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Siebenga FF, van der Weide HL, Gelmers F, Rakers SE, Kramer MCA, van der Hoorn A, Enting RH, Bosma I, Groen RJM, Jeltema HR, Wagemakers M, Spikman JM, Buunk AM. Emotion recognition in relation to tumor characteristics in patients with low-grade glioma. Neuro Oncol 2024; 26:528-537. [PMID: 37904541 PMCID: PMC10912004 DOI: 10.1093/neuonc/noad209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Patients with low-grade gliomas (LGG) treated with surgery, generally function well and have a favorable prognosis. However, LGG can affect neurocognitive functioning. To date, little is known about social cognition (SC) in these patients, although impaired SC is related to social-behavioral problems and poor societal participation. Frontal brain areas are important for SC and LGG frequently have a frontal location. Therefore, the aim of the present study was to investigate whether emotion recognition, a key component of SC, was impaired, and related to general cognition, tumor location, laterality, tumor volume, and histopathological characteristics in patients with LGG, postsurgery, and before start of adjuvant therapy. METHODS A total of 121 patients with LGG were matched with 169 healthy controls (HC). Tumor location [including (frontal) subregions; insula, anterior cingulate cortex, lateral prefrontal cortex (LPFC), orbitofrontal-ventromedial PFC] and tumor volume were determined on MRI scans. Emotion recognition was measured with the Ekman 60 faces test of the Facial Expressions of Emotion-Stimuli and Tests (FEEST). RESULTS Patients with LGG performed significantly lower on the FEEST than HC, with 33.1% showing impairment compared to norm data. Emotion recognition was not significantly correlated to frontal tumor location, laterality, and histopathological characteristics, and significantly but weakly with general cognition and tumor volume. CONCLUSIONS Emotion recognition is impaired in patients with LGG but not (strongly) related to specific tumor characteristics or general cognition. Hence, measuring SC with individual neuropsychological assessment of these patients is crucial, irrespective of tumor characteristics, to inform clinicians about possible impairments, and consequently offer appropriate care.
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Affiliation(s)
- Femke F Siebenga
- Department of Neurology, Unit of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Hiska L van der Weide
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Floor Gelmers
- Department of Neurology, Unit of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sandra E Rakers
- Department of Neurology, Unit of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Miranda C A Kramer
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anouk van der Hoorn
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Roelien H Enting
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ingeborg Bosma
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Rob J M Groen
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Hanne-Rinck Jeltema
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen
| | - Michiel Wagemakers
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen
| | - Jacoba M Spikman
- Department of Neurology, Unit of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anne M Buunk
- Department of Neurology, Unit of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Greene L, Reidy J, Morton N, Atherton A, Barker LA. Dynamic Emotion Recognition and Social Inference Ability in Traumatic Brain Injury: An Eye-Tracking Comparison Study. Behav Sci (Basel) 2023; 13:816. [PMID: 37887466 PMCID: PMC10604615 DOI: 10.3390/bs13100816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/22/2023] [Accepted: 09/27/2023] [Indexed: 10/28/2023] Open
Abstract
Emotion recognition and social inference impairments are well-documented features of post-traumatic brain injury (TBI), yet the mechanisms underpinning these are not fully understood. We examined dynamic emotion recognition, social inference abilities, and eye fixation patterns between adults with and without TBI. Eighteen individuals with TBI and 18 matched non-TBI participants were recruited and underwent all three components of The Assessment of Social Inference Test (TASIT). The TBI group were less accurate in identifying emotions compared to the non-TBI group. Individuals with TBI also scored lower when distinguishing sincere and sarcastic conversations, but scored similarly to those without TBI during lie vignettes. Finally, those with TBI also had difficulty understanding the actor's intentions, feelings, and beliefs compared to participants without TBI. No group differences were found for eye fixation patterns, and there were no associations between fixations and behavioural accuracy scores. This conflicts with previous studies, and might be related to an important distinction between static and dynamic stimuli. Visual strategies appeared goal- and stimulus-driven, with attention being distributed to the most diagnostic area of the face for each emotion. These findings suggest that low-level visual deficits may not be modulating emotion recognition and social inference disturbances post-TBI.
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Affiliation(s)
- Leanne Greene
- Centre for Behavioural Science and Applied Psychology, Department of Psychology, Sociology and Politics, Sheffield Hallam University, Sheffield S10 2BP, UK; (J.R.); (L.A.B.)
| | - John Reidy
- Centre for Behavioural Science and Applied Psychology, Department of Psychology, Sociology and Politics, Sheffield Hallam University, Sheffield S10 2BP, UK; (J.R.); (L.A.B.)
| | - Nick Morton
- Neuro Rehabilitation Outreach Team, Rotherham, Doncaster and South Humber NHS Trust, Doncaster DN4 8QN, UK;
| | - Alistair Atherton
- Consultant Clinical Neuropsychologist, Atherton Neuropsychology Consultancy Ltd. Parkhead Consultancy, 356 Ecclesall Road, Sheffield S11 9PU, UK;
| | - Lynne A. Barker
- Centre for Behavioural Science and Applied Psychology, Department of Psychology, Sociology and Politics, Sheffield Hallam University, Sheffield S10 2BP, UK; (J.R.); (L.A.B.)
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Turkstra LS, Hosseini-Moghaddam S, Wohltjen S, Nurre SV, Mutlu B, Duff MC. Facial affect recognition in context in adults with and without TBI. Front Psychol 2023; 14:1111686. [PMID: 37645059 PMCID: PMC10461638 DOI: 10.3389/fpsyg.2023.1111686] [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: 11/29/2022] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
Introduction Several studies have reported impaired emotion recognition in adults with traumatic brain injury (TBI), but studies have two major design features that limit application of results to real-world contexts: (1) participants choose from among lists of basic emotions, rather than generating emotion labels, and (2) images are typically presented in isolation rather than in context. To address these limitations, we created an open-labeling task with faces shown alone or in real-life scenes, to more closely approximate how adults with TBI label facial emotions beyond the lab. Methods Participants were 55 adults (29 female) with moderate to severe TBI and 55 uninjured comparison peers, individually matched for race, sex, and age. Participants viewed 60 photographs of faces, either alone or in the pictured person's real-life context, and were asked what that person was feeling. We calculated the percent of responses that were standard forced-choice-task options, and also used sentiment intensity analysis to compare verbal responses between the two groups. We tracked eye movements for a subset of participants, to explore whether gaze duration or number of fixations helped explain any group differences in labels. Results Over 50% of responses in both groups were words other than basic emotions on standard affect tasks, highlighting the importance of eliciting open-ended responses. Valence of labels by participants with TBI was attenuated relative to valence of Comparison group labels, i.e., TBI group responses were less positive to positive images and the same was true for negative images, although the TBI group responses had higher lexical diversity. There were no significant differences in gaze duration or number of fixations between groups. Discussion Results revealed qualitative differences in affect labels between adults with and without TBI that would not have emerged on standard forced-choice tasks. Verbal differences did not appear to be attributable to differences in gaze patterns, leaving open the question of mechanisms of atypical affect processing in adults with TBI.
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Affiliation(s)
- Lyn S. Turkstra
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | | | - Sophie Wohltjen
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Sara V. Nurre
- American Speech-Language-Hearing Association, Rockville, MD, United States
| | - Bilge Mutlu
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Melissa C. Duff
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, United States
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Clough S, Morrow E, Mutlu B, Turkstra L, Duff MC. Emotion recognition of faces and emoji in individuals with moderate-severe traumatic brain injury. Brain Inj 2023; 37:596-610. [PMID: 36847497 PMCID: PMC10175112 DOI: 10.1080/02699052.2023.2181401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 01/11/2023] [Accepted: 02/13/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Facial emotion recognition deficits are common after moderate-severe traumatic brain injury (TBI) and linked to poor social outcomes. We examine whether emotion recognition deficits extend to facial expressions depicted by emoji. METHODS Fifty-one individuals with moderate-severe TBI (25 female) and fifty-one neurotypical peers (26 female) viewed photos of human faces and emoji. Participants selected the best-fitting label from a set of basic emotions (anger, disgust, fear, sadness, neutral, surprise, happy) or social emotions (embarrassed, remorseful, anxious, neutral, flirting, confident, proud). RESULTS We analyzed the likelihood of correctly labeling an emotion by group (neurotypical, TBI), stimulus condition (basic faces, basic emoji, social emoji), sex (female, male), and their interactions. Participants with TBI did not significantly differ from neurotypical peers in overall emotion labeling accuracy. Both groups had poorer labeling accuracy for emoji compared to faces. Participants with TBI (but not neurotypical peers) had poorer accuracy for labeling social emotions depicted by emoji compared to basic emotions depicted by emoji. There were no effects of participant sex. DISCUSSION Because emotion representation is more ambiguous in emoji than human faces, studying emoji use and perception in TBI is an important consideration for understanding functional communication and social participation after brain injury.
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Affiliation(s)
- Sharice Clough
- Department of Hearing and Speech Sciences, Vanderbilt
University Medical Center
| | - Emily Morrow
- Department of Hearing and Speech Sciences, Vanderbilt
University Medical Center
| | - Bilge Mutlu
- Department of Computer Sciences, University of
Wisconsin-Madison
| | - Lyn Turkstra
- School of Rehabilitation Science, McMaster University
| | - Melissa C. Duff
- Department of Hearing and Speech Sciences, Vanderbilt
University Medical Center
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Yiew K, Togher L, Power E, Brunner M, Rietdijk R. Differentiating Use of Facial Expression between Individuals with and without Traumatic Brain Injury Using Affectiva Software: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1169. [PMID: 36673925 PMCID: PMC9858815 DOI: 10.3390/ijerph20021169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/18/2022] [Accepted: 12/24/2022] [Indexed: 06/17/2023]
Abstract
This study investigated the feasibility of using an automated facial coding engine, Affectiva (integrated in iMotions, version 8.2), for evaluating facial expression after traumatic brain injury (TBI). An observational cross-sectional study was conducted based on facial expression data from videos of participants with TBI and control participants. The aims were to compare TBI and control groups, and identify confounding factors affecting the data analysis. Video samples of two narrative tasks (personal event and story retell) from ten participants with severe TBI and ten control participants without TBI were analyzed using Affectiva. Automated data on participants' engagement, smile and brow furrow were compared statistically between and within groups. Qualitative notes for each sample were also recorded. Affectiva detected a higher percentage of time of engagement for TBI participants than for control participants on both tasks. There was also a higher percentage of time of smiling for TBI participants in one task. Within groups, there were no significant differences between the two narrative tasks. Affectiva provides standardized data about facial expression and may be sensitive to detecting change in the use of facial expression after TBI. This study also identified factors to avoid during videorecording to ensure high quality samples for future research.
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Affiliation(s)
- Kelly Yiew
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Leanne Togher
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Emma Power
- Graduate School of Health, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Melissa Brunner
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Rachael Rietdijk
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
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Zhao F, Lim H, Morrow EL, Turkstra LS, Duff MC, Mutlu B. Designing evidence-based support aids for social media access for individuals with moderate-severe traumatic brain injury: A preliminary acceptability study. Front Digit Health 2022; 4:991814. [PMID: 36606124 PMCID: PMC9808081 DOI: 10.3389/fdgth.2022.991814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/31/2022] [Indexed: 01/07/2023] Open
Abstract
Background Adults with traumatic brain injury (TBI) report significant barriers to using current social media platforms, including cognitive overload and challenges in interpreting social cues. Rehabilitation providers may be tasked with helping to address these barriers. Objectives To develop technological supports to increase social media accessibility for people with TBI-related cognitive impairments and to obtain preliminary data on the perceived acceptability, ease of use, and utility of proposed technology aids. Methods We identified four major barriers to social media use among individuals with TBI: sensory overload, memory impairments, misreading of social cues, and a lack of confidence to actively engage on social media platforms. We describe the process of developing prototypes of support aids aimed at reducing these specific social media barriers. We created mock-ups of these prototypes and asked 46 community-dwelling adults with TBI (24 females) to rate the proposed aids in terms of their acceptability, ease of use, and utility. Results Across all aids, nearly one-third of respondents agreed they would use the proposed aids frequently, and the majority of respondents rated the proposed aids as easy to use. Respondents indicated that they would be more likely to use the memory and post-writing aids than the attention and social cue interpretation aids. Conclusions Findings provide initial support for social-media-specific technology aids to support social media access and social participation for adults with TBI. Results from this study have design implications for future development of evidence-based social media support aids. Future work should develop and deploy such aids and investigate user experience.
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Affiliation(s)
- Fangyun Zhao
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, United States,Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | - Hajin Lim
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Emily L. Morrow
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Lyn S. Turkstra
- School of Rehabilitation Science, McMaster University, Hamilton, ON, United States
| | - Melissa C. Duff
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States,Correspondence: Melissa Duff
| | - Bilge Mutlu
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, United States
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Gier EC, Pulliam AN, Gaul DA, Moore SG, LaPlaca MC, Fernández FM. Lipidome Alterations following Mild Traumatic Brain Injury in the Rat. Metabolites 2022; 12:150. [PMID: 35208224 PMCID: PMC8878543 DOI: 10.3390/metabo12020150] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 12/10/2022] Open
Abstract
Traumatic brain injury (TBI) poses a major health challenge, with tens of millions of new cases reported globally every year. Brain damage resulting from TBI can vary significantly due to factors including injury severity, injury mechanism and exposure to repeated injury events. Therefore, there is need for robust blood biomarkers. Serum from Sprague Dawley rats was collected at several timepoints within 24 h of mild single or repeat closed head impacts. Serum samples were analyzed via ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS) in positive and negative ion modes. Known lipid species were identified through matching to in-house tandem MS databases. Lipid biomarkers have a unique potential to serve as objective molecular measures of injury response as they may be liberated to circulation more readily than larger protein markers. Machine learning and feature selection approaches were used to construct lipid panels capable of distinguishing serum from injured and uninjured rats. The best multivariate lipid panels had over 90% cross-validated sensitivity, selectivity, and accuracy. These mapped onto sphingolipid signaling, autophagy, necroptosis and glycerophospholipid metabolism pathways, with Benjamini adjusted p-values less than 0.05. The novel lipid biomarker candidates identified provide insight into the metabolic pathways altered within 24 h of mild TBI.
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Affiliation(s)
- Eric C. Gier
- School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, GA 30332, USA; (E.C.G.); (D.A.G.); (S.G.M.)
| | - Alexis N. Pulliam
- Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332, USA;
| | - David A. Gaul
- School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, GA 30332, USA; (E.C.G.); (D.A.G.); (S.G.M.)
- Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Samuel G. Moore
- School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, GA 30332, USA; (E.C.G.); (D.A.G.); (S.G.M.)
- Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Michelle C. LaPlaca
- Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332, USA;
- Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Facundo M. Fernández
- School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, GA 30332, USA; (E.C.G.); (D.A.G.); (S.G.M.)
- Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA 30332, USA
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Vassallo S, Douglas J. Visual scanpath training to emotional faces following severe traumatic brain injury: A single case design. J Eye Mov Res 2021; 14. [PMID: 34760060 PMCID: PMC8575428 DOI: 10.16910/jemr.14.4.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The visual scanpath to emotional facial expressions was recorded in BR, a 35-year-old male with chronic severe traumatic brain injury (TBI), both before and after he underwent intervention. The novel intervention paradigm combined visual scanpath training with verbal feedback and was implemented over a 3-month period using a single case design (AB) with one follow up session. At baseline BR's scanpath was restricted, characterised by gaze allocation primarily to salient facial features on the right side of the face stimulus. Following intervention his visual scanpath became more lateralised, although he continued to demonstrate an attentional bias to the right side of the face stimulus. This study is the first to demonstrate change in both the pattern and the position of the visual scanpath to emotional faces following intervention in a person with chronic severe TBI. In addition, these findings extend upon our previous work to suggest that modification of the visual scanpath through targeted facial feature training can support improved facial recognition performance in a person with severe TBI.
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Affiliation(s)
- Suzane Vassallo
- La Trobe University, Melbourne, Australia.,University of Technology, Sydney, Australia
| | - Jacinta Douglas
- La Trobe University, Melbourne, Australia.,Summer Foundation, Melbourne, Australia
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Khosdelazad S, Jorna LS, McDonald S, Rakers SE, Huitema RB, Buunk AM, Spikman JM. Comparing static and dynamic emotion recognition tests: Performance of healthy participants. PLoS One 2020; 15:e0241297. [PMID: 33112932 PMCID: PMC7592751 DOI: 10.1371/journal.pone.0241297] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/12/2020] [Indexed: 11/19/2022] Open
Abstract
Facial expressions have a communicatory function and the ability to read them is a prerequisite for understanding feelings and thoughts of other individuals. Impairments in recognition of facial emotional expressions are frequently found in patients with neurological conditions (e.g. stroke, traumatic brain injury, frontotemporal dementia). Hence, a standard neuropsychological assessment should include measurement of emotion recognition. However, there is debate regarding which tests are most suitable. The current study evaluates and compares three different emotion recognition tests. 84 healthy participants were included and assessed with three tests, in varying order: a. Ekman 60 Faces Test (FEEST) b. Emotion Recognition Task (ERT) c. Emotion Evaluation Test (EET). The tests differ in type of stimuli from static photographs (FEEST) to more dynamic stimuli in the form of morphed photographs (ERT) to videos (EET). Comparing performances on the three tests, the lowest total scores (67.3% correct answers) were found for the ERT. Significant, but moderate correlations were found between the total scores of the three tests, but nearly all correlations between the same emotions across different tests were not significant. Furthermore, we found cross-over effects of the FEEST and EET to the ERT; participants attained higher total scores on the ERT when another emotion recognition test had been administered beforehand. Moreover, the ERT proved to be sensitive to the effects of age and education. The present findings indicate that despite some overlap, each emotion recognition test measures a unique part of the construct. The ERT seemed to be the most difficult test: performances were lowest and influenced by differences in age and education and it was the only test that showed a learning effect after practice with other tests. This highlights the importance of appropriate norms.
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Affiliation(s)
- Sara Khosdelazad
- Department of Neuropsychology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
- * E-mail:
| | - Lieke S. Jorna
- Department of Neuropsychology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Skye McDonald
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Sandra E. Rakers
- Department of Neuropsychology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Rients B. Huitema
- Department of Neuropsychology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Anne M. Buunk
- Department of Neuropsychology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Jacoba M. Spikman
- Department of Neuropsychology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
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Byom L, O'Neil-Pirozzi TM, Lemoncello R, MacDonald S, Meulenbroek P, Ness B, Sohlberg MM. Social Communication Following Adult Traumatic Brain Injury: A Scoping Review of Theoretical Models. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1735-1748. [PMID: 32569483 DOI: 10.1044/2020_ajslp-19-00020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose Social communication is the set of abilities that allows individuals to achieve relevant social goals across contexts. Speech-language pathology evaluation and treatment of traumatic brain injury (TBI)-related social communication problems should be informed by evidence-supported theories of social communication. The primary purpose of this article is to summarize the results of a scoping review of theoretical models that speech-language pathologists may apply to the evaluation and treatment of social communication problems of adults with TBI. Method A scoping review was conducted of PubMed, PsycINFO, and Embase for sources published in English between 1989 and 2020 that described human social communication and participation. Resulting sources were systematically examined for social communication models. Results Nine theoretical models were identified that speech-language pathologists may apply to their assessment and treatment of social communication abilities of adults with TBI. Identified models were categorized thematically into one of three classes: cognitive models, social competence models, and pragmatic models. Using a framework developed for the purposes of this article, each identified model was evaluated, and one exemplar model in each class is described in depth. Conclusions Social communication problems in adults post-TBI are common. The existence of multiple models empowers speech-language pathologists to select individual-focused assessment and treatment approaches to maximize intervention outcomes.
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Affiliation(s)
- Lindsey Byom
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina, Chapel Hill
| | - Therese M O'Neil-Pirozzi
- Communication Sciences and Disorders, Northeastern University and Spaulding-Harvard Traumatic Brain Injury Model System, Boston, MA
| | - Rik Lemoncello
- School of Communication Sciences and Disorders, Pacific University, Forest Grove, OR
| | - Sheila MacDonald
- Sheila MacDonald & Associates, University of Toronto, Ontario, Canada
| | - Peter Meulenbroek
- Communication Sciences and Disorders, University of Kentucky, Lexington
| | - Bryan Ness
- Communication Sciences and Disorders, California Baptist University, Riverside
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Neumann D, Zupan B. Sex Differences in Emotional Insight After Traumatic Brain Injury. Arch Phys Med Rehabil 2020; 101:1922-1928. [PMID: 32445846 DOI: 10.1016/j.apmr.2020.04.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare sex differences in alexithymia (poor emotional processing) in males and females with traumatic brain injury (TBI) and uninjured controls. DESIGN Cross-sectional study. SETTING TBI rehabilitation facility in the United States and a university in Canada. PARTICIPANTS Sixty adults with moderate to severe TBI (62% men) and 60 uninjured controls (63% men) (N=120). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Toronto Alexithymia Scale-20 (TAS-20). RESULTS Uninjured men had significantly higher (worse) alexithymia scores than uninjured female participants on the TAS-20 (P=.007), whereas, no sex differences were found in the TBI group (P=.698). Men and women with TBI had significantly higher alexithymia compared with uninjured same-sex controls (both P<.001). The prevalence of participants with scores exceeding alexithymia sex-based norms for men and women with TBI was 37.8% and 47.8%, respectively, compared with 7.9% and 0% for men and women without TBI. CONCLUSIONS Contrary to most findings in the general population, men with TBI were not more alexithymic than their female counterparts with TBI. Both men and women with TBI have more severe alexithymia than their uninjured same-sex peers. Moreover, both are equally at risk for elevated alexithymia compared with the norms. Alexithymia should be evaluated and treated after TBI regardless of patient sex.
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Affiliation(s)
- Dawn Neumann
- Department of Physical Medicine and Rehabilitation, Carolinas Rehabilitation, Charlotte, NC, Canada.
| | - Barbra Zupan
- Department of Applied Linguistics, Brock University, St. Catharines, ON, Canada
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Godfrey DA, Babcock JC. Facial affect recognition moderates the relation between autonomic nervous system reactivity and aggression during dyadic conflict. Psychophysiology 2020; 57:e13588. [PMID: 32323355 DOI: 10.1111/psyp.13588] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 02/23/2020] [Accepted: 03/31/2020] [Indexed: 11/27/2022]
Abstract
Researchers examining physiological factors of emotion have identified differential patterns of physiological reactivity among intimate partner violence perpetrators during interpersonal conflict. Although it is unclear what mechanisms are influencing these distinct physiological patterns, research suggests that perpetrators' ability to decode emotions may be involved. The current study examined how the relation between an individual's physiological reactivity and their aggression during conflict with an intimate partner is influenced by the affect they are exposed to and their affect recognition ability. Sixty-seven heterosexual couples completed self-report measures and participated in a conflict discussion while physiological measures were recorded. The sympathetic nervous system (SNS) was indexed by Skin Conductance Level (SCL) and the parasympathetic nervous system (PNS) by Respiratory Sinus Arrhythmia (RSA). Aggressive affect was coded from video. Additionally, men were administered a facial affect recognition task. Results indicated that observed aggression during the conflict discussion was associated with RSA and SCL suppression, but only for men with moderate to high affect recognition ability. Additionally, the interaction effects between physiological reactivity and affect recognition on male aggression was conditional on their partner exhibiting at least moderate levels of aggressive affect. Findings from our study suggest that the relation between autonomic nervous system reactivity during conflict and aggression toward an intimate partner is conditional on men's ability to decode the facial affect of their partner. For individuals who were able to decode aggressive affect from their partner, aggression was associated with decreased parasympathetic and SNS activation.
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Affiliation(s)
- Donald A Godfrey
- Department of Clinical Psychology, University of Houston, Houston, TX, USA
| | - Julia C Babcock
- Department of Clinical Psychology, University of Houston, Houston, TX, USA
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13
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Venkatesan UM, Lancaster K, Lengenfelder J, Genova HM. Independent contributions of social cognition and depression to functional status after moderate or severe traumatic brain injury. Neuropsychol Rehabil 2020; 31:954-970. [PMID: 32314644 DOI: 10.1080/09602011.2020.1749675] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Impairments in cognitive processing related to social understanding and communication (i.e., "social cognition") are well documented after moderate or severe traumatic brain injury (TBI) and can contribute to negative functional outcome. Depression is also a common feature of TBI with detrimental functional consequences. We evaluated relationships between social cognition, depression symptom severity, and functional status in individuals with chronic TBI (>1 year post injury; n = 25) and healthy controls (n = 30) using objective tests of social cognition as well as self-reported depression (Beck Depression Inventory-II) and functional status (Functional Behavior Profile). Results revealed significant relationships between depression and functional status across the sample, and relationships between social cognition and functional status specific to TBI. In the TBI group only, social cognition significantly predicted both overall and social functional status above and beyond depression. Group differences in functional status were independently mediated by social cognition and, especially, depression. Our findings suggest that social cognitive impairments and depression are distinct, functionally relevant TBI sequelae. Interventions to improve social functioning in this population may be most effective when contextualized within treatments for emotional disturbances.
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Affiliation(s)
| | - Katie Lancaster
- Kessler Foundation Research Center, West Orange, NJ, USA.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Jean Lengenfelder
- Kessler Foundation Research Center, West Orange, NJ, USA.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Helen M Genova
- Kessler Foundation Research Center, West Orange, NJ, USA.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
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14
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Vassallo S, Douglas J. A novel combined visual scanning and verbal cuing intervention improves facial affect recognition after chronic severe traumatic brain injury: A single case design. Neuropsychol Rehabil 2020; 31:863-888. [PMID: 32188336 DOI: 10.1080/09602011.2020.1742744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A single case design (AB with follow up) was used to determine the effect of a combined visual scanning and verbal cuing intervention technique in improving facial affect recognition after traumatic brain injury (TBI). A 35-year-old male (BR) with impaired ability to recognize facial emotions as a result of severe TBI participated in the study over a 3-month duration. BR's mean accuracy across six universal static facial expressions of emotion improved significantly during intervention and was maintained at follow up. BR was most impaired in labelling negative (sad, angry, disgusted, anxious) versus positive facial expressions (surprised, happy). BR's accuracy to negative facial affect significantly improved during intervention. No further improvement was possible for positive expressions because a ceiling effect was observed at baseline. Overall BR's mean response times across emotions was reduced at baseline but increased significantly during intervention. This was also recorded for both positive and negative expressions, respectively. This novel combined intervention has potential to improve facial affect recognition after TBI. Further evaluation using a multiple-baseline design is recommended. Additional research is needed to determine whether improved facial affect recognition following training translates to improvements in social function and communication in people with TBI.
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Affiliation(s)
- Suzane Vassallo
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia.,Discipline of Orthoptics, School of Allied Health, Human Services & Sport, La Trobe University, Melbourne, Australia
| | - Jacinta Douglas
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia.,Summer Foundation, Melbourne, Australia.,Moving Ahead Centre of Research Excellence in Brain Recovery, Australia
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15
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Turkstra LS, Mutlu B, Ryan CW, Despins Stafslien EH, Richmond EK, Hosokawa E, Duff MC. Sex and Gender Differences in Emotion Recognition and Theory of Mind After TBI: A Narrative Review and Directions for Future Research. Front Neurol 2020; 11:59. [PMID: 32117021 PMCID: PMC7010954 DOI: 10.3389/fneur.2020.00059] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 01/15/2020] [Indexed: 11/13/2022] Open
Abstract
A growing body of literature has examined sex differences in a variety of outcomes from moderate-severe traumatic brain injury (TBI), including outcomes for social functioning. Social functioning is an area in which adults with TBI have significant long-term challenges (1-4), and a better understanding of sex and gender differences in this domain may have a significant clinical impact. This paper presents a brief narrative review of current evidence regarding sex differences in one aspect of social functioning in adults with TBI: social cognition, specifically affect recognition and Theory of Mind (ToM). Data from typical adults and adults with TBI are considered in the broader context of common stereotypes about social skills and behaviors in men vs. women. We then discuss considerations for future research on sex- and gender-based differences in social cognition in TBI, and in adults more generally.
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Affiliation(s)
- Lyn S Turkstra
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Bilge Mutlu
- Department of Computer Science, University of Wisconsin-Madison, Madison, WI, United States
| | - Caitlin W Ryan
- ThedaCare Regional Medical Center, Neenah, WI, United States
| | | | - Erica K Richmond
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, United States
| | - Emily Hosokawa
- Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Melissa C Duff
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, United States
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16
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Abstract
Facial affect recognition deficits following traumatic brain injury (TBI) have been well documented, as has their relationship with impairment in several other cognitive domains. However, little is known about the neurobiological mechanisms underlying affect recognition deficits, in particular mechanisms underlying different aspects of facial affect recognition (e.g., perceptual and interpretive processes). In the current study, 33 adults with moderate-to-severe TBI and 24 demographically matched healthy comparison (HC) participants completed an fMRI facial affect recognition study. While in the scanner, participants were asked to match the affect of a target face to either (a) one of two faces differing in affect (perceptual condition) or (b) one of two written affect labels (interpretative condition). In both groups we found activations in regions typically involved in affect recognition. Our results revealed that in the perceptual condition individuals with TBI tended to activate the left dorsolateral prefrontal cortex less than HCs, and within the HC group individuals with higher perceptual affect recognition scores showed higher levels of activation in the same brain region. Individuals with TBI who were specifically impaired at interpretative affect recognition showed less activation than HCs in the right fusiform gyrus. Moreover, in the labeling condition individuals with TBI tended to de-activate medial prefrontal regions less than HCs. A region of interest analysis revealed that individuals with TBI showed significantly less activation than HCs in the FFA for all the contrasts of interest. Our results suggest involvement of several brain regions in facial affect recognition impairment post TBI, and provide neurobiological support for the notion that distinct aspects of facial affect recognition can be differentially impaired following TBI.
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17
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Lancelot C, Gilles C. How does visual context influence recognition of facial emotion in people with traumatic brain injury? Brain Inj 2018; 33:4-11. [DOI: 10.1080/02699052.2018.1531308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Céline Lancelot
- Faculty of Literature, Languages & Human Sciences, LUNAM, Psychology Laboratory of the Pays de la Loire (EA 4638), University of Angers, Angers Cedex 1, France
| | - Cindy Gilles
- Faculty of Literature, Languages & Human Sciences, LUNAM, Psychology Laboratory of the Pays de la Loire (EA 4638), University of Angers, Angers Cedex 1, France
- UEROS Fontenailles, Château de Fontenailles, Louestault, France
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18
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Rigon A, Voss MW, Turkstra LS, Mutlu B, Duff MC. White matter correlates of different aspects of facial affect recognition impairment following traumatic brain injury. Soc Neurosci 2018; 14:434-448. [PMID: 29902960 DOI: 10.1080/17470919.2018.1489302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Although facial affect recognition deficits are well documented in individuals with moderate-to-severe traumatic brain injury (TBI), little research has examined the neural mechanisms underlying these impairments. Here, we use diffusion tensor imaging (DTI), specifically the scalars fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD), to examine relationships between regional white-matter integrity and two facial affect sub-skills: perceptual affect recognition abilities (measured by an affect matching task) and verbal categorization of facial affect (measured by an affect labeling task). Our results showed that, within the TBI group, higher levels of white-matter integrity in tracts involved in affect recognition (inferior fronto-occipital, inferior longitudinal, and uncinate fasciculi) were associated with better performance on both tasks. Verbal categorization skills were specifically and positively correlated with integrity of the left uncinate fasciculus. Moreover, we observed a striking lateralization effect, with perceptual abilities having an almost exclusive relationship with integrity of right hemisphere tracts, while verbal abilities were associated with both left and right hemisphere integrity. The findings advance our understanding of the neurobiological mechanisms that underlie subcomponents of facial affect recognition and lead to different patterns of facial affect recognition impairment in adults with TBI.
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Affiliation(s)
- Arianna Rigon
- a Interdisciplinary Neuroscience Program , The University of Iowa , Iowa City , IA , USA
| | - Michelle W Voss
- b Department of Psychological and Brain Sciences , The University of Iowa , Iowa City , IA , USA
| | - Lyn S Turkstra
- c School of Rehabilitation Sciences , McMaster University , Hamilton , ON , Canada
| | - Bilge Mutlu
- d Department of Computer Sciences , The University of Wisconsin - Madison , Madison , WI , USA
| | - Melissa C Duff
- e Department of Hearing and Speech Sciences , Vanderbilt University Medical Center , Nashville , TN , USA
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19
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Rigon A, Voss MW, Turkstra LS, Mutlu B, Duff MC. Different aspects of facial affect recognition impairment following traumatic brain injury: The role of perceptual and interpretative abilities. J Clin Exp Neuropsychol 2018; 40:805-819. [PMID: 29562838 DOI: 10.1080/13803395.2018.1437120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
It is well established that many individuals with traumatic brain injury (TBI) are impaired at facial affect recognition, yet little is known about the mechanisms underlying such deficits. In particular, little work has examined whether the breakdown of facial affect recognition abilities occurs at the perceptual level (e.g., recognizing a smile) or at the verbal categorization stage (e.g., assigning the label "happy" to a smiling face). The aim of the current study was to investigate the integrity of these two distinct facial affect recognition subskills in a sample of 38 individuals with moderate-to-severe TBI and 24 demographically matched healthy individuals. Participants were administered an affect matching (perceptual skills) and an affect labeling (verbal categorization skills) task. Statistical analyses revealed that, while individuals with TBI showed significantly higher levels of impairment in the verbal categorization task than in the perceptual task, they performed less well than healthy comparison participants on both tasks. These findings indicate that facial affect recognition impairment can occur at different cognitive stages following TBI, suggesting the necessity of careful screening to offer targeted treatment. Moreover, they provide further neuropsychological evidence supporting the notion that distinct types of subskills are necessary to achieve successful recognition of facial affects.
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Affiliation(s)
- Arianna Rigon
- a Interdisciplinary Neuroscience Program, The University of Iowa , Iowa City , IA , USA
| | - Michelle W Voss
- b Department of Psychological and Brain Sciences , The University of Iowa , Iowa City , IA , USA
| | - Lyn S Turkstra
- c School of Rehabilitation Sciences, McMaster University , Hamilton , ON , Canada
| | - Bilge Mutlu
- d Department of Computer Sciences , The University of Wisconsin-Madison , Madison , WI , USA
| | - Melissa C Duff
- e Department of Hearing and Speech Sciences , Vanderbilt University Medical Center , Nashville , TN , USA
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