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Martins MI, Cardoso FEC, Caramelli P, Mariano LI, Rocha NP, Jaeger A, Teixeira AL, Tumas V, Camargos ST, de Souza LC. Hearts and Minds: Emotion Recognition and Mentalizing in Parkinson's Disease and Progressive Supranuclear Palsy. Arch Clin Neuropsychol 2024; 39:516-522. [PMID: 37856362 DOI: 10.1093/arclin/acad081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVE There are scarce data comparing Parkinson's disease (PD) and Progressive Supranuclear Palsy (PSP) in social cognition (SC). We aimed to compare patients with PSP and PD in SC. METHODS We included three groups: PD (n = 18), PSP (n = 20) and controls (n = 23). Participants underwent neuropsychological exams, including the mini-version of the Social and Emotional Assessment, which is composed of the facial emotion recognition test (FERT) and the modified faux-pas (mFP) test, which assesses Theory of Mind (ToM). RESULTS Patients with PD scored lower than controls in the FERT, but not in the mFP test. Patients with PSP performed worse than controls in both the mFP and FERT. PD and PSP groups did not differ in the FERT, but PSP performed worse than PD in the mFP test. The mFP test distinguished PSP from PD with 89% accuracy. CONCLUSION The assessment of ToM may contribute to the differentiation between PD and PSP.
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Affiliation(s)
- Marina I Martins
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Francisco E C Cardoso
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Ambulatório de Distúrbios de Movimento da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Departamento de Clínica Médica da Faculdade de Medicina da UFMG, Belo Horizonte, MG, Brazil
| | - Paulo Caramelli
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Departamento de Clínica Médica da Faculdade de Medicina da UFMG, Belo Horizonte, MG, Brazil
- Grupo de Neurologia Cognitiva e do Comportamento da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Luciano I Mariano
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Grupo de Neurologia Cognitiva e do Comportamento da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Natalia P Rocha
- The Mitchell Center for Alzheimer's Disease and Related Brain Disorders, Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Antônio Jaeger
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Antônio L Teixeira
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
- Santa Casa BH Ensino e Pesquisa, Avenida dos Andradas, 2.688, Santa Efigênia, Belo Horizonte, MG, Brazil
| | - Vítor Tumas
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Sarah T Camargos
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Ambulatório de Distúrbios de Movimento da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Departamento de Clínica Médica da Faculdade de Medicina da UFMG, Belo Horizonte, MG, Brazil
| | - Leonardo C de Souza
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Departamento de Clínica Médica da Faculdade de Medicina da UFMG, Belo Horizonte, MG, Brazil
- Grupo de Neurologia Cognitiva e do Comportamento da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Cruz de Souza L, Bertoux M, Radakovic R, Hornberger M, Mariano LI, de Paula França Resende E, Quesque F, Guimarães HC, Gambogi LB, Tumas V, Camargos ST, Costa Cardoso FE, Teixeira AL, Caramelli P. I’m Looking Through You: Mentalizing In Frontotemporal Dementia And Progressive Supranuclear Palsy. Cortex 2022; 155:373-389. [DOI: 10.1016/j.cortex.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 05/02/2022] [Accepted: 07/28/2022] [Indexed: 11/03/2022]
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3
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Measuring social cognition in frontotemporal lobar degeneration: a clinical approach. J Neurol 2021; 269:2227-2244. [PMID: 34797433 DOI: 10.1007/s00415-021-10889-9] [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: 08/18/2021] [Revised: 10/14/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022]
Abstract
Alterations in social cognition, a broad term indicating our ability to understand others and adapt our behavior accordingly, have been the focus of growing attention in the past years. Some neurological conditions, such as those belonging to the frontotemporal lobar degeneration (FTLD) spectrum, are associated to varying degrees with social cognition deficits, encompassing problems with theory of mind (ToM), empathy, perception of social stimuli, and social behavior. In this review, we outline a clinical framework for the evaluation of social cognition and discuss its role in the assessment of patients affected by a range of FTLD conditions.
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Magno MA, Canu E, Filippi M, Agosta F. Social cognition in the FTLD spectrum: evidence from MRI. J Neurol 2021; 269:2245-2258. [PMID: 34797434 DOI: 10.1007/s00415-021-10892-0] [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: 08/18/2021] [Revised: 10/14/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022]
Abstract
Over the past few years, there has been great interest in social cognition, a wide term referring to the human ability of understanding others' emotions, thoughts, and intentions, to empathize with them and to behave accordingly. While there is no agreement on the classification of social cognitive processes, they can broadly be categorized as consisting of theory of mind, empathy, social perception, and social behavior. The study of social cognition and its relative deficits is increasingly assuming clinical relevance. However, the clinical and neuroanatomical correlates of social cognitive alterations in neurodegenerative conditions, such as those belonging to the frontotemporal lobar (FTLD) spectrum, are not fully established. In this review, we describe the current understanding of social cognition impairments in different FTLD conditions with respect to MRI.
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Affiliation(s)
- Maria Antonietta Magno
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Elisa Canu
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy. .,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. .,Vita-Salute San Raffaele University, Milan, Italy.
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Heilman KM. Disorders of facial emotional expression and comprehension. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:99-108. [PMID: 34389127 DOI: 10.1016/b978-0-12-822290-4.00006-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
One of the most important means of communicating emotions is by facial expressions. About 30-40 years ago, several studies examined patients with right and left hemisphere strokes for deficits in expressing and comprehending emotional facial expressions. The participants with right- or left-hemispheric strokes attempted to determine if two different actors were displaying the same or different emotions, to name the different emotions being displayed, and to select the face displaying an emotion named by the examiner. Investigators found that the right hemisphere-damaged group was impaired on all these emotional facial tests and that this deficit was not solely related to visuoperceptual processing defects. Further studies revealed that the patients who were impaired at recognizing emotional facial expressions and who had lost these visual representations of emotional faces often had damage to their right parietal lobe and their right somatosensory cortex. Injury to the cerebellum has been reported to impair emotional facial recognition, as have dementing diseases such as Alzheimer's disease and frontotemporal dementia, movement disorders such as Parkinson's disease and Huntington's disease, traumatic brain injuries, and temporal lobe epilepsy. Patients with right hemisphere injury are also more impaired than left-hemisphere-damaged patients when attempting to voluntarily produce facial emotional expressions and in their spontaneous expression of emotions in response to stimuli. This impairment does not appear to be induced by emotional conceptual deficits or an inability to experience emotions. Many of the disorders that cause impairments of comprehension of affective facial expressions also impair facial emotional expression. Treating the underlying disease may help patients with impairments of facial emotion recognition and expression, but unfortunately, there have not been many studies of rehabilitation.
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Affiliation(s)
- Kenneth M Heilman
- Department of Neurology, University of Florida College of Medicine and Geriatric Research, Education, and Clinical Center, Malcom Randall Veterans Affairs Medical Center, Gainesville, FL, United States.
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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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Cerroni R, Liguori C, Stefani A, Conti M, Garasto E, Pierantozzi M, Mercuri NB, Bernardini S, Fucci G, Massoud R. Increased Noradrenaline as an Additional Cerebrospinal Fluid Biomarker in PSP-Like Parkinsonism. Front Aging Neurosci 2020; 12:126. [PMID: 32612521 PMCID: PMC7308889 DOI: 10.3389/fnagi.2020.00126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/15/2020] [Indexed: 12/12/2022] Open
Abstract
Academic centers utilize sequential clinical and neuroimaging assessments, including morphometric ratios, to obtain an unequivocal diagnosis of the non-synucleinopathic forms of Parkinsonism, such as progressive supranuclear palsy (PSP), however, a 1–2 year follow-up is required. The on-going long-lasting trials using anti-tau antibodies for PSP patients might therefore be biased by the incorrect enrollment of Parkinson’s disease (PD) patients manifesting early axial signs. This perspective study aimed at achieving two major goals: first, to summarize the established biomarker candidates found in cerebrospinal fluid (CSF) in probable PSP patients, including low p-tau and altered neurofilaments. Second, we share our recent data, from CSF samples of well-selected PSP subjects, attributable to both main variants (and revisited in light of MDS criteria), who were followed for 1 year before and 2 years after lumbar puncture. We found a significantly high level of noradrenaline (NE) in these patients, similar to controls, when compared to PD patients. In contrast, CSF samples, in PD, showed a significant reduction in CSF NE and its major metabolite, which confirmed that PD is a multi-system disease involving several endogenous pathways. The NE axis impairments were prominent in PSP featuring worse NPI. It might represent a counterpart to the early and peculiar psycho-pathological profiles that are observed in tauopathies. In conclusion, we highlight that CSF biomarkers, which are easy to collect, can provide rapid insights as diagnostic tools. Early alterations in endogenous NE machinery in atypical Parkinsonism may represent a specific risk trait in forms characterized by a worse prognosis.
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Affiliation(s)
- Rocco Cerroni
- Parkinson Center, Department of System Medicine, University Tor Vergata, Rome, Italy
| | - Claudio Liguori
- Parkinson Center, Department of System Medicine, University Tor Vergata, Rome, Italy
| | - Alessandro Stefani
- Parkinson Center, Department of System Medicine, University Tor Vergata, Rome, Italy
| | - Matteo Conti
- Parkinson Center, Department of System Medicine, University Tor Vergata, Rome, Italy
| | - Elena Garasto
- Parkinson Center, Department of System Medicine, University Tor Vergata, Rome, Italy
| | | | - Nicola B Mercuri
- UOC Neurology, Department of System Medicine, University Tor Vergata, Rome, Italy
| | - Sergio Bernardini
- Department of Experimental Medicine and Surgery, Faculty of Medicine and Surgery, University Tor Vergata, Rome, Italy
| | - Giorgio Fucci
- Department of Experimental Medicine and Surgery, Faculty of Medicine and Surgery, University Tor Vergata, Rome, Italy
| | - Renato Massoud
- Department of Experimental Medicine and Surgery, Faculty of Medicine and Surgery, University Tor Vergata, Rome, Italy
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Prediction of the Clinical Severity of Progressive Supranuclear Palsy by Diffusion Tensor Imaging. J Clin Med 2019; 9:jcm9010040. [PMID: 31878122 PMCID: PMC7020078 DOI: 10.3390/jcm9010040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/14/2019] [Accepted: 12/15/2019] [Indexed: 01/06/2023] Open
Abstract
Progressive supranuclear palsy (PSP) is characterized by a rapid and progressive clinical course. A timely and objective image-based evaluation of disease severity before standard clinical assessments might increase the diagnostic confidence of the neurologist. We sought to investigate whether features from diffusion tensor imaging of the entire brain with a machine learning algorithm, rather than a few pathogenically involved regions, may predict the clinical severity of PSP. Fifty-three patients who met the diagnostic criteria for probable PSP were subjected to diffusion tensor imaging. Of them, 15 underwent follow-up imaging. Clinical severity was assessed by the neurological examinations. Mean diffusivity and fractional anisotropy maps were spatially co-registered, normalized, and parcellated into 246 brain regions from the human Brainnetome atlas. The predictors of clinical severity from a stepwise linear regression model were determined after feature reduction by the least absolute shrinkage and selection operator. Performance estimates were obtained using bootstrapping, cross-validation, and through application of the model in the patients who underwent repeated imaging. The algorithm confidently predicts the clinical severity of PSP at the individual level (adjusted R2: 0.739 and 0.892, p < 0.001). The machine learning algorithm for selection of diffusion tensor imaging-based features is accurate in predicting motor subscale of unified Parkinson’s disease rating scale and postural instability and gait disturbance of PSP.
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Assogna F, Pellicano C, Cravello L, Savini C, Macchiusi L, Pierantozzi M, Stefani A, Mercuri B, Caltagirone C, Pontieri FE, Spalletta G. Alexithymia and anhedonia in early Richardson's syndrome and progressive supranuclear palsy with predominant parkinsonism. Brain Behav 2019; 9:e01448. [PMID: 31743601 PMCID: PMC6908877 DOI: 10.1002/brb3.1448] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/01/2019] [Accepted: 09/20/2019] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Phenotypic variants of progressive supranuclear palsy (PSP) are all characterized by the combination of motor symptoms of parkinsonism with a number of neuropsychiatric and cognitive disorders. Despite the strong effort in characterizing these features in PSP, alexithymia and anhedonia have not been investigated at present. Here, we aimed at investigating the qualitative and quantitative differences of alexithymia and anhedonia in the two more frequent variants of PSP, Richardson's syndrome (PSP-RS) and PSP with predominant parkinsonism (PSP-P) compared to Parkinson's disease (PD) patients recruited within 24 months after the onset of motor symptoms. METHODS One hundred fifty-five PD, 11 PSP-P, and 14 PSP-RS patients underwent clinical, neuropsychiatric, and neuropsychological evaluations. Alexithymia was assessed using the Toronto Alexithymia Scale-20 item (TAS-20), and hedonic tone was measured by the Snaith-Hamilton Pleasure Scale (SHAPS). RESULTS In PSP-P and PSP-RS patients, the frequency of alexithymia diagnosis was higher than in PD. On the TAS-20 scores, PSP-RS performed worse in the total score and in F2 sub-scale when compared to PD. Among patients with diagnosis of depression, PSP-RS showed higher scores in TAS-20 total and TAS-20 F2 than PD. No significant differences in TAS-20 scores were found in nondepressed patients. Finally, we did not find significant differences among PD, PSP-P, and PSP-RS groups in the SHAPS scores. CONCLUSIONS Alexithymia is identifiable very early in PSP-P and PSP-RS patients. Alexithymic symptoms differentiate PSP-RS group from PD group but not between the two subtypes of PSP. Further, alexithymia in PSP seems to be predicted by the presence of depression. Altered emotional capability could be related to specific neurophysiological dysfunction occurring precociously in PSP; therefore, its identification could orient the diagnosis toward PSP cases.
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Affiliation(s)
| | - Clelia Pellicano
- Fondazione Santa Lucia, IRCCS, Roma, Italy.,UOC Neurologia, Azienda Ospedaliera "Belcolle", Viterbo, Italy
| | | | | | | | | | - Alessandro Stefani
- Dipartimento di Medicina dei Sistemi, Università "Tor Vergata", Roma, Italy
| | - Bruno Mercuri
- UOC Neurologia, Azienda Ospedaliera "San Giovanni Addolorata", Roma, Italy
| | | | - Francesco E Pontieri
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso, "Sapienza" Università di Roma, Roma, Italy
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Fabbrini G, Fabbrini A, Suppa A. Progressive supranuclear palsy, multiple system atrophy and corticobasal degeneration. ACTA ACUST UNITED AC 2019; 165:155-177. [DOI: 10.1016/b978-0-444-64012-3.00009-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Social Cognition Dysfunctions in Neurodegenerative Diseases: Neuroanatomical Correlates and Clinical Implications. Behav Neurol 2018; 2018:1849794. [PMID: 29854017 PMCID: PMC5944290 DOI: 10.1155/2018/1849794] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 04/03/2018] [Accepted: 04/11/2018] [Indexed: 02/07/2023] Open
Abstract
Social cognitive function, involved in the perception, processing, and interpretation of social information, has been shown to be crucial for successful communication and interpersonal relationships, thereby significantly impacting mental health, well-being, and quality of life. In this regard, assessment of social cognition, mainly focusing on four key domains, such as theory of mind (ToM), emotional empathy, and social perception and behavior, has been increasingly evaluated in clinical settings, given the potential implications of impairments of these skills for therapeutic decision-making. With regard to neurodegenerative diseases (NDs), most disorders, characterized by variable disease phenotypes and progression, although similar for the unfavorable prognosis, are associated to impairments of social cognitive function, with consequent negative effects on patients' management. Specifically, in some NDs these deficits may represent core diagnostic criteria, such as for behavioral variant frontotemporal dementia (bvFTD), or may emerge during the disease course as critical aspects, such as for Parkinson's and Alzheimer's diseases. On this background, we aimed to revise the most updated evidence on the neurobiological hypotheses derived from network-based approaches, clinical manifestations, and assessment tools of social cognitive dysfunctions in NDs, also prospecting potential benefits on patients' well-being, quality of life, and outcome derived from potential therapeutic perspectives of these deficits.
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Belvisi D, Berardelli I, Suppa A, Fabbrini A, Pasquini M, Pompili M, Fabbrini G. Neuropsychiatric disturbances in atypical parkinsonian disorders. Neuropsychiatr Dis Treat 2018; 14:2643-2656. [PMID: 30349262 PMCID: PMC6186304 DOI: 10.2147/ndt.s178263] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD) are the most common atypical parkinsonisms. These disorders are characterized by varying combinations of autonomic, cerebellar and pyramidal system, and cognitive dysfunctions. In this paper, we reviewed the evidence available on the presence and type of neuropsychiatric disturbances in MSA, PSP, and CBD. A MedLine, Excerpta Medica, PsycLit, PsycInfo, and Index Medicus search was performed to identify all articles published on this topic between 1965 and 2018. Neuropsychiatric disturbances including depression, anxiety, agitation, and behavioral abnormalities have been frequently described in these disorders, with depression as the most frequent disturbance. MSA patients show a higher frequency of depressive disorders when compared to healthy controls. An increased frequency of anxiety disorders has also been reported in some patients, and no studies have investigated apathy. PSP patients may have depression, apathy, disinhibition, and to a lesser extent, anxiety and agitation. In CBD, neuropsychiatric disorders are similar to those present in PSP. Hallucinations and delusions are rarely reported in these disorders. Neuropsychiatric symptoms in MSA, PSP, and CBD do not appear to be related to the severity of motor dysfunction and are one of the main factors that determine a low quality of life. The results suggest that neuropsychiatric disturbances should always be assessed in patients with atypical parkinsonisms.
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Affiliation(s)
| | - Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Antonio Suppa
- IRCCS Neuromed, Pozzilli, Italy, .,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy,
| | - Andrea Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy,
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy,
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Giovanni Fabbrini
- IRCCS Neuromed, Pozzilli, Italy, .,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy,
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Pellicano C, Assogna F, Cellupica N, Piras F, Pierantozzi M, Stefani A, Cerroni R, Mercuri B, Caltagirone C, Pontieri FE, Spalletta G. Neuropsychiatric and cognitive profile of early Richardson's syndrome, Progressive Supranuclear Palsy-parkinsonism and Parkinson's disease. Parkinsonism Relat Disord 2017; 45:50-56. [DOI: 10.1016/j.parkreldis.2017.10.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 09/14/2017] [Accepted: 10/03/2017] [Indexed: 02/05/2023]
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Silver H, Bilker WB. Colour influences perception of facial emotions but this effect is impaired in healthy ageing and schizophrenia. Cogn Neuropsychiatry 2016; 20:438-55. [PMID: 26395165 DOI: 10.1080/13546805.2015.1080157] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Social cognition is commonly assessed by identification of emotions in facial expressions. Presence of colour, a salient feature of stimuli, might influence emotional face perception. METHODS We administered 2 tests of facial emotion recognition, the Emotion Recognition Test (ER40) using colour pictures and the Penn Emotional Acuity Test using monochromatic pictures, to 37 young healthy, 39 old healthy and 37 schizophrenic men. RESULTS Among young healthy individuals recognition of emotions was more accurate and faster in colour than in monochromatic pictures. Compared to the younger group, older healthy individuals revealed impairment in identification of sad expressions in colour but not monochromatic pictures. Schizophrenia patients showed greater impairment in colour than monochromatic pictures of neutral and sad expressions and overall total score compared to both healthy groups. Patients showed significant correlations between cognitive impairment and perception of emotion in colour but not monochromatic pictures. CONCLUSIONS Colour enhances perception of general emotional clues and this contextual effect is impaired in healthy ageing and schizophrenia. The effects of colour need to be considered in interpreting and comparing studies of emotion perception. Coloured face stimuli may be more sensitive to emotion processing impairments but less selective for emotion-specific information than monochromatic stimuli. This may impact on their utility in early detection of impairments and investigations of underlying mechanisms.
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Affiliation(s)
- Henry Silver
- a Brain Behavior Laboratory , Sha'ar Menashe Mental Health Center , Mobile Post Hefer 37806, Israel.,b Rappaport Faculty of Medicine , Technion Institute of Technology , Haifa , Israel
| | - Warren B Bilker
- c Department of Biostatistics and Epidemiology , University of Pennsylvania , Philadelphia , PA , USA
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Bluett B, Litvan I. Pathophysiology, genetics, clinical features, diagnosis and therapeutic trials in progressive supranuclear palsy. Expert Opin Orphan Drugs 2015. [DOI: 10.1517/21678707.2015.1018180] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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McIntosh LG, Mannava S, Camalier CR, Folley BS, Albritton A, Konrad PE, Charles D, Park S, Neimat JS. Emotion recognition in early Parkinson's disease patients undergoing deep brain stimulation or dopaminergic therapy: a comparison to healthy participants. Front Aging Neurosci 2015; 6:349. [PMID: 25653616 PMCID: PMC4301000 DOI: 10.3389/fnagi.2014.00349] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 12/28/2014] [Indexed: 01/24/2023] Open
Abstract
Parkinson's disease (PD) is traditionally regarded as a neurodegenerative movement disorder, however, nigrostriatal dopaminergic degeneration is also thought to disrupt non-motor loops connecting basal ganglia to areas in frontal cortex involved in cognition and emotion processing. PD patients are impaired on tests of emotion recognition, but it is difficult to disentangle this deficit from the more general cognitive dysfunction that frequently accompanies disease progression. Testing for emotion recognition deficits early in the disease course, prior to cognitive decline, better assesses the sensitivity of these non-motor corticobasal ganglia-thalamocortical loops involved in emotion processing to early degenerative change in basal ganglia circuits. In addition, contrasting this with a group of healthy aging individuals demonstrates changes in emotion processing specific to the degeneration of basal ganglia circuitry in PD. Early PD patients (EPD) were recruited from a randomized clinical trial testing the safety and tolerability of deep brain stimulation (DBS) of the subthalamic nucleus (STN-DBS) in early-staged PD. EPD patients were previously randomized to receive optimal drug therapy only (ODT), or drug therapy plus STN-DBS (ODT + DBS). Matched healthy elderly controls (HEC) and young controls (HYC) also participated in this study. Participants completed two control tasks and three emotion recognition tests that varied in stimulus domain. EPD patients were impaired on all emotion recognition tasks compared to HEC. Neither therapy type (ODT or ODT + DBS) nor therapy state (ON/OFF) altered emotion recognition performance in this study. Finally, HEC were impaired on vocal emotion recognition relative to HYC, suggesting a decline related to healthy aging. This study supports the existence of impaired emotion recognition early in the PD course, implicating an early disruption of fronto-striatal loops mediating emotional function.
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Affiliation(s)
- Lindsey G McIntosh
- Department of Neurological Surgery, Vanderbilt University Medical Center Nashville, TN, USA ; Department of Psychology, Vanderbilt University Nashville, TN, USA
| | - Sishir Mannava
- Department of Neurological Surgery, Vanderbilt University Medical Center Nashville, TN, USA
| | - Corrie R Camalier
- Department of Neurological Surgery, Vanderbilt University Medical Center Nashville, TN, USA
| | | | - Aaron Albritton
- Department of Neurological Surgery, Vanderbilt University Medical Center Nashville, TN, USA
| | - Peter E Konrad
- Department of Neurological Surgery, Vanderbilt University Medical Center Nashville, TN, USA
| | - David Charles
- Department of Neurology, Vanderbilt University Medical Center Nashville, TN, USA
| | - Sohee Park
- Department of Psychology, Vanderbilt University Nashville, TN, USA
| | - Joseph S Neimat
- Department of Neurological Surgery, Vanderbilt University Medical Center Nashville, TN, USA
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Facial and bodily emotion recognition in multiple sclerosis: the role of alexithymia and other characteristics of the disease. J Int Neuropsychol Soc 2014; 20:1004-14. [PMID: 25373767 DOI: 10.1017/s1355617714000939] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Multiple sclerosis (MS) may be associated with impaired perception of facial emotions. However, emotion recognition mediated by bodily postures has never been examined in these patients. Moreover, several studies have suggested a relation between emotion recognition impairments and alexithymia. This is in line with the idea that the ability to recognize emotions requires the individuals to be able to understand their own emotions. Despite a deficit in emotion recognition has been observed in MS patients, the association between impaired emotion recognition and alexithymia has received little attention. The aim of this study was, first, to investigate MS patient's abilities to recognize emotions mediated by both facial and bodily expressions and, second, to examine whether any observed deficits in emotions recognition could be explained by the presence of alexithymia. Thirty patients with MS and 30 healthy matched controls performed experimental tasks assessing emotion discrimination and recognition of facial expressions and bodily postures. Moreover, they completed questionnaires evaluating alexithymia, depression, and fatigue. First, facial emotion recognition and, to a lesser extent, bodily emotion recognition can be impaired in MS patients. In particular, patients with higher disability showed an impairment in emotion recognition compared with patients with lower disability and controls. Second, their deficit in emotion recognition was not predicted by alexithymia. Instead, the disease's characteristics and the performance on some cognitive tasks significantly correlated with emotion recognition. Impaired facial emotion recognition is a cognitive signature of MS that is not dependent on alexithymia.
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Active aging for individuals with Parkinson's disease: definitions, literature review, and models. PARKINSONS DISEASE 2014; 2014:739718. [PMID: 25225618 PMCID: PMC4158465 DOI: 10.1155/2014/739718] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 08/13/2014] [Indexed: 11/17/2022]
Abstract
Active aging has been emerged to optimize different aspects of health opportunities during the aging process in order to enhance quality of life. Yet, most of the efforts are on normal aging and less attention has been paid for the elderly suffering from a chronic illness such as Parkinson's disease (PD). The aim of this review was to investigate how the concept of "active aging" fit for the elderly with PD and to propose a new model for them using the recent improvements in caring models and management approaches. For this purpose, biomedical databases have been assessed using relevant keywords to find out appropriate articles. Movement problems of PD affect physical activity, psychiatric symptoms lessen social communication, and cognitive impairment could worsen mental well-being in elderly with PD, all of which could lead to earlier retirement and poorer quality of life compared with healthy elderly. Based on the multisystematic nature of PD, a new "Active Aging Model for Parkinson's Disease" is proposed consisting of self-care, multidisciplinary and interdisciplinary care, palliative care, patient-centered care, and personalized care. These strategies could potentially help the individuals with PD to have a better management approach for their condition towards the concept of active aging.
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Gerstenecker A, Duff K, Mast B, Litvan I. Behavioral abnormalities in progressive supranuclear palsy. Psychiatry Res 2013; 210:1205-10. [PMID: 24035530 PMCID: PMC3840159 DOI: 10.1016/j.psychres.2013.08.045] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 08/15/2013] [Accepted: 08/17/2013] [Indexed: 12/23/2022]
Abstract
Progressive supranuclear palsy (PSP) is a rare neurodegenerative disorder in which, classically, patients present with postural instability and falls, parkinsonism, and slowing of vertical saccades. PSP patients typically have deficits in cognitive functioning, difficulties with most daily activities, and present with notable behavioral disturbances-particularly apathy, impulsivity, and irritability. Using data from 154 patients meeting criteria for clinically probable PSP, domain and total scores of the Neuropsychiatric Inventory were examined and compared to demographics, disease severity, cognition, and motor features. Behavioral abnormalities were common in this cohort of PSP patients, with more than half experiencing apathy, depression, and sleeping problems, and approximately one third displaying agitation, irritability, disinhibition, and eating problems. Few clinical correlates of neuropsychiatric symptoms were observed in this cohort. Given the prevalence of neuropsychiatric symptoms in PSP, these patients are expected to be frequently seen by psychiatrists and other mental health professionals for symptom management and increased quality of life. Clinical trials are clearly needed to address the neuropsychiatric morbidity in these patients.
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Affiliation(s)
- Adam Gerstenecker
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292, USA.
| | - Kevin Duff
- Department of Neurology, University of Utah, Salt Lake City, UT 84108 USA
| | - Benjamin Mast
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, 40292 USA
| | - Irene Litvan
- Department of Neurosciences, University of California San Diego, La Jolla, CA, 92037, USA
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Labus JS, Gupta A, Coveleskie K, Tillisch K, Kilpatrick L, Jarcho J, Feier N, Bueller J, Stains J, Smith S, Suyenobu B, Naliboff B, Mayer EA. Sex differences in emotion-related cognitive processes in irritable bowel syndrome and healthy control subjects. Pain 2013; 154:2088-2099. [PMID: 23791896 DOI: 10.1016/j.pain.2013.06.024] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 05/29/2013] [Accepted: 06/17/2013] [Indexed: 12/12/2022]
Abstract
Greater responsiveness of emotional arousal circuits in relation to delivered visceral pain has been implicated as underlying central pain amplification in irritable bowel syndrome (IBS), with female subjects showing greater responses than male subjects. Functional magnetic resonance imaging was used to measure neural responses to an emotion recognition paradigm, using faces expressing negative emotions (fear and anger). Sex and disease differences in the connectivity of affective and modulatory cortical circuits were studied in 47 IBS (27 premenopausal female subjects) and 67 healthy control subjects (HCs; 38 premenopausal female subjects). Male subjects (IBS+HC) showed greater overall brain responses to stimuli than female subjects in prefrontal cortex, insula, and amygdala. Effective connectivity analyses identified major sex- and disease-related differences in the functioning of brain networks related to prefrontal regions, cingulate, insula, and amygdala. Male subjects had stronger connectivity between anterior cingulate subregions, amygdala, and insula, whereas female subjects had stronger connectivity to and from the prefrontal modulatory regions (medial/dorsolateral cortex). Male IBS subjects demonstrate greater engagement of cortical and affect-related brain circuitry compared to male control subjects and female subjects, when viewing faces depicting emotions previously shown to elicit greater behavioral and brain responses in male subjects.
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Affiliation(s)
- Jennifer S Labus
- Oppenheimer Family Center for Neurobiology of Stress and Pain and Interoception Network (PAIN) Repository, Los Angeles, CA, USA Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA National Institute of Mental Health (NIMH), Section of Developmental and Affective Neuroscience, Bethesda, MD, USA Department of Psychiatry, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, CA, USA
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Kumfor F, Piguet O. Emotion recognition in the dementias: brain correlates and patient implications. Neurodegener Dis Manag 2013. [DOI: 10.2217/nmt.13.16] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Changes in behavior, personality and the ability to interact in social situations have been reported to varying extents across dementia syndromes. Deficits in the ability to recognize emotion in others probably contribute to these socioemotional changes. This article reviews the patterns of emotion recognition impairments and their underlying brain correlates in four dementia syndromes: Alzheimer’s disease; frontotemporal dementia; Huntington’s disease; and progressive supranuclear palsy. Despite emotion recognition deficits being observed in all these patient groups, a limited understanding exists on how these deficits translate into everyday behavior. The adoption of ecologically valid tasks is likely to improve our understanding of these deficits in everyday settings, and will help to provide guidance for management strategies for patients and their carers.
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Affiliation(s)
- Fiona Kumfor
- Neuroscience Research Australia, PO Box 1165, Randwick, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
- Australian Research Council Centre of Excellence in Cognition & its Disorders, University of New South Wales, Sydney, Australia
| | - Olivier Piguet
- School of Medical Sciences, University of New South Wales, Sydney, Australia
- Australian Research Council Centre of Excellence in Cognition & its Disorders, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, PO Box 1165, Randwick, New South Wales, Australia.
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