Understanding facial emotion perception in Parkinson's disease: The role of configural processing

Facial expressions and identities recognition in Parkinson disease

Parkinson's Disease (PD) is associated with motor and non-motor symptoms. Among the latter are deficits in matching, identification, and recognition of emotional facial expressions. On one hand, this deficit has been attributed to a dysfunction in emotion processing. Another explanation (which does not exclude the former) links this deficit with reduced facial expressiveness in these patients, which prevents them from properly understanding or embodying emotions. To disentangle the specific contribution of emotion comprehension and that of facial expression processing in PD's observed deficit with emotions we performed two experiments on non-emotional facial expressions. In Experiment 1, a group of PD patients and a group of Healthy Controls (HC) underwent a task of non-emotional expression recognition in faces of different identity and a task of identity recognition in faces with different expression. No differences were observed between the two groups in accuracies. In Experiment 2, PD patients and Healthy Controls underwent a task where they had to recognize the identity of faces encoded through a non-emotional facial expression, through a rigid head movement, or as neutral. Again, no group differences were observed. In none of the two experiments hypomimia scores had a specific effect on expression processing. We conclude that in PD patients the observed impairment with emotional expressions is likely due to a specific deficit for emotions to a greater extent than for facial expressivity processing.

The Story behind the Mask: A Narrative Review on Hypomimia in Parkinson's Disease

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.

Longitudinal assessment of social cognition in de novo Parkinson's disease patients and its relationship with dopaminergic innervation

BACKGROUND

Social Cognition (SC) has been scarcely studied in Parkinson's disease (PD), and findings in early disease are controversial. SC encompasses different capacities such as facial emotion recognition (FER); Theory of Mind (ToM), the ability to understand other people's intentions (cognitive-ToM) and emotions (affective-ToM); and self-monitoring, the ability to regulate one's own behavior in social contexts. A relationship between dopaminergic deficit and SC in PD has been suggested.

OBJECTIVES

To prospectively assess, over a two-year period, SC in newly diagnosed drug-naïve, cognitively normal and non-depressed PD patients. Furthermore, we aimed to evaluate the relationship between SC and Fluorodopa (Positron Emission Tomography) Ki uptake, which is a marker of dopaminergic depletion.

METHODS

We compared SC performance between 25 de novo PD patients and 20 healthy controls (HC), and within-patients at baseline and two-year follow-up. The SC assessment included FER, ToM, as well as self-monitoring measures. The relationship between SC and dopaminergic innervation was also assessed in patients.

RESULTS

SC scores did not differ between PD and HC groups at baseline, nor between baseline and follow-up evaluation in PD. A significant positive correlation between self-monitoring and Fluorodopa Ki uptake in the left pallidum in PD patients was found at baseline. At follow-up, ToM (stories) positively correlated with Fluorodopa Ki uptake in the right thalamus and the left putamen.

CONCLUSION

SC appears to be preserved in de novo PD and remains stable in the short-term. Although more evidence is needed, our results support a relationship between dopamine innervation in subcortical regions and SC.

The Enigmatic CA2: Exploring the Understudied Region of the Hippocampus and Its Involvement in Parkinson's Disease

Parkinson's disease (PD) is a neurodegenerative disease that affects both motor and non-motor functions. Although motor impairment is a prominent clinical sign of PD, additional neurological symptoms may also occur, particularly in the preclinical and prodromal stages. Among these symptoms, social cognitive impairment is common and detrimental. This article aims to review non-motor symptoms in PD patients, focusing on social cognitive deficits. It also examines the specific characteristics of the CA2 region and its involvement in social behavior, highlighting recent advances and perspectives. Additionally, this review provides critical insights into and analysis of research conducted in rodents and humans, which may help improve the understanding of the current status of putative therapeutic strategies for social cognitive dysfunction in PD and potential avenues related to the function of the hippocampal CA2 region.

Social Cognition and Cognitive Decline in Patients with Parkinson's Disease

Social cognition (SC) comprises an array of cognitive and affective abilities such as social perception, theory of mind, empathy, and social behavior. Previous studies have suggested the existence of deficits in several SC abilities in Parkinson disease (PD), although not unanimously.

OBJECTIVE

The aim of this study is to assess the SC construct and to explore its relationship with cognitive state in PD patients.

METHOD

We compare 19 PD patients with cognitive decline, 27 cognitively preserved PD patients, and 29 healthy control (HC) individuals in social perception (static and dynamic emotional facial recognition), theory of mind, empathy, and social behavior tasks. We also assess processing speed, executive functions, memory, language, and visuospatial ability.

RESULTS

PD patients with cognitive decline perform worse than the other groups in both facial expression recognition tasks and theory of mind. Cognitively preserved PD patients only score worse than HCs in the static facial expression recognition task. We find several significant correlations between each of the SC deficits and diverse cognitive processes.

CONCLUSIONS

The results indicate that some components of SC are impaired in PD patients. These problems seem to be related to a global cognitive decline rather than to specific deficits. Considering the importance of these abilities for social interaction, we suggest that SC be included in the assessment protocols in PD.

Interoception Primes Emotional Processing: Multimodal Evidence from Neurodegeneration

Recent frameworks in cognitive neuroscience and behavioral neurology underscore interoceptive priors as core modulators of negative emotions. However, the field lacks experimental designs manipulating the priming of emotions via interoception and exploring their multimodal signatures in neurodegenerative models. Here, we designed a novel task that involves interoceptive and control-exteroceptive priming conditions followed by post-interoception and post-exteroception facial emotion recognition (FER). We recruited 114 participants, including healthy controls (HCs) as well as patients with behavioral variant frontotemporal dementia (bvFTD), Parkinson's disease (PD), and Alzheimer's disease (AD). We measured online EEG modulations of the heart-evoked potential (HEP), and associations with both brain structural and resting-state functional connectivity patterns. Behaviorally, post-interoception negative FER was enhanced in HCs but selectively disrupted in bvFTD and PD, with AD presenting generalized disruptions across emotion types. Only bvFTD presented impaired interoceptive accuracy. Increased HEP modulations during post-interoception negative FER was observed in HCs and AD, but not in bvFTD or PD patients. Across all groups, post-interoception negative FER correlated with the volume of the insula and the ACC. Also, negative FER was associated with functional connectivity along the (a) salience network in the post-interoception condition, and along the (b) executive network in the post-exteroception condition. These patterns were selectively disrupted in bvFTD (a) and PD (b), respectively. Our approach underscores the multidimensional impact of interoception on emotion, while revealing a specific pathophysiological marker of bvFTD. These findings inform a promising theoretical and clinical agenda in the fields of nteroception, emotion, allostasis, and neurodegeneration.SIGNIFICANCE STATEMENT We examined whether and how emotions are primed by interoceptive states combining multimodal measures in healthy controls and neurodegenerative models. In controls, negative emotion recognition and ongoing HEP modulations were increased after interoception. These patterns were selectively disrupted in patients with atrophy across key interoceptive-emotional regions (e.g., the insula and the cingulate in frontotemporal dementia, frontostriatal networks in Parkinson's disease), whereas persons with Alzheimer's disease presented generalized emotional processing abnormalities with preserved interoceptive mechanisms. The integration of both domains was associated with the volume and connectivity (salience network) of canonical interoceptive-emotional hubs, critically involving the insula and the anterior cingulate. Our study reveals multimodal markers of interoceptive-emotional priming, laying the groundwork for new agendas in cognitive neuroscience and behavioral neurology.

Impaired Recognition of Facial Emotion in Patients With Parkinson Disease Under Dopamine Therapy

INTRODUCTION

Parkinson disease (PD) is a neurodegenerative disorder characterized by motor and nonmotor symptoms. The impaired ability to recognize facial emotion expressions represents an important nonmotor symptom. The aim of this study is to investigate the ability in recognizing facial emotion expressions in patients with PD under dopamine replacement therapy.

METHODS

Thirty medicated patients with PD and 15 healthy controls (HC) were enrolled. All participants performed the Ekman 60-Faces test for emotional recognition. All patients underwent a neuropsychological evaluation for global cognitive functioning, depression, and anxiety.

RESULTS

Patients with PD were impaired in recognizing emotions. Significant differences between PD and HC were found in Ekman 60-Faces test scores (P < .001), and in Ekman 60-Faces test subscales, in particular, sadness, fear, disgust, anger, and surprise (P < .001).

CONCLUSIONS

The nigrostriatal dopaminergic depletion seems to determine emotional information processing dysfunction. This relevant nonmotor symptom could have consequences in daily living reducing interactions and social behavioral competence.

Understanding the role of configural processing in face emotion recognition in Parkinson's disease

This investigation examined whether impairment in configural processing could explain deficits in face emotion recognition in people with Parkinson's disease (PD). Stimuli from the Radboud Faces Database were used to compare recognition of four negative emotion expressions by older adults with PD (n = 16) and matched controls (n = 17). Participants were tasked with categorizing emotional expressions from upright and inverted whole faces and facial composites; it is difficult to derive configural information from these two types of stimuli so featural processing should play a larger than usual role in accurate recognition of emotional expressions. We found that the PD group were impaired relative to controls in recognizing anger, disgust and fearful expressions in upright faces. Then, consistent with a configural processing deficit, participants with PD showed no composite effect when attempting to identify facial expressions of anger, disgust and fear. A face inversion effect, however, was observed in the performance of all participants in both the whole faces and facial composites tasks. These findings can be explained in terms of a configural processing deficit if it is assumed that the disruption caused by facial composites was specific to configural processing, whereas inversion reduced performance by making it difficult to derive both featural and configural information from faces.

Event-Related Potentials Elicited by Face and Face Pareidolia in Parkinson's Disease

Background

Parkinson's disease is associated with impaired ability to recognize emotional facial expressions. In addition to a visual processing disorder, a visual recognition disorder may be involved in these patients. Pareidolia is a type of complex visual illusion that permits the interpretation of a vague stimulus as something known to the observer. Parkinson's patients experience pareidolic illusions. N170 and N250 waveforms are two event-related potentials (ERPs) involved in emotional facial expression recognition.

Objective

In this study, we investigated how Parkinson's patients process face and face-pareidolia stimuli at the neural level using N170, vertex positive potential (VPP), and N250 components of event-related potentials.

Methods

To examine the response of face and face-pareidolia processing in Parkinson's patients, we measured the N170, VPP, and N250 components of the event-related brain potentials in a group of 21 participants with Parkinson's disease and 26 control participants.

Results

We found that the latencies of N170 and VPP responses to both face and face-pareidolia stimuli were increased along with their amplitudes, and the amplitude of N250 responses decreased in Parkinson's patients compared to the control group. In both control and Parkinson's patients, face stimuli generated greater ERP amplitude and shorter latency in responses than did face-pareidolia stimuli.

Conclusion

The results of our study showed that ERPs associated with face and also face-pareidolia stimuli processing are changed in early-stage neurophysiological activity in the temporoparietal cortex of Parkinson's patients.

Facial expressions recognition and discrimination in Parkinson's disease

Emotion processing impairment is a common non-motor symptom in Parkinson's Disease (PD). Previous literature reported conflicting results concerning, in particular, the performance for different emotions, the relation with cognitive and neuropsychiatric symptoms and the affected stage of processing. This study aims at assessing emotion recognition and discrimination in PD. Recognition of six facial expressions was studied in order to clarify its relationship with motor, cognitive and neuropsychiatric symptoms. Sensitivity in discriminating happy and fearful faces was investigated to address controversial findings on impairment in early stages of emotion processing. To do so, seventy PD patients were tested with the Ekman 60 Faces test and compared with 46 neurologically unimpaired participants. Patients' performances were correlated with clinical scales and neuropsychological tests. A subsample of 25 PD patients and 25 control participants were also tested with a backward masking paradigm for sensitivity in happiness and fear discrimination. Results showed that PD patients were impaired in facial emotion recognition, especially for fearful expressions. The performance correlated with perceptual, executive and general cognitive abilities, but facial expression recognition deficits were present even in cognitively unimpaired patients. In contrast, patients' sensitivity in backward masking tasks was not reduced as compared to controls. Taken together our data demonstrate that facial emotion recognition, and fear expression in particular, is critically affected by neurodegeneration in PD and related to cognitive abilities; however, it appears before other cognitive impairments. Preserved performances in discriminating shortly presented facial expressions, suggest unimpaired early stages of emotion processing.

Emotion Recognition in Patients With Parkinson Disease

BACKGROUND

Individuals with Parkinson disease (PD) display cognitive dysfunction. However, few studies have investigated how facial and musical emotion recognition are affected in individuals with PD.

OBJECTIVE

To explore the relationship between facial and musical emotion recognition and executive functions in Chinese individuals with PD.

METHODS

We showed 40 Chinese individuals with PD and 40 Chinese healthy controls 24 black-and-white portraits and 24 musical excerpts that were designed to express happiness, sadness, fear, and anger. Then, we used four tests to assess the participants' executive functions, including the Trail Making Test (TMT), Clock Drawing Test (CDT), semantic Verbal Fluency Test (VFT), and Digit Span Test (DST).

RESULTS

The PD group showed significant impairment in recognizing anger from facial expressions, although their emotion recognition from musical excerpts was similar to that of the control group. Recognition of an angry face was significantly correlated to scores on the TMT and DST. Recognition of happy music was significantly correlated to the Hamilton Rating Scale for Depression score, whereas recognition of angry music was significantly correlated to musical knowledge background. Recognition of happy, sad, or angry music was significantly correlated to tests of executive function, whereas recognition of fearful music was not.

CONCLUSIONS

The PD group showed impaired recognition of angry faces, which may be related to executive dysfunction. However, the PD group did not show any difficulties in recognizing emotions in music. This dissociation indicates that the mechanisms underlying the recognition of emotions in faces and music are partly independent.

Impairments in face discrimination and emotion recognition are related to aging and cognitive dysfunctions in Parkinson's disease with dementia

Patients with Parkinson's disease (PD) suffer from motor and non-motor symptoms; 40% would develop dementia (PD-D). Impaired face and emotion processing in PD has been reported; however, the deficits of face processing in PD-D remain unclear. We investigated three essential aspects of face processing capacity in PD-D, and the associations between cognitive, neuropsychiatric assessments and task performances. Twenty-four PD-D patients (mean age: 74.0 ± 5.55) and eighteen age-matched healthy controls (HC) (mean age: 71.0 ± 6.20) received three computerized tasks, morphing-face discrimination, dynamic facial emotion recognition, and expression imitation. Compared to HC, PD-D patients had lower sensitivity (d') and greater neural internal noises in discriminating faces; responded slower and had difficulties with negative emotions; imitated some expressions but with lower strength. Correlation analyses revealed that patients with advancing age, slow mentation, and poor cognition (but not motor symptoms) showed stronger deterioration in face perception. Importantly, these correlations were absent in the age-matched HC. The present study is among the first few examined face processing in patients with PD-D, and found consistent deficits correlated with advancing age and slow mentation. We propose that face discrimination task could be included as a potential test for the early detection of dementia in PD.

Social perceptual function in parkinson's disease: A meta-analysis

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.

Emotional Processing Impairments in Apathetic Patients with Parkinson's Disease: An ERP Study in Early Time Windows

We investigated emotional processing in apathetic patients with Parkinson's disease (PD) by observing components of event-related potentials (ERPs) in early time windows. Forty PD patients and 21 healthy controls (HCs) were enrolled. The Starkstein Apathy Scale (SAS) was used to divide the PD patients into apathetic and nonapathetic groups. Cognitive function was evaluated by the forward and backward Digit Span tests, Trail Making Test (TMT), and Word Fluency Test. The participants were required to recognize positive, neutral, and negative emotional faces and engage in an emotion categorization task while EEG was recorded. The time to completion for the TMT (Part A and Part B) from highest to lowest was in the order of apathetic group > nonapathetic group > HC group. Compared with the nonapathetic and HC groups, in the apathetic group, P100 amplitudes were smaller for positive expressions in the right hemisphere and latencies were longer for positive expressions in the left hemisphere, while latencies were longer for neutral expressions bilaterally. Compared with the nonapathetic group, in the apathetic group, N170 amplitudes were attenuated and latencies were delayed for neutral and negative expressions in the right hemisphere. A trend towards larger N170 amplitudes in the right hemisphere than in the left was observed in the nonapathetic and HC groups, but this difference was not significant in the apathetic group. In the apathetic group, bilateral P100 amplitudes elicited by negative expressions were negatively correlated with SAS scores, and SAS scores were positively correlated with Part B of the TMT. N170 amplitudes elicited by negative expressions in the right hemisphere were negatively correlated with SAS in the apathetic group and with Part B of TMT in both PD groups. Our findings suggested that emotional processing was impaired in apathetic PD patients and that the right hemisphere was more sensitive to reflecting this impairment in the early time windows of ERPs.

Emotional faces guide the eyes in the absence of awareness

The ability to act quickly to a threat is a key skill for survival. Under awareness, threat-related emotional information, such as an angry or fearful face, has not only perceptual advantages but also guides rapid actions such as eye movements. Emotional information that is suppressed from awareness still confers perceptual and attentional benefits. However, it is unknown whether suppressed emotional information can directly guide actions, or whether emotional information has to enter awareness to do so. We suppressed emotional faces from awareness using continuous flash suppression and tracked eye gaze position. Under successful suppression, as indicated by objective and subjective measures, gaze moved towards fearful faces, but away from angry faces. Our findings reveal that: (1) threat-related emotional stimuli can guide eye movements in the absence of visual awareness; (2) threat-related emotional face information guides distinct oculomotor actions depending on the type of threat conveyed by the emotional expression.

Facial emotion recognition in Parkinson's disease: A review and new hypotheses

Parkinson's disease is a neurodegenerative disorder classically characterized by motor symptoms. Among them, hypomimia affects facial expressiveness and social communication and has a highly negative impact on patients' and relatives' quality of life. Patients also frequently experience nonmotor symptoms, including emotional-processing impairments, leading to difficulty in recognizing emotions from faces. Aside from its theoretical importance, understanding the disruption of facial emotion recognition in PD is crucial for improving quality of life for both patients and caregivers, as this impairment is associated with heightened interpersonal difficulties. However, studies assessing abilities in recognizing facial emotions in PD still report contradictory outcomes. The origins of this inconsistency are unclear, and several questions (regarding the role of dopamine replacement therapy or the possible consequences of hypomimia) remain unanswered. We therefore undertook a fresh review of relevant articles focusing on facial emotion recognition in PD to deepen current understanding of this nonmotor feature, exploring multiple significant potential confounding factors, both clinical and methodological, and discussing probable pathophysiological mechanisms. This led us to examine recent proposals about the role of basal ganglia-based circuits in emotion and to consider the involvement of facial mimicry in this deficit from the perspective of embodied simulation theory. We believe our findings will inform clinical practice and increase fundamental knowledge, particularly in relation to potential embodied emotion impairment in PD. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

Gaze Behavior Consistency among Older and Younger Adults When Looking at Emotional Faces

The identification of non-verbal emotional signals, and especially of facial expressions, is essential for successful social communication among humans. Previous research has reported an age-related decline in facial emotion identification, and argued for socio-emotional or aging-brain model explanations. However, more perceptual differences in the gaze strategies that accompany facial emotional processing with advancing age have been under-explored yet. In this study, 22 young (22.2 years) and 22 older (70.4 years) adults were instructed to look at basic facial expressions while their gaze movements were recorded by an eye-tracker. Participants were then asked to identify each emotion, and the unbiased hit rate was applied as performance measure. Gaze data were first analyzed using traditional measures of fixations over two preferential regions of the face (upper and lower areas) for each emotion. Then, to better capture core gaze changes with advancing age, spatio-temporal gaze behaviors were deeper examined using data-driven analysis (dimension reduction, clustering). Results first confirmed that older adults performed worse than younger adults at identifying facial expressions, except for "joy" and "disgust," and this was accompanied by a gaze preference toward the lower-face. Interestingly, this phenomenon was maintained during the whole time course of stimulus presentation. More importantly, trials corresponding to older adults were more tightly clustered, suggesting that the gaze behavior patterns of older adults are more consistent than those of younger adults. This study demonstrates that, confronted to emotional faces, younger and older adults do not prioritize or ignore the same facial areas. Older adults mainly adopted a focused-gaze strategy, consisting in focusing only on the lower part of the face throughout the whole stimuli display time. This consistency may constitute a robust and distinctive "social signature" of emotional identification in aging. Younger adults, however, were more dispersed in terms of gaze behavior and used a more exploratory-gaze strategy, consisting in repeatedly visiting both facial areas.

Nonmotor Symptoms in Parkinson Disease: A Descriptive Review on Social Cognition Ability

Parkinson disease (PD) is a neurodegenerative disorder characterized by motor and nonmotor symptoms. Nonmotor symptoms include cognitive deficits and impairment in emotions recognition ability associated with loss of dopaminergic neurons in the substantia nigra and with alteration in frontostriatal circuits. In this review, we analyzed the studies on social cognition ability in patients with PD. We searched on PubMed and Web of Science databases and screening references of included studied and review articles for additional citations. From initial 260 articles, only 18 met search criteria. A total of 496 patients were compared with 514 health controls, through 16 different tests that assessed some subcomponents of social cognition, such as theory of mind, decision-making, and emotional face recognition. Studies on cognitive function in patients with PD have focused on executive function. Patients with PD showed impairment in social cognition from the earliest stages of disease. This ability seems to not be significantly associated with other cognitive functions.

Degraded Impairment of Emotion Recognition in Parkinson's Disease Extends from Negative to Positive Emotions

Because of dopaminergic neurodegeneration, patients with Parkinson's disease (PD) show impairment in the recognition of negative facial expressions. In the present study, we aimed to determine whether PD patients with more advanced motor problems would show a much greater deficit in recognition of emotional facial expressions than a control group and whether impairment of emotion recognition would extend to positive emotions. Twenty-nine PD patients and 29 age-matched healthy controls were recruited. Participants were asked to discriminate emotions in Experiment  1 and identify gender in Experiment  2. In Experiment  1, PD patients demonstrated a recognition deficit for negative (sadness and anger) and positive faces. Further analysis showed that only PD patients with high motor dysfunction performed poorly in recognition of happy faces. In Experiment  2, PD patients showed an intact ability for gender identification, and the results eliminated possible abilities in the functions measured in Experiment  2 as alternative explanations for the results of Experiment  1. We concluded that patients' ability to recognize emotions deteriorated as the disease progressed. Recognition of negative emotions was impaired first, and then the impairment extended to positive emotions.

Social Cognition Impairments in Mice Overexpressing Alpha-Synuclein Under the Thy1 Promoter, a Model of Pre-manifest Parkinson's Disease

Background: Patients with Parkinson’s disease (PD) may exhibit deficits in “Theory of Mind”, the ability to read others’ mental states and react appropriately, a prerequisite for successful social interaction. Alpha-synuclein overexpression is widely distributed in the brain of patients with sporadic PD, suggesting that it may contribute to the non-motor deficits observed in PD patients. Mice over-expressing human wild-type alpha-synuclein under the Thy1 promoter (Thy1-aSyn mice) have synaptic deficits in the frontostriatal pathway, low cortical acetylcholine, and high level of expression of mGluR5 receptors, which have all been implicated in social recognition deficits.

Objective: To determine whether Thy1-aSyn mice present alterations in their response to social stimuli.

Methods: We have submitted Thy1-aSyn mice to tests adapted from autism models.

Results: At 7–8 month of age Thy1-aSyn mice explored their conspecifics significantly less than did wild-type littermates, without differences in exploration of inanimate objects, and pairs of Thy1-aSyn mice were involved in reciprocal interactions for a shorter duration than wild-type mice at this age. These deficits persisted when the test animal was enclosed in a beaker and were not present at 3–4 months of age despite the presence of olfactory deficits at that age, indicating that they were not solely caused by impairment in olfaction.

Conclusion: Thy1-aSyn mice present progressive deficits in social recognition, supporting an association between alpha-synuclein overexpression and Theory of Mind deficits in PD and providing a useful model for identifying mechanisms and testing novel treatments for these deficits which impact patients and caretakers quality of life.

Advanced Parkinson disease patients have impairment in prosody processing

BACKGROUND

The ability to recognize and interpret emotions in others is a crucial prerequisite of adequate social behavior. Impairments in emotion processing have been reported from the early stages of Parkinson's disease (PD). This study aims to characterize emotion recognition in advanced Parkinson's disease (APD) candidates for deep-brain stimulation and to compare emotion recognition abilities in visual and auditory domains.

METHOD

APD patients, defined as those with levodopa-induced motor complications (N = 42), and healthy controls (N = 43) matched by gender, age, and educational level, undertook the Comprehensive Affect Testing System (CATS), a battery that evaluates recognition of seven basic emotions (happiness, sadness, anger, fear, surprise, disgust, and neutral) on facial expressions and four emotions on prosody (happiness, sadness, anger, and fear). APD patients were assessed during the "ON" state. Group performance was compared with independent-samples t tests.

RESULTS

Compared to controls, APD had significantly lower scores on the discrimination and naming of emotions in prosody, and visual discrimination of neutral faces, but no significant differences in visual emotional tasks.

CONCLUSION

The contrasting performance in emotional processing between visual and auditory stimuli suggests that APD candidates for surgery have either a selective difficulty in recognizing emotions in prosody or a general defect in prosody processing. Studies investigating early-stage PD, and the effect of subcortical lesions in prosody processing, favor the latter interpretation. Further research is needed to understand these deficits in emotional prosody recognition and their possible contribution to later behavioral or neuropsychiatric manifestations of PD.

Emotional processing in Parkinson's disease and schizophrenia: evidence for response bias deficits in PD

Deficits in facial emotion recognition in Parkinson's disease (PD) patients has been well documented. Nevertheless, it is still not clear whether facial emotion recognition deficits are secondary to other cognitive impairments. The aim of this study was to answer the question of whether deficits in facial emotion recognition in PD result from impaired sensory processes, or from impaired decision processes. To address this question, we tested the ability to recognize a mixture of basic and complex emotions in 38 non-demented PD patients and 38 healthy controls matched on demographic characteristics. By using a task with an increased level of ambiguity, in conjunction with the signal detection theory, we were able to differentiate between sensitivity and response bias in facial emotion recognition. Sensitivity and response bias for facial emotion recognition were calculated using a d-prime value and a c index respectively. Our study is the first to employ the EIS-F scale for assessing facial emotion recognition among PD patients; to test its validity as an assessment tool, a group comprising schizophrenia patients and healthy controls were also tested. Patients with PD recognized emotions with less accuracy than healthy individuals (d-prime) and used a more liberal response criterion (c index). By contrast, patients with schizophrenia merely showed diminished sensitivity (d-prime). Our results suggest that an impaired ability to recognize facial emotions in PD patients may result from both decreased sensitivity and a significantly more liberal response criteria, whereas facial emotion recognition in schizophrenia may stem from a generalized sensory impairment only.

On the particular vulnerability of face recognition to aging: a review of three hypotheses

Age-related face recognition deficits are characterized by high false alarms to unfamiliar faces, are not as pronounced for other complex stimuli, and are only partially related to general age-related impairments in cognition. This paper reviews some of the underlying processes likely to be implicated in theses deficits by focusing on areas where contradictions abound as a means to highlight avenues for future research. Research pertaining to the three following hypotheses is presented: (i) perceptual deterioration, (ii) encoding of configural information, and (iii) difficulties in recollecting contextual information. The evidence surveyed provides support for the idea that all three factors are likely to contribute, under certain conditions, to the deficits in face recognition seen in older adults. We discuss how these different factors might interact in the context of a generic framework of the different stages implicated in face recognition. Several suggestions for future investigations are outlined.

Discriminating facial expressions of emotion and its link with perceiving visual form in Parkinson's disease

We investigated the link between the ability to perceive facial expressions of emotion and the ability to perceive visual form in Parkinson's disease (PD). We assessed in individuals with PD and healthy controls the ability to discriminate graded intensities of facial expressions of anger from neutral expressions and the ability to discriminate radial frequency (RF) patterns with modulations in amplitude from a perfect circle. Those with PD were, as a group, impaired relative to controls in discriminating graded intensities of angry from neutral expressions and discriminating modulated amplitudes of RF patterns from perfect circles; these two abilities correlated positively and moderately to highly, even after removing the variance that was shared with disease progression and general cognitive functioning. The results indicate that the impaired ability to perceive visual form is likely to contribute to the impaired ability to perceive facial expressions of emotion in PD, and that both are related to the progression of the disease.

Working memory and facial expression recognition in patients with Parkinson's disease

Facial expression recognition impairment has been reported in Parkinson's disease. While some authors have referred to specific emotional disabilities, others view them as secondary to executive deficits frequently described in the disease, such as working memory. The present study aims to analyze the relationship between working memory and facial expression recognition abilities in Parkinson's disease. We observed 50 patients with Parkinson's disease and 49 healthy controls by means of an n-back procedure with four types of stimuli: emotional facial expressions, gender, spatial locations, and non-sense syllables. Other executive and visuospatial neuropsychological tests were also administered. Results showed that Parkinson's disease patients with high levels of disability performed worse than healthy individuals on the emotional facial expression and spatial location tasks. Moreover, spatial location task performance was correlated with executive neuropsychological scores, but emotional facial expression was not. Thus, working memory seems to be altered in Parkinson's disease, particularly in tasks that involve the appreciation of spatial relationships in stimuli. Additionally, non-executive, facial emotional recognition difficulty seems to be present and related to disease progression.

Effects of Anticipation on Perception of Facial Expressions

Human beings do not passively perceive the facial expressions of other people, but predict observed facial expressions by employing past experiences. The aim of the current study was to investigate whether and how anticipation affected the perception of facial expressions. A 3-way repeated-measures ANOVA on anticipation, orientation, and facial expression was performed on RTs and recognition accuracy in Experiments 1 and 2. The results showed that anticipation reduced susceptibility to negative facial expressions. In this regard, anticipation might be considered as an effective emotion-regulation strategy. In addition, a decreased inversion effect for positive facial expressions was found in the predictable condition, which might reflect a switch from feature-based to holistic processing.

Discrimination and categorization of emotional facial expressions and faces in Parkinson's disease

Our objective was to compare the ability to discriminate and categorize emotional facial expressions (EFEs) and facial identity characteristics (age and/or gender) in a group of 53 individuals with Parkinson's disease (PD) and another group of 53 healthy subjects. On the one hand, by means of discrimination and identification tasks, we compared two stages in the visual recognition process that could be selectively affected in individuals with PD. On the other hand, facial expression versus gender and age comparison permits us to contrast whether the emotional or non-emotional content influences the configural perception of faces. In Experiment I, we did not find differences between groups, either with facial expression or age, in discrimination tasks. Conversely, in Experiment II, we found differences between the groups, but only in the EFE identification task. Taken together, our results indicate that configural perception of faces does not seem to be globally impaired in PD. However, this ability is selectively altered when the categorization of emotional faces is required. A deeper assessment of the PD group indicated that decline in facial expression categorization is more evident in a subgroup of patients with higher global impairment (motor and cognitive). Taken together, these results suggest that the problems found in facial expression recognition may be associated with the progressive neuronal loss in frontostriatal and mesolimbic circuits, which characterizes PD.

Processing Facial Expressions of Emotion: Upright vs. Inverted Images

We studied discrimination of briefly presented upright vs. inverted emotional facial expressions (FEs), hypothesizing that inversion would impair emotion decoding by disrupting holistic FE processing. Stimuli were photographs of seven emotion prototypes, of a male and female poser (Ekman and Friesen, 1976), and eight intermediate morphs in each set. Subjects made speeded Same/Different judgments of emotional content for all upright (U) or inverted (I) pairs of FEs, presented for 500 ms, 100 times each pair. Signal Detection Theory revealed the sensitivity measure d' to be slightly but significantly higher for the upright FEs. In further analysis using multidimensional scaling (MDS), percentages of Same judgments were taken as an index of pairwise perceptual similarity, separately for U and I presentation mode. The outcome was a 4D "emotion expression space," with FEs represented as points and the dimensions identified as Happy-Sad, Surprise/Fear, Disgust, and Anger. The solutions for U and I FEs were compared by means of cophenetic and canonical correlation, Procrustes analysis, and weighted-Euclidean analysis of individual differences. Differences in discrimination produced by inverting FE stimuli were found to be small and manifested as minor changes in the MDS structure or weights of the dimensions. Solutions differed substantially more between the two posers, however. Notably, for stimuli containing elements of Happiness (whether U or I), the MDS structure showed signs of implicit categorization, indicating that mouth curvature - the dominant feature conveying Happiness - is visually salient and receives early processing. The findings suggest that for briefly presented FEs, Same/Different decisions are dominated by low-level visual analysis of abstract patterns of lightness and edge filters, but also reflect emerging featural analysis. These analyses, insensitive to face orientation, enable initial positive/negative Valence categorization of FEs.

Recognition of facial and musical emotions in Parkinson's disease

BACKGROUND AND PURPOSE

Patients with amygdala lesions were found to be impaired in recognizing the fear emotion both from face and from music. In patients with Parkinson's disease (PD), impairment in recognition of emotions from facial expressions was reported for disgust, fear, sadness and anger, but no studies had yet investigated this population for the recognition of emotions from both face and music.

METHODS

The ability to recognize basic universal emotions (fear, happiness and sadness) from both face and music was investigated in 24 medicated patients with PD and 24 healthy controls. The patient group was tested for language (verbal fluency tasks), memory (digit and spatial span), executive functions (Similarities and Picture Completion subtests of the WAIS III, Brixton and Stroop tests), visual attention (Bells test), and fulfilled self-assessment tests for anxiety and depression.

RESULTS

Results showed that the PD group was significantly impaired for recognition of both fear and sadness emotions from facial expressions, whereas their performance in recognition of emotions from musical excerpts was not different from that of the control group. The scores of fear and sadness recognition from faces were neither correlated to scores in tests for executive and cognitive functions, nor to scores in self-assessment scales.

CONCLUSION

We attributed the observed dissociation to the modality (visual vs. auditory) of presentation and to the ecological value of the musical stimuli that we used. We discuss the relevance of our findings for the care of patients with PD.

Effects of dopamine on sensitivity to social bias in Parkinson's disease

Patients with Parkinson's disease (PD) sometimes develop impulsive compulsive behaviours (ICBs) due to their dopaminergic medication. We compared 26 impulsive and 27 non-impulsive patients with PD, both on and off medication, on a task that examined emotion bias in decision making. No group differences were detected, but patients on medication were less biased by emotions than patients off medication and the strongest effects were seen in patients with ICBs. PD patients with ICBs on medication also showed more learning from negative feedback and less from positive feedback, whereas off medication they showed the opposite effect.