 studies, 518 patients). The UPDRS Section II (activities of daily living) scores for patients on medication improved equally in both DBS groups (p = 0.97). STN DBS allowed medication dosages to be reduced more than GPi DBS (95% CI 129.27-316.64, p < 0.00001; 5 studies, 540 patients). Psychiatric symptoms, measured by Beck Depression Inventory, 2nd edition scores, showed greater improvement from baseline after GPi DBS than after STN DBS (standardized mean difference -2.28, 95% CI -3.73 to -0.84, p = 0.002; 3 studies, 382 patients). CONCLUSIONS GPi and STN DBS improve motor function and activities of daily living for PD patients. Differences in therapeutic efficacy for PD were not observed between the 2 procedures. STN DBS allowed greater reduction in medication for patients, whereas GPi DBS provided greater relief from psychiatric symptoms. An understanding of other symptomatic aspects of targeting each region and long-term observations on therapeutic effects are needed.
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Affiliation(s)
- Yi Liu
- Department of Neurology, the Second Affiliated Hospital of Chong Qing Medical University, YuZhong, Chong Qing, China
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21
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Castrioto A, Lhommée E, Moro E, Krack P. Mood and behavioural effects of subthalamic stimulation in Parkinson's disease. Lancet Neurol 2014; 13:287-305. [PMID: 24556007 DOI: 10.1016/s1474-4422(13)70294-1] [Citation(s) in RCA: 202] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Deep-brain stimulation (DBS) of the subthalamic nucleus (STN) is an established treatment for motor complications in Parkinson's disease. 20 years of experience with this procedure have contributed to improved understanding of the role of the STN in motor, cognitive, and emotional control. In Parkinson's disease, the pathological STN neuronal activity leads to motor, cognitive, and emotional inhibition. Deafferentation of the STN by DBS can reverse such behavioural inhibition. The release of this brake allows both motor and non-motor improvement, but can also be associated with excessive motor, cognitive, and emotional behavioural disinhibition. Conversely, the notable reduction in anti-parkinsonian drug dose allowed by motor improvement can unveil mesolimbic hypodopaminergic behaviours such as apathy, anxiety, or depression. Fine-tuning of stimulation parameters with dopaminergic drugs is necessary to prevent or improve pathological behaviours.
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Affiliation(s)
- Anna Castrioto
- Movement Disorder Unit, Department of Psychiatry and Neurology, Centre Hospitalier Universitaire de Grenoble, Joseph Fourier University, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 836, Grenoble Institut des Neurosciences, Grenoble, France; Clinica Neurologica, Università di Perugia, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - Eugénie Lhommée
- Movement Disorder Unit, Department of Psychiatry and Neurology, Centre Hospitalier Universitaire de Grenoble, Joseph Fourier University, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 836, Grenoble Institut des Neurosciences, Grenoble, France
| | - Elena Moro
- Movement Disorder Unit, Department of Psychiatry and Neurology, Centre Hospitalier Universitaire de Grenoble, Joseph Fourier University, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 836, Grenoble Institut des Neurosciences, Grenoble, France
| | - Paul Krack
- Movement Disorder Unit, Department of Psychiatry and Neurology, Centre Hospitalier Universitaire de Grenoble, Joseph Fourier University, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 836, Grenoble Institut des Neurosciences, Grenoble, France.
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22
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Aiello M, Eleopra R, Lettieri C, Mondani M, D'Auria S, Belgrado E, Piani A, De Simone L, Rinaldo S, Rumiati RI. Emotion recognition in Parkinson's disease after subthalamic deep brain stimulation: Differential effects of microlesion and STN stimulation. Cortex 2014; 51:35-45. [DOI: 10.1016/j.cortex.2013.11.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 09/25/2013] [Accepted: 11/08/2013] [Indexed: 12/19/2022]
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STN-DBS does not change emotion recognition in advanced Parkinson's disease. Parkinsonism Relat Disord 2013; 20:166-9. [PMID: 24182523 DOI: 10.1016/j.parkreldis.2013.10.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 09/07/2013] [Accepted: 10/09/2013] [Indexed: 11/23/2022]
Abstract
UNLABELLED Deep brain stimulation of the subthalamic nuclei (STN-DBS) for the treatment of levodopa-induced motor complications in advanced Parkinson's disease (APD) has been associated with neuropsychiatric disorders. It has been suggested that a postoperative decline in visual emotion recognition is responsible for those adverse events, although there is also evidence that emotional processing deficits can be present before surgery. The aim of the present study is to compare the ability to recognize emotions before and one year after surgery in APD. METHODS Consecutively operated APD patients were tested pre-operatively and one year after STN-DBS by the Comprehensive Affect Testing System (CATS), which evaluates visual recognition of 7 basic emotions (happiness, sadness, anger, fear, surprise, disgust and neutral) on facial expressions and 4 emotions on prosody (happiness, sadness, anger and fear). RESULTS In a sample of 30 patients 6 had depression or apathy at baseline that significantly increased to 14 post-surgery. There were no significant changes in the tests of identity discrimination, discrimination of emotional faces, naming of emotional faces, recognition of emotional prosody, and naming of emotional prosody after STN-DBS. The results of emotion tests could not predict the development of the neuropsychiatric symptoms. DISCUSSION This study does not support the hypothesis of an acquired change in emotion recognition, either in faces or in prosody, after STN-DBS in APD patients. Neuropsychiatric symptoms appearing after STN-DBS should not be attributed to new deficits in emotional recognition.
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Péron J, Frühholz S, Vérin M, Grandjean D. Subthalamic nucleus: a key structure for emotional component synchronization in humans. Neurosci Biobehav Rev 2013; 37:358-73. [PMID: 23318227 DOI: 10.1016/j.neubiorev.2013.01.001] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2012] [Revised: 12/12/2012] [Accepted: 01/03/2013] [Indexed: 11/28/2022]
Abstract
Affective neuroscience is concerned with identifying the neural bases of emotion. For historical and methodological reasons, models describing the brain architecture that supports emotional processes in humans have tended to neglect the basal ganglia, focusing instead on cortical and amygdalar mechanisms. Now, however, deep brain stimulation (DBS) of the subthalamic nucleus (STN), a neurosurgical treatment for Parkinson's disease and obsessive-compulsive disorder, is helping researchers explore the possible functional role of this particular basal ganglion in emotional processes. After reviewing studies that have used DBS in this way, we propose a model in which the STN plays a crucial role in producing temporally organized neural co-activation patterns at the cortical and subcortical levels that are essential for generating emotions and related feelings.
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Affiliation(s)
- Julie Péron
- Swiss Center for Affective Sciences, 7 rue des Battoirs, 1205 Geneva, Switzerland.
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25
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Simonyan K, Horwitz B, Jarvis ED. Dopamine regulation of human speech and bird song: a critical review. BRAIN AND LANGUAGE 2012; 122:142-50. [PMID: 22284300 PMCID: PMC3362661 DOI: 10.1016/j.bandl.2011.12.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Revised: 12/11/2011] [Accepted: 12/12/2011] [Indexed: 05/23/2023]
Abstract
To understand the neural basis of human speech control, extensive research has been done using a variety of methodologies in a range of experimental models. Nevertheless, several critical questions about learned vocal motor control still remain open. One of them is the mechanism(s) by which neurotransmitters, such as dopamine, modulate speech and song production. In this review, we bring together the two fields of investigations of dopamine action on voice control in humans and songbirds, who share similar behavioral and neural mechanisms for speech and song production. While human studies investigating the role of dopamine in speech control are limited to reports in neurological patients, research on dopaminergic modulation of bird song control has recently expanded our views on how this system might be organized. We discuss the parallels between bird song and human speech from the perspective of dopaminergic control as well as outline important differences between these species.
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Affiliation(s)
- Kristina Simonyan
- Department of Neurology, Mount Sinai School of Medicine, New York, NY, United States.
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26
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Mondillon L, Mermillod M, Musca SC, Rieu I, Vidal T, Chambres P, Auxiette C, Dalens H, Marie Coulangeon L, Jalenques I, Lemaire JJ, Ulla M, Derost P, Marques A, Durif F. The combined effect of subthalamic nuclei deep brain stimulation and L-dopa increases emotion recognition in Parkinson's disease. Neuropsychologia 2012; 50:2869-2879. [PMID: 22944002 DOI: 10.1016/j.neuropsychologia.2012.08.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Revised: 07/17/2012] [Accepted: 08/19/2012] [Indexed: 11/28/2022]
Abstract
Deep brain stimulation of the subthalamic nucleus (DBS) is a widely used surgical technique to suppress motor symptoms in Parkinson's disease (PD), and as such improves patients' quality of life. However, DBS may produce emotional disorders such as a reduced ability to recognize emotional facial expressions (EFE). Previous studies have not considered the fact that DBS and l-dopa medication can have differential, common, or complementary consequences on EFE processing. A thorough way of investigating the effect of DBS and l-dopa medication in greater detail is to compare patients' performances after surgery, with the two therapies either being administered ('on') or not administered ('off'). We therefore used a four-condition (l-dopa 'on'/DBS 'on', l-dopa 'on'/DBS 'off', l-dopa 'off'/DBS 'on', and l-dopa 'off'/DBS 'off') EFE recognition paradigm and compared implanted PD patients to healthy controls. The results confirmed those of previous studies, yielding a significant impairment in the detection of some facial expressions relative to controls. Disgust recognition was impaired when patients were 'off' l-dopa and 'on' DBS, and fear recognition impaired when 'off' of both therapies. More interestingly, the combined effect of both DBS and l-dopa administration seems much more beneficial for EFE recognition than the separate administration of each individual therapy. We discuss the implications of these findings in the light of the inverted U curve function that describes the differential effects of dopamine level on the right orbitofrontal cortex (OFC). We propose that, while l-dopa could "overdose" in dopamine the ventral stream of the OFC, DBS would compensate for this over-activation by decreasing OFC activity, thereby restoring the necessary OFC-amygdala interaction. Another finding is that, when collapsing over all treatment conditions, PD patients recognized more neutral faces than the matched controls, a result that concurs with embodiment theories.
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Affiliation(s)
- Laurie Mondillon
- LAPSCO (UMR 6024), Blaise Pascal University, Clermont-Ferrand 63000, France.
| | - Martial Mermillod
- LAPSCO (UMR 6024), Blaise Pascal University, Clermont-Ferrand 63000, France; Institut Universitaire de France, Paris 75005, France
| | - Serban C Musca
- CRPCC (EA 1285), European University of Brittany, Rennes 35000, France
| | - Isabelle Rieu
- Neurology Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France; UFR Medecine, University of Clermont 1, Clermont-Ferrand F-63009, France
| | - Tiphaine Vidal
- Neurology Department, Resource and Research Memory Center (CMRR), CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France
| | - Patrick Chambres
- LAPSCO (UMR 6024), Blaise Pascal University, Clermont-Ferrand 63000, France
| | - Catherine Auxiette
- Neurology Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France
| | - Hélène Dalens
- Ophtalmology Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France
| | | | - Isabelle Jalenques
- UFR Medecine, University of Clermont 1, Clermont-Ferrand F-63009, France; Psychiatry A Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France
| | - Jean-Jacques Lemaire
- UFR Medecine, University of Clermont 1, Clermont-Ferrand F-63009, France; Neurosurgery Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France
| | - Miguel Ulla
- Neurology Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France
| | - Philippe Derost
- Neurology Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France
| | - Ana Marques
- Neurology Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France; UFR Medecine, University of Clermont 1, Clermont-Ferrand F-63009, France
| | - Franck Durif
- Neurology Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France; UFR Medecine, University of Clermont 1, Clermont-Ferrand F-63009, France
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Brück C, Kreifelts B, Wildgruber D. Emotional voices in context: A neurobiological model of multimodal affective information processing. Phys Life Rev 2011; 8:383-403. [DOI: 10.1016/j.plrev.2011.10.002] [Citation(s) in RCA: 108] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 10/11/2011] [Indexed: 11/27/2022]
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