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Rasing NB, van de Geest-Buit W, Chan OYA, Mul K, Lanser A, Erasmus CE, Groothuis JT, Holler J, Ingels KJAO, Post B, Siemann I, Voermans NC. Psychosocial functioning in patients with altered facial expression: a scoping review in five neurological diseases. Disabil Rehabil 2024; 46:3772-3791. [PMID: 37752723 DOI: 10.1080/09638288.2023.2259310] [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: 05/19/2022] [Revised: 09/06/2023] [Accepted: 09/10/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE To perform a scoping review to investigate the psychosocial impact of having an altered facial expression in five neurological diseases. METHODS A systematic literature search was performed. Studies were on Bell's palsy, facioscapulohumeral muscular dystrophy (FSHD), Moebius syndrome, myotonic dystrophy type 1, or Parkinson's disease patients; had a focus on altered facial expression; and had any form of psychosocial outcome measure. Data extraction focused on psychosocial outcomes. RESULTS Bell's palsy, myotonic dystrophy type 1, and Parkinson's disease patients more often experienced some degree of psychosocial distress than healthy controls. In FSHD, facial weakness negatively influenced communication and was experienced as a burden. The psychosocial distress applied especially to women (Bell's palsy and Parkinson's disease), and patients with more severely altered facial expression (Bell's palsy), but not for Moebius syndrome patients. Furthermore, Parkinson's disease patients with more pronounced hypomimia were perceived more negatively by observers. Various strategies were reported to compensate for altered facial expression. CONCLUSIONS This review showed that patients with altered facial expression in four of five included neurological diseases had reduced psychosocial functioning. Future research recommendations include studies on observers' judgements of patients during social interactions and on the effectiveness of compensation strategies in enhancing psychosocial functioning.
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Affiliation(s)
- Nathaniël B Rasing
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Willianne van de Geest-Buit
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - On Ying A Chan
- Medical Library, Radboud University, Nijmegen, The Netherlands
| | - Karlien Mul
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anke Lanser
- Patient Representative and Chairman FSHD Advocacy Group, Patient Organization for Muscular Disease Spierziekten Nederland, Baarn, The Netherlands
| | - Corrie E Erasmus
- Department of Pediatric Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan T Groothuis
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Judith Holler
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, and Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | - Koen J A O Ingels
- Department of Otorhinolaryngology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bart Post
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ietske Siemann
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicol C Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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Abo Foul Y, Arkadir D, Demikhovskaya A, Noyman Y, Linetsky E, Abu Snineh M, Aviezer H, Eitan R. Perception of emotionally incongruent cues: evidence for overreliance on body vs. face expressions in Parkinson's disease. Front Psychol 2024; 15:1287952. [PMID: 38770252 PMCID: PMC11103677 DOI: 10.3389/fpsyg.2024.1287952] [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: 09/03/2023] [Accepted: 04/08/2024] [Indexed: 05/22/2024] Open
Abstract
Individuals with Parkinson's disease (PD) may exhibit impaired emotion perception. However, research demonstrating this decline has been based almost entirely on the recognition of isolated emotional cues. In real life, emotional cues such as expressive faces are typically encountered alongside expressive bodies. The current study investigated emotion perception in individuals with PD (n = 37) using emotionally incongruent composite displays of facial and body expressions, as well as isolated face and body expressions, and congruent composite displays as a baseline. In addition to a group of healthy controls (HC) (n = 50), we also included control individuals with schizophrenia (SZ) (n = 30), who display, as in PD, similar motor symptomology and decreased emotion perception abilities. The results show that individuals with PD showed an increased tendency to categorize incongruent face-body combinations in line with the body emotion, whereas those with HC showed a tendency to classify them in line with the facial emotion. No consistent pattern for prioritizing the face or body was found in individuals with SZ. These results were not explained by the emotional recognition of the isolated cues, cognitive status, depression, or motor symptoms of individuals with PD and SZ. As real-life expressions may include inconsistent cues in the body and face, these findings may have implications for the way individuals with PD and SZ interpret the emotions of others.
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Affiliation(s)
- Yasmin Abo Foul
- Department of Psychology, Hebrew University of Jerusalem, Jerusalem, Israel
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - David Arkadir
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Anastasia Demikhovskaya
- Neuropsychiatry Unit, Jerusalem Mental Health Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yehuda Noyman
- Neuropsychiatry Unit, Jerusalem Mental Health Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eduard Linetsky
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Muneer Abu Snineh
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Hillel Aviezer
- Department of Psychology, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Renana Eitan
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
- Neuropsychiatry Unit, Jerusalem Mental Health Center, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Medical Neurobiology (Physiology), Institute for Medical Research Israel-Canada, Hebrew University-Hadassah Medical School, Jerusalem, Israel
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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3
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Roßkopf S, Wechsler TF, Tucha S, Mühlberger A. Effects of facial biofeedback on hypomimia, emotion recognition, and affect in Parkinson's disease. J Int Neuropsychol Soc 2024; 30:360-369. [PMID: 38017615 DOI: 10.1017/s1355617723000747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
OBJECTIVES Facial expressions are a core component of emotions and nonverbal social communication. Therefore, hypomimia as secondary symptom of Parkinson's disease (PD) has adverse effects like social impairment, stigmatization, under-diagnosis and under-treatment of depression, and a generally lower quality of life. Beside unspecific dopaminergic treatment, specific treatment options for hypomimia in PD are rarely investigated. This quasi-randomized controlled trial evaluated the short-term effects of facial electromyogram (EMG) based biofeedback to enhance facial expression and emotion recognition as nonverbal social communication skills in PD patients. Furthermore effects on affect are examined. METHOD A sample of 34 in-patients with PD were allocated either to facial EMG-biofeedback as experimental group or non-facial exercises as control group. Facial expression during posing of emotions (measured via EMG), facial emotion recognition, and positive and negative affect were assessed before and after treatment. Stronger improvements were expected in the EMG-biofeedback in comparison to the control group. RESULTS The facial EMG-biofeedback group showed significantly greater improvements in overall facial expression, and especially for happiness and disgust. Also, overall facial emotion recognition abilities improved significantly stronger in the experimental group. Positive affect was significantly increased in both groups with no significant differences between them, while negative affect did not change within both groups. CONCLUSIONS The study provides promising evidence for facial EMG-biofeedback as a tool to improve facial expression and emotion recognition in PD. Embodiment theories are discussed as working mechanism.
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Affiliation(s)
- Sarah Roßkopf
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Theresa Friederike Wechsler
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Stefanie Tucha
- Schön Klinik München Schwabing - Neurologie München, München, Germany
- Schön Klinik MVZ, München, Germany
| | - Andreas Mühlberger
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Regensburg, Regensburg, Germany
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4
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Bianchini E, Rinaldi D, Alborghetti M, Simonelli M, D’Audino F, Onelli C, Pegolo E, Pontieri FE. The Story behind the Mask: A Narrative Review on Hypomimia in Parkinson's Disease. Brain Sci 2024; 14:109. [PMID: 38275529 PMCID: PMC10814039 DOI: 10.3390/brainsci14010109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
Facial movements are crucial for social and emotional interaction and well-being. Reduced facial expressions (i.e., hypomimia) is a common feature in patients with Parkinson's disease (PD) and previous studies linked this manifestation to both motor symptoms of the disease and altered emotion recognition and processing. Nevertheless, research on facial motor impairment in PD has been rather scarce and only a limited number of clinical evaluation tools are available, often suffering from poor validation processes and high inter- and intra-rater variability. In recent years, the availability of technology-enhanced quantification methods of facial movements, such as automated video analysis and machine learning application, led to increasing interest in studying hypomimia in PD. In this narrative review, we summarize the current knowledge on pathophysiological hypotheses at the basis of hypomimia in PD, with particular focus on the association between reduced facial expressions and emotional processing and analyze the current evaluation tools and management strategies for this symptom, as well as future research perspectives.
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Affiliation(s)
- Edoardo Bianchini
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- AGEIS, Université Grenoble Alpes, 38000 Grenoble, France
- Sant’Andrea University Hospital, 00189 Rome, Italy;
| | - Domiziana Rinaldi
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- Sant’Andrea University Hospital, 00189 Rome, Italy;
| | - Marika Alborghetti
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- Sant’Andrea University Hospital, 00189 Rome, Italy;
| | - Marta Simonelli
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- Ospedale dei Castelli, ASL Rome 6, 00040 Ariccia, Italy
| | | | - Camilla Onelli
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy;
| | - Elena Pegolo
- Department of Information Engineering, University of Padova, 35131 Padova, Italy;
| | - Francesco E. Pontieri
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- Sant’Andrea University Hospital, 00189 Rome, Italy;
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
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Rodríguez-Antigüedad J, Martínez-Horta S, Horta-Barba A, Puig-Davi A, Campolongo A, Sampedro F, Bejr-Kasem H, Marín-Lahoz J, Pagonabarraga J, Kulisevsky J. Facial emotion recognition deficits are associated with hypomimia and related brain correlates in Parkinson's disease. J Neural Transm (Vienna) 2024:10.1007/s00702-023-02725-3. [PMID: 38206439 DOI: 10.1007/s00702-023-02725-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/30/2023] [Indexed: 01/12/2024]
Abstract
Hypomimia is a frequent manifestation in Parkinson's disease (PD) that can affect interpersonal relationships and quality of life. Recent studies have suggested that hypomimia is not only related to motor dysfunction but also to impairment in emotional processing networks. Therefore, we hypothesized that the severity of hypomimia could be associated with performance on a task aimed at assessing facial emotion recognition. In this study, we explored the association between hypomimia, recognition of facial expressions of basic emotions using the Ekman 60 Faces Test (EF), and brain correlates of both hypomimia and performance on the EF. A total of 94 subjects underwent clinical assessments (neurological and neuropsychological examinations), and 56 of them participated in the neuroimaging study. We found significant correlation between hypomimia, EF Disgust (r = -0.242, p = 0.022) and EF Happiness (r = -0.264, p = 0.012); an independent reduction in Cortical Thickness (Cth) in the postcentral gyrus, insula, middle and superior temporal gyri, supramarginal gyrus, banks of the superior temporal sulcus, bilateral fusiform gyri, entorhinal cortex, parahippocampal gyrus, inferior and superior parietal cortex, and right cuneus and precuneus; and multiple correlations between negative emotions such as EF Disgust or EF Anger and a reduced Cth in fronto-temporo-parietal regions. In conclusion, these results suggest that the association between hypomimia and emotion recognition deficits in individuals with PD might be mediated by shared circuits, supporting the concept that hypomimia is not only the result of the dysfunction of motor circuits, but also of higher cognitive functions.
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Affiliation(s)
- Jon Rodríguez-Antigüedad
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Institut d'Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Saül Martínez-Horta
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Institut d'Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Andrea Horta-Barba
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Institut d'Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Arnau Puig-Davi
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Institut d'Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Antonia Campolongo
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Institut d'Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Frederic Sampedro
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain
- Institut d'Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Helena Bejr-Kasem
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Institut d'Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Juan Marín-Lahoz
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
- Neurology Department, Miguel Servet University Hospital, Saragossa, Spain
- Servet Neuroscience Group, Institute of Health Research of Aragon (IIS Aragón), Saragossa, Spain
| | - Javier Pagonabarraga
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Institut d'Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Jaime Kulisevsky
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain.
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
- Institut d'Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain.
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.
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Rasing NB, van de Geest-Buit WA, Chan OYA, Mul K, Lanser A, van Engelen BG, Erasmus CE, Fischer AH, Ingels KJ, Post B, Siemann I, Groothuis JT, Voermans NC. Treatment Approaches for Altered Facial Expression: A Systematic Review in Facioscapulohumeral Muscular Dystrophy and Other Neurological Diseases. J Neuromuscul Dis 2024; 11:535-565. [PMID: 38517799 PMCID: PMC11091602 DOI: 10.3233/jnd-230213] [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] [Accepted: 02/25/2024] [Indexed: 03/24/2024]
Abstract
Background Facial weakness is a key feature of facioscapulohumeral muscular dystrophy (FSHD) and may lead to altered facial expression and subsequent psychosocial impairment. There is no cure and supportive treatments focus on optimizing physical fitness and compensation of functional disabilities. Objective We hypothesize that symptomatic treatment options and psychosocial interventions for other neurological diseases with altered facial expression could be applicable to FSHD. Therefore, the aim of this review is to collect symptomatic treatment approaches that target facial muscle function and psychosocial interventions in various neurological diseases with altered facial expression in order to discuss the applicability to FSHD. Methods A systematic search was performed. Selected studies had to include FSHD, Bell's palsy, Moebius syndrome, myotonic dystrophy type 1, or Parkinson's disease and treatment options which target altered facial expression. Data was extracted for study and patients' characteristics, outcome assessment tools, treatment, outcome of facial expression and or psychosocial functioning. Results Forty studies met the inclusion criteria, of which only three studies included FSHD patients exclusively. Most, twenty-one, studies were performed in patients with Bell's palsy. Studies included twelve different therapy categories and results were assessed with different outcomes measures. Conclusions Five therapy categories were considered applicable to FSHD: training of (non-verbal) communication compensation strategies, speech training, physical therapy, conference attendance, and smile restoration surgery. Further research is needed to establish the effect of these therapies in FSHD. We recommend to include outcome measures in these studies that cover at least cosmetic, functional, communication, and quality of life domains.
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Affiliation(s)
- Nathaniël B. Rasing
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Willianne A. van de Geest-Buit
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - On Ying A. Chan
- Information Specialist, Medical Library, Radboud University, Nijmegen, The Netherlands
| | - Karlien Mul
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anke Lanser
- Patient Representative and Chairman FSHD Advocacy Group, Patient Organization for Muscular Disease Spierziekten Nederland, Baarn, The Netherlands
| | - Baziel G.M. van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Corrie E. Erasmus
- Department of Paediatric Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Amalia Children’s Hospital, Nijmegen, The Netherlands
| | - Agneta H. Fischer
- Department of Psychology, Social Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Koen J.A.O. Ingels
- Department of Otorhinolaryngology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bart Post
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ietske Siemann
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan T. Groothuis
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicol C. Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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7
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Eccles FJR, Garner IW, Murray CD, Doyle C, Simpson J. The joint impact of symptom deterioration and social factors on wellbeing for people with Parkinson's during the covid-19 pandemic in the UK. J Neurol Sci 2023; 452:120768. [PMID: 37611512 DOI: 10.1016/j.jns.2023.120768] [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: 10/28/2022] [Revised: 07/28/2023] [Accepted: 08/14/2023] [Indexed: 08/25/2023]
Abstract
The covid-19 pandemic and associated restrictions have had significant consequences for those living with chronic conditions such as Parkinson's. The restrictions in access to healthcare as well as reductions in social care, family support and community activities have led to decreases in physical and mental wellbeing. However, not everyone has been equally affected and the predictors of distress are currently being investigated worldwide. Here we use data from a UK survey conducted by the charity Parkinson's UK during Summer 2021 to look at physical and social predictors of wellbeing of people with Parkinson's. Specifically, we aimed to look at the combined effects of worsening physical symptoms, social isolation and loneliness on psychological wellbeing when controlling for age, gender and disease duration. The data from 612 participants were analysed using multiple regression analyses and showed that worsened physical symptoms, loneliness and social isolation each independently predicted wellbeing thus showing the impact of both physical symptoms and social factors. Improved access to healthcare and physical activity is needed to help improve physical health. However, addressing the social needs of people with Parkinson's is also important, and not only during a pandemic. Additional interventions may be needed to reduce social isolation and loneliness as there may be added barriers for people with Parkinson's which need to be considered.
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Affiliation(s)
- Fiona J R Eccles
- Division of Health Research, Faulty of Health and Medicine, Lancaster University, Lancaster LA1 4AT, UK.
| | - Ian W Garner
- Division of Health Research, Faulty of Health and Medicine, Lancaster University, Lancaster LA1 4AT, UK
| | - Craig D Murray
- Division of Health Research, Faulty of Health and Medicine, Lancaster University, Lancaster LA1 4AT, UK
| | - Cathal Doyle
- Parkinson's UK, 215 Vauxhall Bridge Road, London SW1V 1EJ, UK
| | - Jane Simpson
- Division of Health Research, Faulty of Health and Medicine, Lancaster University, Lancaster LA1 4AT, UK
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8
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Ettinger T, Berberian M, Acosta I, Cucca A, Feigin A, Genovese D, Pollen T, Rieders J, Kilachand R, Gomez C, Kaimal G, Biagioni M, Di Rocco A, Ghilardi FM, Rizzo JR. Art therapy as a comprehensive complementary treatment for Parkinson's disease. Front Hum Neurosci 2023; 17:1110531. [PMID: 37250693 PMCID: PMC10215005 DOI: 10.3389/fnhum.2023.1110531] [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: 11/28/2022] [Accepted: 04/11/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Parkinson's disease (PD) is the second most prevalent neurodegenerative disease. Complementary and alternative therapies are increasingly utilized to address its complex multisystem symptomatology. Art therapy involves motoric action and visuospatial processing while promoting broad biopsychosocial wellness. The process involves hedonic absorption, which provides an escape from otherwise persistent and cumulative PD symptoms, refreshing internal resources. It involves the expression in nonverbal form of multilayered psychological and somatic phenomena; once these are externalized in a symbolic arts medium, they can be explored, understood, integrated, and reorganized through verbal dialogue, effecting relief and positive change. Methods 42 participants with mild to moderate PD were treated with 20 sessions of group art therapy. They were assessed before and after therapy with a novel arts-based instrument developed to match the treatment modality for maximum sensitivity. The House-Tree-Person PD Scale (HTP-PDS) assesses motoric and visuospatial processing-core PD symptoms-as well as cognition (thought and logic), affect/mood, motivation, self (including body-image, self-image, and self- efficacy), interpersonal functioning, creativity, and overall level of functioning. It was hypothesized that art therapy will ameliorate core PD symptoms and that this will correlate with improvements in all other variables. Results HTP-PDS scores across all symptoms and variables improved significantly, though causality among variables was indeterminate. Discussion Art therapy is a clinically efficacious complementary treatment for PD. Further research is warranted to disentangle causal pathways among the aforementioned variables, and additionally, to isolate and examine the multiple, discrete healing mechanisms believed to operate simultaneously in art therapy.
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Affiliation(s)
- Tom Ettinger
- Steinhardt Graduate Art Therapy Program, New York University, New York, NY, United States
| | - Marygrace Berberian
- Steinhardt Graduate Art Therapy Program, New York University, New York, NY, United States
| | - Ikuko Acosta
- Steinhardt Graduate Art Therapy Program, New York University, New York, NY, United States
| | - Alberto Cucca
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
- Doctoral Program in Neural and Cognitive Neurosciences, Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Andrew Feigin
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
| | - Danilo Genovese
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
| | - Travis Pollen
- Department of Exercise Science, Thomas Jefferson University, Philadelphia, PA, United States
| | - Julianne Rieders
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
| | - Rohita Kilachand
- Steinhardt Graduate Art Therapy Program, New York University, New York, NY, United States
| | - Clara Gomez
- Steinhardt Graduate Art Therapy Program, New York University, New York, NY, United States
| | - Girija Kaimal
- Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | - Milton Biagioni
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
| | | | - Felice M. Ghilardi
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
| | - John-Ross Rizzo
- Department of Rehabilitation Medicine, New York University Grossman School of Medicine, New York, NY, United States
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Kuehne M, Polotzek L, Haghikia A, Zaehle T, Lobmaier JS. I spy with my little eye: The detection of changes in emotional faces and the influence of facial feedback in Parkinson disease. Eur J Neurol 2023; 30:622-630. [PMID: 36435983 DOI: 10.1111/ene.15647] [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: 07/20/2022] [Revised: 10/27/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Parkinson disease (PD) is a progressive neurodegenerative disorder that affects the motor system but also involves deficits in emotional processing such as facial emotion recognition. In healthy participants, it has been shown that facial mimicry, the automatic imitation of perceived facial expressions, facilitates the interpretation of the emotional states of our counterpart. In PD patients, recent studies revealed reduced facial mimicry and consequently reduced facial feedback, suggesting that this reduction might contribute to the prominent emotion recognition deficits found in PD. METHODS We investigated the influence of facial mimicry on facial emotion recognition. Twenty PD patients and 20 healthy controls (HCs) underwent a classical facial mimicry manipulation (holding a pen with the lips, teeth, or nondominant hand) while performing an emotional change detection task with faces. RESULTS As expected, emotion recognition was significantly influenced by facial mimicry manipulation in HCs, further supporting the hypothesis of facial feedback and the related theory of embodied simulation. Importantly, patients with PD, generally and independent from the facial mimicry manipulation, were impaired in their ability to detected emotion changes. Our data further show that PD patients' facial emotional recognition abilities are completely unaffected by mimicry manipulation, suggesting that PD patients cannot profit from an artificial modulation of the already impaired facial feedback. CONCLUSIONS These findings suggest that it is not the hypomimia and the absence of facial feedback per se, but a disruption of the facial feedback loop, that leads to the prominent emotion recognition deficit in PD patients.
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Affiliation(s)
- Maria Kuehne
- Department of Social Neuroscience and Social Psychology, Institute of Psychology, University of Bern, Bern, Switzerland
- Department of Neurology, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Laura Polotzek
- Department of Neurology, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Aiden Haghikia
- Department of Neurology, Otto von Guericke University Magdeburg, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Tino Zaehle
- Department of Neurology, Otto von Guericke University Magdeburg, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Janek S Lobmaier
- Department of Social Neuroscience and Social Psychology, Institute of Psychology, University of Bern, Bern, Switzerland
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10
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Schade RN, Springer U, Mikos A, Gokcay D, Clark A, Sapienza C, Fernandez HH, Okun MS, Bowers D. A Pilot Trial of Dopamine Replacement for Dynamic Facial Expressions in Parkinson's Disease. Mov Disord Clin Pract 2023; 10:213-222. [PMID: 36825053 PMCID: PMC9941940 DOI: 10.1002/mdc3.13603] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/23/2022] [Accepted: 10/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Current conflict exists regarding the potential beneficial effects of dopamine medications on facial expressivity in Parkinson's disease. Via digital video analysis software, we previously found reduced facial movement (entropy) and slower time to reach peak entropy in individuals with Parkinson's disease compared to controls. Objectives We aimed to determine whether levodopa medications improved parameters of dynamic facial expressions (amplitude, speed). Methods A total of 34 individuals with idiopathic Parkinson's disease were videotaped making voluntary facial expressions (happy, fear, anger, disgust) when "on" and "off" levodopa. Participants were 52 to 80 years old, early to mid-stage disease, non-demented, and included more men (65%). Expressions were digitized and analyzed using software that extracted three variables: two indices of movement change (total entropy, percent entropy change) and time to reach peak expression. Results Indices of facial movement (total entropy, peak entropy) and timing were significantly improved when patients were "on" vs "off" medication (all F's ≥ 3.00, P < 0.05). For total movement and time to reach peak entropy, levodopa-related improvements were emotion nonspecific. Levodopa-related improvement for peak entropy was driven primarily by happy expressions. There was no relationship between quantitative indices and clinical measures of mood (depression, anxiety) and motor disease severity. Conclusion The effects of levodopa on Parkinson's disease voluntary facial movement and on timing were robust and consistent with those of levodopa on other intentional movements in Parkinson's disease. This improvement possibly occurred because of levodopa enhanced activation of face representation areas in fronto-cortical regions or because of less movement-based suppression.
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Affiliation(s)
- Rachel N. Schade
- Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleFloridaUSA
| | - Utaka Springer
- Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleFloridaUSA
- Present address:
Department of Behavioral HealthNative American Health CenterOaklandCaliforniaUSA
| | - Ania Mikos
- Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleFloridaUSA
- Present address:
ZurichSwitzerland
| | - Didem Gokcay
- Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleFloridaUSA
- Present address:
McCombs School of BusinessUniversity of TexasAustinTexasUSA
| | - Alexandra Clark
- Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleFloridaUSA
- Present address:
Department of PsychologyUniversity of TexasAustinTexasUSA
| | - Christine Sapienza
- Department of Speech, Language, and Hearing SciencesUniversity of FloridaGainesvilleFloridaUSA
- Present address:
Department of Communication Sciences and DisordersJacksonville UniversityJacksonvilleFloridaUSA
| | - Hubert H. Fernandez
- Department of Neurology, Norman Fixel Institute for Neurological DiseasesUniversity of Florida HealthGainesvilleFloridaUSA
- Present address:
Center for Neurologic Restoration, Cleveland ClinicClevelandOhioUSA
| | - Michael S. Okun
- Department of Neurology, Norman Fixel Institute for Neurological DiseasesUniversity of Florida HealthGainesvilleFloridaUSA
| | - Dawn Bowers
- Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleFloridaUSA
- Department of Neurology, Norman Fixel Institute for Neurological DiseasesUniversity of Florida HealthGainesvilleFloridaUSA
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11
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Sampedro F, Martínez‐Horta S, Horta‐Barba A, Grothe MJ, Labrador‐Espinosa MA, Jesús S, Adarmes‐Gomez A, Carrillo F, Puig‐Davi A, Roldan‐Lora F, Aguilar‐Barbera M, Pastor P, Escalante Arroyo S, Solano‐Vila B, Cots‐Foraster A, Ruiz‐Martínez J, Carrillo‐Padilla F, Pueyo‐Morlans M, Gonzalez‐Aramburu I, Infante‐Ceberio J, Hernandez‐Vara J, de Fabregues‐Boixar O, de Deus Fonticoba T, Avila A, Martínez‐Castrillo JC, Bejr‐Kasem H, Campolongo A, Pascual‐Sedano B, Martínez‐Martín P, Santos‐García D, Mir P, Garcia‐Ruiz PJ, Kulisevsky J. Clinical and structural brain correlates of hypomimia in early‐stage Parkinson’s disease. Eur J Neurol 2022; 29:3720-3727. [DOI: 10.1111/ene.15513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/21/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Frederic Sampedro
- Centro de Investigacion Biomedica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III Madrid Spain
- Unidad de Trastornos del Movimiento, Servicio de Neurología, Hospital de Sant Pau Barcelona Spain
- Instituto de Investigacion del Hospital de Sant Pau Barcelona Spain
| | - Saul Martínez‐Horta
- Centro de Investigacion Biomedica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III Madrid Spain
- Unidad de Trastornos del Movimiento, Servicio de Neurología, Hospital de Sant Pau Barcelona Spain
- Instituto de Investigacion del Hospital de Sant Pau Barcelona Spain
| | - Andrea Horta‐Barba
- Centro de Investigacion Biomedica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III Madrid Spain
- Unidad de Trastornos del Movimiento, Servicio de Neurología, Hospital de Sant Pau Barcelona Spain
- Instituto de Investigacion del Hospital de Sant Pau Barcelona Spain
| | - Michel J. Grothe
- Centro de Investigacion Biomedica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III Madrid Spain
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla Seville Spain
| | - Miguel A. Labrador‐Espinosa
- Centro de Investigacion Biomedica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III Madrid Spain
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla Seville Spain
| | - Silvia Jesús
- Centro de Investigacion Biomedica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III Madrid Spain
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla Seville Spain
| | - Astrid Adarmes‐Gomez
- Centro de Investigacion Biomedica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III Madrid Spain
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla Seville Spain
| | - Fatima Carrillo
- Movement Disorders Unit, Neurology Department, Hospital Universitario Virgen del Rocío Seville Spain
| | - Arnau Puig‐Davi
- Centro de Investigacion Biomedica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III Madrid Spain
- Unidad de Trastornos del Movimiento, Servicio de Neurología, Hospital de Sant Pau Barcelona Spain
- Instituto de Investigacion del Hospital de Sant Pau Barcelona Spain
| | - Florinda Roldan‐Lora
- Unidad de Radiodiagnostico, Hospital Universitario Virgen del Rocío Seville Spain
| | | | - Pau Pastor
- Hospital Universitari Mutua de Terrassa, Terrassa Barcelona Spain
| | | | - Berta Solano‐Vila
- Institut Catala de la Salud (Girona), Institut d’Assistencia Sanitaria (IAS) Spain
| | - Anna Cots‐Foraster
- Institut Catala de la Salud (Girona), Institut d’Assistencia Sanitaria (IAS) Spain
| | - Javier Ruiz‐Martínez
- Instituto de Investigacion Biodonostia, Hospital Universitario Donostia San Sebastian Spain
| | | | | | - Isabel Gonzalez‐Aramburu
- Unidad de Trastornos del Movimiento, Servicio de Neurología, Hospital Universitario Marques de Valdecilla Santander Spain
| | - Jon Infante‐Ceberio
- Unidad de Trastornos del Movimiento, Servicio de Neurología, Hospital Universitario Marques de Valdecilla Santander Spain
| | - Jorge Hernandez‐Vara
- Neurology Department and Neurodegenerative Diseases Research Group, Vall D’Hebron Universitary Campus Barcelona Spain
| | - Oriol de Fabregues‐Boixar
- Neurology Department and Neurodegenerative Diseases Research Group, Vall D’Hebron Universitary Campus Barcelona Spain
| | | | - Asuncion Avila
- Consorci Sanitari Integral, Hospital General de L’Hospitalet, L’Hospitalet de Llobregat Barcelona Spain
| | | | - Helena Bejr‐Kasem
- Centro de Investigacion Biomedica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III Madrid Spain
- Unidad de Trastornos del Movimiento, Servicio de Neurología, Hospital de Sant Pau Barcelona Spain
- Instituto de Investigacion del Hospital de Sant Pau Barcelona Spain
| | - Antonia Campolongo
- Centro de Investigacion Biomedica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III Madrid Spain
- Unidad de Trastornos del Movimiento, Servicio de Neurología, Hospital de Sant Pau Barcelona Spain
- Instituto de Investigacion del Hospital de Sant Pau Barcelona Spain
| | - Berta Pascual‐Sedano
- Centro de Investigacion Biomedica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III Madrid Spain
- Unidad de Trastornos del Movimiento, Servicio de Neurología, Hospital de Sant Pau Barcelona Spain
- Instituto de Investigacion del Hospital de Sant Pau Barcelona Spain
| | - Pablo Martínez‐Martín
- Centro de Investigacion Biomedica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III Madrid Spain
| | | | - Pablo Mir
- Centro de Investigacion Biomedica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III Madrid Spain
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla Seville Spain
| | | | - Jaime Kulisevsky
- Centro de Investigacion Biomedica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III Madrid Spain
- Unidad de Trastornos del Movimiento, Servicio de Neurología, Hospital de Sant Pau Barcelona Spain
- Instituto de Investigacion del Hospital de Sant Pau Barcelona Spain
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12
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Islam SS, Neargarder S, Kinger SB, Fox-Fuller JT, Salazar RD, Cronin-Golomb A. Perceived stigma and quality of life in Parkinson’s disease with additional health conditions. Gen Psychiatr 2022; 35:e100653. [PMID: 35846485 PMCID: PMC9226861 DOI: 10.1136/gpsych-2021-100653] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 05/20/2022] [Indexed: 11/04/2022] Open
Abstract
BackgroundParkinson’s disease (PD) is associated with perceived stigma and affects quality of life (QoL). Additional health conditions may influence these consequences of PD.AimsThis study assessed the impact of health conditions on perceived stigma and QoL in persons with PD. We hypothesised that individuals with more health conditions would report more stigma and poorer QoL. We also examined the contributions of demographic and clinical characteristics to the correlations between health conditions and perceived stigma/QoL.MethodsWe identified 196 eligible participants from the Boston University Online Survey Study of Parkinson’s Disease and examined their health history, performance on multiple stigma measures, and scores on the 39-item Parkinson’s Disease Questionnaire assessing QoL.ResultsAt least one health condition was reported by 79% of the sample, with a median of 2 and a range of 0–7 health conditions. More perceived stigma and poorer QoL were associated with thyroid disease, depression, anxiety, and the total number of health conditions. These correlations were related to younger age, less education, and earlier disease onset. Other health conditions (high blood pressure, back/leg surgery, headache, cancer/tumours, and heart disease) were not significantly correlated with stigma or QoL.ConclusionsHaving more health conditions, or thyroid disease, depression, or anxiety, was associated with more perceived stigma and poorer QoL, with younger age, less education, and earlier disease onset affecting the associations. It is important to consider the burden of health conditions and how they affect persons with PD with specific clinical characteristics.
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Affiliation(s)
- Samia S Islam
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Sandy Neargarder
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
- Department of Psychology, Bridgewater State University, Bridgewater, Massachusetts, USA
| | - Shraddha B Kinger
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Joshua T Fox-Fuller
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Robert D Salazar
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Alice Cronin-Golomb
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
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13
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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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14
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Kay KR, Uc EY. Real-life consequences of cognitive dysfunction in Parkinson's disease. PROGRESS IN BRAIN RESEARCH 2022; 269:113-136. [DOI: 10.1016/bs.pbr.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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15
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Khomchenkova A, Prokopenko S, Gurevich V, Peresunko P. Diagnosis of hypomimia in Parkinson’s disease. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:24-29. [DOI: 10.17116/jnevro202212211224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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16
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Ali MR, Myers T, Wagner E, Ratnu H, Dorsey ER, Hoque E. Facial expressions can detect Parkinson's disease: preliminary evidence from videos collected online. NPJ Digit Med 2021; 4:129. [PMID: 34480109 PMCID: PMC8417264 DOI: 10.1038/s41746-021-00502-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 08/03/2021] [Indexed: 02/08/2023] Open
Abstract
A prevalent symptom of Parkinson's disease (PD) is hypomimia - reduced facial expressions. In this paper, we present a method for diagnosing PD that utilizes the study of micro-expressions. We analyzed the facial action units (AU) from 1812 videos of 604 individuals (61 with PD and 543 without PD, with a mean age 63.9 y/o, sd. 7.8) collected online through a web-based tool ( www.parktest.net ). In these videos, participants were asked to make three facial expressions (a smiling, disgusted, and surprised face) followed by a neutral face. Using techniques from computer vision and machine learning, we objectively measured the variance of the facial muscle movements and used it to distinguish between individuals with and without PD. The prediction accuracy using the facial micro-expressions was comparable to methodologies that utilize motor symptoms. Logistic regression analysis revealed that participants with PD had less variance in AU6 (cheek raiser), AU12 (lip corner puller), and AU4 (brow lowerer) than non-PD individuals. An automated classifier using Support Vector Machine was trained on the variances and achieved 95.6% accuracy. Using facial expressions as a future digital biomarker for PD could be potentially transformative for patients in need of remote diagnoses due to physical separation (e.g., due to COVID) or immobility.
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Affiliation(s)
| | - Taylor Myers
- Center for Health+Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - Ellen Wagner
- Center for Health+Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - Harshil Ratnu
- Computer Science, University of Rochester, Rochester, NY, USA
| | - E Ray Dorsey
- Center for Health+Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - Ehsan Hoque
- Computer Science, University of Rochester, Rochester, NY, USA
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Aristotelidou V, Tsatali M, Overton PG, Vivas AB. Autonomic factors do not underlie the elevated self-disgust levels in Parkinson's disease. PLoS One 2021; 16:e0256144. [PMID: 34473758 PMCID: PMC8412376 DOI: 10.1371/journal.pone.0256144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/30/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Parkinson's disease (PD) is manifested along with non-motor symptoms such as impairments in basic emotion regulation, recognition and expression. Yet, self-conscious emotion (SCEs) such as self-disgust, guilt and shame are under-investigated. Our previous research indicated that Parkinson patients have elevated levels of self-reported and induced self-disgust. However, the cause of that elevation-whether lower level biophysiological factors, or higher level cognitive factors, is unknown. METHODS To explore the former, we analysed Skin Conductance Response (SCR, measuring sympathetic activity) amplitude and high frequency Heart Rate Variability (HRV, measuring parasympathetic activity) across two emotion induction paradigms, one involving narrations of personal experiences of self-disgust, shame and guilt, and one targeting self-disgust selectively via images of the self. Both paradigms had a neutral condition. RESULTS Photo paradigm elicited significant changes in physiological responses in patients relative to controls-higher percentages of HRV in the high frequency range but lower SCR amplitudes, with patients to present lower responses compared to controls. In the narration paradigm, only guilt condition elicited significant SCR differences between groups. CONCLUSIONS Consequently, lower level biophysiological factors are unlikely to cause elevated self-disgust levels in Parkinson's disease, which by implication suggests that higher level cognitive factors may be responsible.
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Affiliation(s)
| | - Marianna Tsatali
- Greek Alzheimer Association Day Care Centre “Saint John”, Thessaloniki, Greece
- Department of Psychology, CITY College, University of York Europe Campus, Thessaloniki, Greece
| | - Paul G. Overton
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Ana B. Vivas
- Department of Psychology, CITY College, University of York Europe Campus, Thessaloniki, Greece
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Sundström M, Jola C. "I'm Never Going to Be in Phantom of the Opera": Relational and Emotional Wellbeing of Parkinson's Carers and Their Partners in and Beyond Dancing. Front Psychol 2021; 12:636135. [PMID: 34393878 PMCID: PMC8358682 DOI: 10.3389/fpsyg.2021.636135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 06/29/2021] [Indexed: 11/21/2022] Open
Abstract
The caregiving of people who suffer from Parkinson's predominantly falls on their life partners. Living with and caring for somebody with Parkinson's can cause a range of emotional, psychological, and financial pressures. Whilst an increasing number of alternative treatments for Parkinson's is available, such as dancing, the focus is predominantly on the motor and emotional improvements of the person suffering from Parkinson's. For caregivers, however, dancing can be a double-edged sword: Although dancing can offer an opportunity to enjoy a social event with their partner; attending dance classes puts additional responsibilities on the carer. The present study thus aimed at exploring the experiences of participants with Parkinson's who attended dance classes as well as the experiences of their care-partners in and around these classes along with their view on everyday life changes experienced since dancing. Six couples were interviewed individually where one partner had Parkinson's. The interviews were also analyzed separately using inductive thematic analysis. In line with existing programmes that offer dance for people with Parkinson's, the classes used a mixture of ballroom, ballet, contemporary, and creative dance styles; supported and influenced by an instructors' extensive knowledge of the abilities and needs of those with Parkinson's. A recurring challenge for Parkinson's sufferers relates to "who is in control?" based on the many unknown changes of Parkinson's; as well as seeing/being seen. Yet frustrations were oftentimes counteracted with humour. Also, when dancing, participants with Parkinson's reported enjoying playful interactions. Caregivers' themes focussed on theirs and their partners' wellbeing regarding social contacts and openness, as well as issues surrounding their responsibilities as carers. Whilst some identified dance movements that help them in everyday tasks, they and their care-partners question the impact of dance on their motor control. Yet, participants unanimously agree that dance provides relevant opportunities for social contact and comparison. Nevertheless, the care-partners' concerns remain about the burden of increasing responsibility for the wellbeing of both partners but they also reported enjoying dancing with their partner. Experiencing their loved ones as more cheerful after starting dance classes is recognised an important positive and impactful outcome of dancing together.
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Affiliation(s)
- Moa Sundström
- Health Psychology Section, Psychology Department, IoPPN, King’s College London, London, United Kingdom
- Division of Psychology, School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Corinne Jola
- Division of Psychology, School of Applied Sciences, Abertay University, Dundee, United Kingdom
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19
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Basirat A, Moreau C, Knutsen D. Parkinson's disease impacts feedback production during verbal communication. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:826-840. [PMID: 34227719 DOI: 10.1111/1460-6984.12630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Parkinson's disease (PD) leads to changes in verbal communications. The focus of most studies to date has been on speech impairment, which is specifically referred to as dysarthria. Although these studies are crucial to understanding the impact of PD on verbal communication, they do not focus on the features of dialogues between people with PD (PwPD) and other people in communicative contexts. AIMS To investigate whether PwPD produce less feedback than typical people during dialogue, thus potentially making it more difficult for them to reach mutual comprehension (i.e., common ground) with their conversational partner. METHODS & PROCEDURES A matching task experiment was conducted during which an experimenter described abstract pictures to a participant, who was either a PwPD or a typical participant, so that he or she could organize these pictures in a grid. The participants could produce as much feedback as they liked. OUTCOMES & RESULTS PwPD were less likely to produce feedback than typical participants. This effect was mainly driven by two specific types of feedback: acknowledgment tokens and hesitations. CONCLUSIONS & IMPLICATIONS The results suggest that PD impacts feedback production. This could decrease the communicative abilities of PwPD in interactive contexts by affecting grounding, that is, the ability to build common ground with others. This paper is one of the first to specifically document the production of feedback markers in PwPD. Future studies should examine the extent to which our results, which were obtained in a controlled dialogue task, may be generalized to daily-life conversions. From a clinical perspective, our study points to the necessity of assessing feedback production, and more generally abilities related to common ground construction and use, during PD progression. WHAT IS ALREADY KNOWN ON THE SUBJECT A few studies to date have analyzed conversational interactions between people with Parkinson's disease (PwPD) and others. The main focus is usually on potential difficulties of PwPD and their partners during the interaction and the strategies adopted to "repair" these problems. Another important feature of any interaction is the production of feedback. Feedback production plays a key role in building and using common ground to ensure mutual comprehension between interlocutors. The impact of Parkinson's disease on feedback production has received little attention in the literature to date. WHAT THIS STUDY ADDS The purpose of this study was to compare feedback production in a dialogue task (i.e., goal-oriented interaction) in PwPD versus typical controls. Our results revealed that PwPD produced less feedback for their dialogue partners than did typical participants. This effect was mainly driven by two specific types of feedback: acknowledgment tokens and hesitations. This paper is one of the firsts to specifically document the production of feedback markers in PwPD and to illustrate that PwPD and their dialogue partners may require more time and effort to establish common ground. CLINICAL IMPLICATIONS OF THIS STUDY Our findings suggest that an appropriate evaluation of feedback production by speech and language therapists, as well the management of potential deficits, would be beneficial. More broadly, we believe that the evaluation and management of PwPD should take into account the theoretical framework used in this study, in particular the role of common ground in communication.
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Affiliation(s)
- Anahita Basirat
- University of Lille, CNRS, UMR 9193-SCALab-Sciences Cognitives et Sciences Affectives, Lille, France
| | - Caroline Moreau
- Expert Center for Parkinson's Disease, CHU Lille, Inserm UMR 1171-2, University of Lille, Lille, France
- University of Lille, Inserm, CHU Lille, U1171-2-LilNCog-Lille Neuroscience & Cognition, Lille, France
| | - Dominique Knutsen
- University of Lille, CNRS, UMR 9193-SCALab-Sciences Cognitives et Sciences Affectives, Lille, France
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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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21
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Disorders of vocal emotional expression and comprehension: The aprosodias. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:63-98. [PMID: 34389126 DOI: 10.1016/b978-0-12-822290-4.00005-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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22
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Social Symptoms of Parkinson's Disease. PARKINSONS DISEASE 2020; 2020:8846544. [PMID: 33489081 PMCID: PMC7790585 DOI: 10.1155/2020/8846544] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/05/2020] [Accepted: 12/03/2020] [Indexed: 12/28/2022]
Abstract
Parkinson's disease (PD) is typically well recognized by its characteristic motor symptoms (e.g., bradykinesia, rigidity, and tremor). The cognitive symptoms of PD are increasingly being acknowledged by clinicians and researchers alike. However, PD also involves a host of emotional and communicative changes which can cause major disruptions to social functioning. These incude problems producing emotional facial expressions (i.e., facial masking) and emotional speech (i.e., dysarthria), as well as difficulties recognizing the verbal and nonverbal emotional cues of others. These social symptoms of PD can result in severe negative social consequences, including stigma, dehumanization, and loneliness, which might affect quality of life to an even greater extent than more well-recognized motor or cognitive symptoms. It is, therefore, imperative that researchers and clinicans become aware of these potential social symptoms and their negative effects, in order to properly investigate and manage the socioemotional aspects of PD. This narrative review provides an examination of the current research surrounding some of the most common social symptoms of PD and their related social consequences and argues that proactively and adequately addressing these issues might improve disease outcomes.
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Ricciardi L, De Angelis A, Marsili L, Faiman I, Pradhan P, Pereira EA, Edwards MJ, Morgante F, Bologna M. Hypomimia in Parkinson’s disease: an axial sign responsive to levodopa. Eur J Neurol 2020; 27:2422-2429. [DOI: 10.1111/ene.14452] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/17/2020] [Accepted: 07/19/2020] [Indexed: 11/30/2022]
Affiliation(s)
- L. Ricciardi
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London London UK
- Nuffield Department of Clinical Neurosciences MRC Brain Network Dynamics Unit Oxford UK
| | - A. De Angelis
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London London UK
| | - L. Marsili
- Gardner Family Center for Parkinson's Disease and Movement Disorders Department of Neurology University of Cincinnati Cincinnati OH USA
| | - I. Faiman
- Clinical Neuropsychology Service St George’s University Hospital NHS Foundation Trust London UK
| | - P. Pradhan
- Clinical Neuropsychology Service St George’s University Hospital NHS Foundation Trust London UK
| | - E. A. Pereira
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London London UK
| | - M. J. Edwards
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London London UK
| | - F. Morgante
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London London UK
- Department of Experimental and Clinical Medicine University of Messina Messina Italy
| | - M. Bologna
- Department of Human Neurosciences Sapienza University of Rome Rome Italy
- IRCCS Neuromed Pozzilli (IS) Italy
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Tickle-Degnen L, Stevenson MT, Gunnery SD, Saint-Hilaire M, Thomas CA, Sprague Martinez L, Habermann B, Naumova EN. Profile of social self-management practices in daily life with Parkinson's disease is associated with symptom severity and health quality of life. Disabil Rehabil 2020; 43:3212-3224. [PMID: 32233702 DOI: 10.1080/09638288.2020.1741035] [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: 10/24/2022]
Abstract
Purpose: Social participation is a key determinant of healthy aging, yet little is known about how people with Parkinson's disease manage social living. This study describes individual differences in social self-management practices and their association with symptom severity and health quality of life.Methods: People with Parkinson's disease (N = 90) completed measures of healthy routines, activities and relationships, symptom severity, and health related quality of life. Cluster analysis identified profiles of social self-management practices. Analysis of variance tested differences between profiles in symptom severity and health quality of life.Results: Participants clustered into one of seven groups according to different combinations of three practices: health resources utilization, activities in home and community, and social support relationships. The healthiest cluster engaged equally in all three practices at above sample average degree of engagement. Four clusters that engaged at or above sample average in activities in home and community experienced less health problems than three clusters that engaged below average. Variation in aspects of social lifestyle unrelated to health appeared also to contribute to profile diversity.Conclusion: Findings provide insight into similarity and variation in how people with Parkinson's disease engage with social self-management resources and point to person-centered interventions.Implications for RehabilitationSocial self-management is a biopsychosocial construct to identify and describe self-care practices that engage one's social resources for managing healthful daily living.People with Parkinson's disease vary in their profiles of engaging in social self-management practices in daily living, and this variability relates to severity of symptoms and health quality of life.Learning how to identify health-centered social self-management practices may help people with Parkinson's disease to focus on the healthfulness of their own practices.Learning how to strategically engage one's social resources as part of self-care may help people with Parkinson's disease to master managing their health and well-being in daily life.
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Affiliation(s)
- Linda Tickle-Degnen
- Department of Occupational Therapy, School of Arts & Sciences, Tufts University, Medford, MA, USA
| | - Michael T Stevenson
- Department of Occupational Therapy, School of Arts & Sciences, Tufts University, Medford, MA, USA
| | - Sarah D Gunnery
- Department of Psychology, New England College, Henniker, NH, USA
| | | | - Cathi A Thomas
- Department of Neurology, Boston University Medical Center, Boston, MA, USA
| | | | - Barbara Habermann
- School of Nursing, College of Health Sciences, University of Delaware, Newark, DE, USA
| | - Elena N Naumova
- The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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Kuramoto E, Yoshinaga S, Nakao H, Nemoto S, Ishida Y. Characteristics of facial muscle activity during voluntary facial expressions: Imaging analysis of facial expressions based on myogenic potential data. Neuropsychopharmacol Rep 2019; 39:183-193. [PMID: 31136686 PMCID: PMC7292300 DOI: 10.1002/npr2.12059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 04/17/2019] [Accepted: 04/24/2019] [Indexed: 01/05/2023] Open
Abstract
PURPOSE Facial expressions are formed by the coordination of facial muscles and reflect changes in emotion. Nurses observe facial expressions as way of understanding patients. This study conducted basic research using facial myogenic potential topography to visually determine changes in the location and strength of facial muscle activity associated with voluntary facial expression to examine relationships with facial expressions. METHODS Participants comprised 18 healthy adults (6 men, 12 women; mean age, 24.3 ± 4.3 years). Facial myogenic potentials were measured from 19 electrodes arranged concentrically on the face, and topographic analysis was conducted. Using potential changes and topograms, the muscle activity associated with nonvoluntary facial expression and voluntary facial expressions of happiness and disgust were classified according to the characteristics of expressions. To classify homogeneous groups among the reaction of disgust, hierarchical cluster analysis was utilized. RESULTS One characteristic of the facial expression of happiness was activity in areas including the greater zygomatic muscle. With the facial expression of disgust, characteristic changes were seen in areas including the corrugator supercilii. Cluster analysis of the expression of disgust showed four homogeneous subgroups. CONCLUSION With facial myogenic potential topography, facial expressions can be evaluated objectively without being influenced by face shape or countenance. Color changes in topograms showed subtle changes in expressions that could not be supplemented with statistical processing alone, and these were useful in identifying individuality. Topography is thus expected to be utilized to supplement basic knowledge of facial expressions for a better understanding of patients.
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Affiliation(s)
- Eriko Kuramoto
- Faculty of NursingMiyazaki Prefectural Nursing UniversityMiyazaki CityJapan
- Department of Psychiatry, Faculty of MedicineUniversity of MiyazakiMiyazaki CityJapan
| | - Saori Yoshinaga
- School of Nursing, Faculty of MedicineUniversity of MiyazakiMiyazaki CityJapan
| | - Hiroyuki Nakao
- Faculty of NursingMiyazaki Prefectural Nursing UniversityMiyazaki CityJapan
| | | | - Yasushi Ishida
- Department of Psychiatry, Faculty of MedicineUniversity of MiyazakiMiyazaki CityJapan
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Perepezko K, Hinkle JT, Shepard MD, Fischer N, Broen MP, Leentjens AFG, Gallo J, Pontone GM. Social role functioning in Parkinson's disease: A mixed-methods systematic review. Int J Geriatr Psychiatry 2019; 34:1128-1138. [PMID: 31069845 PMCID: PMC6949188 DOI: 10.1002/gps.5137] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 04/19/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Parkinson's disease (PD) is a progressive neurodegenerative disease that often impedes activities of daily living (ADL) and social functioning. Impairment in these areas can alter social roles by interfering with employment status, household management, friendships, and other relationships. Understanding how PD affects social functioning can help clinicians choose management strategies that mitigate these changes. METHODS We conducted a mixed-methods systematic review of existing literature on social roles and social functioning in PD. A tailored search strategy in five databases identified 51 full-text reports that fulfilled the inclusion criteria and passed the quality appraisal. We aggregated and analyzed the results from these studies and then created a narrative summary. RESULTS Our review demonstrates how PD causes many people to withdraw from their accustomed social roles and experience deficits in corresponding activities. We describe how PD symptoms (eg, tremor, facial masking, and neuropsychiatric symptoms) interfere with relationships (eg, couple, friends, and family) and precipitate earlier departure from the workforce. Additionally, several studies demonstrated that conventional PD therapy has little positive effect on social role functioning. CONCLUSIONS Our report presents critical insight into how PD affects social functioning and gives direction to future studies and interventions (eg, couple counseling and recreational activities).
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Affiliation(s)
- Kate Perepezko
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jared T. Hinkle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins School of Medicine, Medical Scientist Training Program, Baltimore, MD, USA
| | - Melissa D. Shepard
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicole Fischer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Martinus P.G. Broen
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Albert F. G. Leentjens
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Joe Gallo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Gregory M. Pontone
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Ma HI, Gunnery SD, Stevenson MT, Saint-Hilaire M, Thomas CA, Tickle-Degnen L. Experienced facial masking indirectly compromises quality of life through stigmatization of women and men with Parkinson's disease. STIGMA AND HEALTH 2019; 4:462-472. [PMID: 33225063 PMCID: PMC7678084 DOI: 10.1037/sah0000168] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
This study examined the relationship between self-reported facial masking and quality of life (QoL) in people with Parkinson's disease (PD), and tested experienced stigma as a mediator and gender as a moderator of this relationship. The strength of stigma as a mediator was compared against an alternative mediator, depression. Ninety people with PD (34 women) rated difficulty showing facial expression (masking), and completed the Stigma Scale for Chronic Illness, Geriatric Depression Scale (15-item), and Parkinson's Disease Questionnaire-39. A conditional process model tested the indirect effect of facial masking on QoL through stigma, separately for women and men. A parallel indirect model included both stigma and depression to compare their statistical and clinical significance as mediators. Gender-moderated mediation of stigma reduced the association between facial masking and QoL to non-significance, suggesting stigma explained the association between facial masking and QoL. While facial masking was more stigmatizing for women than for men, stigma mediated the facial masking-QoL association for both women and men. Stigma (controlling for depression) reached a statistically and clinically significant level of mediation, whereas depression (controlling for stigma) reached a statistically yet not clinically significant level of mediation. People with PD who experience more severe facial masking feel more stigmatized, especially women. Regardless of gender, an increase in stigma from facial masking increases the likelihood of compromised QoL that reaches both statistical and clinical levels of significance.
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Affiliation(s)
- Hui-Ing Ma
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 701, Taiwan
| | - Sarah D. Gunnery
- Department of Psychology, New England College, 98 Bridge St., Henniker, NH, 03242
| | - Michael T. Stevenson
- Department of Occupational Therapy, Tufts University, 574 Boston Ave., Medford, MA 02155, USA
| | - Marie Saint-Hilaire
- Department of Neurology, Boston University Medical Center, 725 Albany St., Boston, MA, 02118, USA
| | - Cathi A. Thomas
- Department of Neurology, Boston University Medical Center, 725 Albany St., Boston, MA, 02118, USA
| | - Linda Tickle-Degnen
- Department of Occupational Therapy, Tufts University, 574 Boston Ave., Medford, MA 02155, USA
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Berger S, Chen T, Eldridge J, Thomas CA, Habermann B, Tickle-Degnen L. The self-management balancing act of spousal care partners in the case of Parkinson's disease. Disabil Rehabil 2017; 41:887-895. [PMID: 29228835 DOI: 10.1080/09638288.2017.1413427] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Living with and caring for someone with chronic illness can lead to limitations in activity and social participation for the care partner. Past research emphasizes the importance of care partners taking care of themselves physically and emotionally so they can stay healthy to support the care recipient. There is little information regarding how the care partner takes care of their own social lives. The purpose of this study was to explore the concept of social self-management from the perspective of spousal care partners of people with Parkinson's disease. METHOD Twenty spousal care partners of people with Parkinson's disease were interviewed three times. A grounded theory approach informed data analysis. RESULTS Findings that emerged from the data focused on balance in activities, support, and emotions and were summarized into three main themes: (1) Activities: Caregiving and beyond; (2) Strategies to support self and spouse; and (3) Emotional impact: Burden and compassion. CONCLUSION This research shows that care partners want to retain social participation and provides support for the importance of addressing the socio-emotional needs of care partners of people with a chronic disease. Interventions that guide care partners to take care of their spectrum of needs may lead to healthier, positive relationships. Implications for rehabilitation The focus of rehabilitation is often on the person diagnosed with the chronic condition. Living with and caring for someone with a chronic illness, such as Parkinson's disease, can lead to limitations in activity and social participation for the care partner. Including care partners in the rehabilitation process is key to helping maintain their health and well-being. Learning caregiving and self-management strategies may help care partners support their loved ones while staying socially engaged.
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Affiliation(s)
- Sue Berger
- a Department of Occupational Therapy , Boston University , Boston , MA , USA
| | - Tiffany Chen
- b Department of Occupational Therapy , Whittier Rehabilitation Hospital , Westborough , MA , USA
| | - Jenna Eldridge
- c Department of Occupational Therapy , Tufts University , Medford , MA , USA
| | - Cathi A Thomas
- d Department of Neurology , Boston University Medical Center , Boston , MA , USA
| | | | - Linda Tickle-Degnen
- c Department of Occupational Therapy , Tufts University , Medford , MA , USA
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