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Coenen MA, Spikman JM, Smit M, Klooster J, Tijssen MAJ, Gerritsen MJJ. Moving on with (social) cognition in idiopathic cervical dystonia. J Int Neuropsychol Soc 2024; 30:464-470. [PMID: 38223955 DOI: 10.1017/s1355617723011426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
OBJECTIVE Cervical dystonia (CD) is a movement disorder characterized by involuntary muscle contractions causing sustained twisting movements and abnormal postures of the neck and head. Assumed affected neuronal regions are the cortico-striatal-thalamo-cortical circuits, which are also involved in cognitive functioning. Indeed, impairments in different cognitive domains have been found in CD patients. However, to date studies have only investigated a limited range of cognitive functions within the same sample. In particular, social cognition (SC) is often missing from study designs. Hence, we aimed to evaluate a broad range of cognitive functions including SC in CD patients. METHOD In the present study 20 idiopathic CD patients and 40 age-, gender-, and IQ-matched healthy controls (HCs) were assessed with tests for non-SC (verbal memory, psychomotor speed, and executive functions) as well as for SC (emotion recognition, Theory of Mind (ToM), and empathy). RESULTS CD patients scored on average significantly lower than HC on tests for non-SC, but did not show impairments on any of the tests for SC. CONCLUSIONS The current study showed impairments in non-SC in CD, but intact social cognitive functions. These results underline the importance of recognizing non-motor symptoms in idiopathic CD patients, but emphasize a focus on identifying strengths and weaknesses in cognitive functioning as these influence daily life activities.
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Affiliation(s)
- Maraike A Coenen
- Department of Neurology, University of Groningen, University Medical Center, Groningen, The Netherlands
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Jacoba M Spikman
- Department of Neurology, University of Groningen, University Medical Center, Groningen, The Netherlands
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Marenka Smit
- Department of Neurology, University of Groningen, University Medical Center, Groningen, The Netherlands
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Jesper Klooster
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
- Tactus Verslavingszorg, Zwolle, The Netherlands
| | - Marina A J Tijssen
- Department of Neurology, University of Groningen, University Medical Center, Groningen, The Netherlands
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Marleen J J Gerritsen
- Department of Neurology, University of Groningen, University Medical Center, Groningen, The Netherlands
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
- Department of Medical Psychology, Deventer Ziekenhuis, Deventer, The Netherlands
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Colucci F, Pugliatti M, Casetta I, Capone JG, Diozzi E, Sensi M, Tugnoli V. Idiopathic cervical dystonia and non-motor symptoms: a pilot case-control study on autonomic nervous system. Neurol Sci 2024; 45:629-638. [PMID: 37648939 PMCID: PMC10791952 DOI: 10.1007/s10072-023-07033-y] [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: 03/15/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE Non-motor symptoms, such as sleep disturbances, fatigue, neuropsychiatric manifestations, cognitive impairment, and sensory abnormalities, have been widely reported in patients with idiopathic cervical dystonia (ICD). This study aimed to clarify the autonomic nervous system (ANS) involvement in ICD patients, which is still unclear in the literature. METHODS We conducted a pilot case-control study to investigate ANS in twenty ICD patients and twenty age-sex-matched controls. The Composite Autonomic System Scale 31 was used for ANS clinical assessment. The laser Doppler flowmetry quantitative spectral analysis, applied to the skin and recorded from indices, was used to measure at rest, after a parasympathetic activation (six deep breathing) and two sympathetic stimuli (isometric handgrip and mental calculation), the power of high-frequency and low-frequency oscillations, and the low-frequency/high-frequency ratio. RESULTS ICD patients manifested higher clinical dysautonomic symptoms than controls (p < 0.05). At rest, a lower high-frequency power band was detected among ICD patients than controls, reaching a statistically significant difference in the age group of ≥ 57-year-olds (p < 0.05). In the latter age group, ICD patients showed a lower low-frequency/high-frequency ratio than controls at rest (p < 0.05) and after mental calculation (p < 0.05). Regardless of age, during handgrip, ICD patients showed (i) lower low-frequency/high-frequency ratio (p < 0.05), (ii) similar increase of the low-frequency oscillatory component compared to controls, and (iii) stable high-frequency oscillatory component, which conversely decreased in controls. No differences between the two groups were detected during deep breathing. CONCLUSION ICD patients showed ANS dysfunction at clinical and neurophysiological levels, reflecting an abnormal parasympathetic-sympathetic interaction likely related to abnormal neck posture and neurotransmitter alterations.
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Affiliation(s)
- Fabiana Colucci
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via Aldo Moro, 8, 44100, Ferrara, Italy.
- Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
| | - Maura Pugliatti
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via Aldo Moro, 8, 44100, Ferrara, Italy
| | - Ilaria Casetta
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via Aldo Moro, 8, 44100, Ferrara, Italy
| | - Jay Guido Capone
- Department of Neuroscience and Rehabilitation, Azienda Ospedaliero-Universitaria S, Anna, Ferrara, Italy
| | - Enrica Diozzi
- Department of Neuroscience and Rehabilitation, Azienda Ospedaliero-Universitaria S, Anna, Ferrara, Italy
| | - Mariachiara Sensi
- Department of Neuroscience and Rehabilitation, Azienda Ospedaliero-Universitaria S, Anna, Ferrara, Italy
| | - Valeria Tugnoli
- Department of Neuroscience and Rehabilitation, Azienda Ospedaliero-Universitaria S, Anna, Ferrara, Italy
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Rizzo G, Martino D, Avanzino L, Avenanti A, Vicario CM. Social cognition in hyperkinetic movement disorders: a systematic review. Soc Neurosci 2023; 18:331-354. [PMID: 37580305 DOI: 10.1080/17470919.2023.2248687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 07/10/2023] [Accepted: 08/09/2023] [Indexed: 08/16/2023]
Abstract
Numerous lines of research indicate that our social brain involves a network of cortical and subcortical brain regions that are responsible for sensing and controlling body movements. However, it remains unclear whether movement disorders have a systematic impact on social cognition. To address this question, we conducted a systematic review examining the influence of hyperkinetic movement disorders (including Huntington disease, Tourette syndrome, dystonia, and essential tremor) on social cognition. Following the PRISMA guidelines and registering the protocol in the PROSPERO database (CRD42022327459), we analyzed 50 published studies focusing on theory of mind (ToM), social perception, and empathy. The results from these studies provide evidence of impairments in ToM and social perception in all hyperkinetic movement disorders, particularly during the recognition of negative emotions. Additionally, individuals with Huntington's Disease and Tourette syndrome exhibit empathy disorders. These findings support the functional role of subcortical structures (such as the basal ganglia and cerebellum), which are primarily responsible for movement disorders, in deficits related to social cognition.
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Affiliation(s)
- Gaetano Rizzo
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e degli studi culturali, Università di Messina, Messina, Italy
| | - Davide Martino
- Department of Clinical Neurosciences, Hotchkiss Brain Institute, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Laura Avanzino
- Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy
| | - Alessio Avenanti
- Centro studi e ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia "Renzo Canestrari", Campus di Cesena, Alma Mater Studiorum Università di Bologna, Cesena, Italy
- Centro de Investigación en Neuropsicología y Neurociencias Cognitivas, Universidad Católica del Maule, Talca, Chile
| | - Carmelo Mario Vicario
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e degli studi culturali, Università di Messina, Messina, Italy
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Xu J, Luo Y, Liu Y, Zhong L, Liu H, Zhang X, Cheng Q, Yang Z, Zhang Y, Weng A, Ou Z, Yan Z, Zhang W, Hu Q, Peng K, Liu G. Neural Correlates of Facial Emotion Recognition Impairment in Blepharospasm: A Functional Magnetic Resonance Imaging Study. Neuroscience 2023; 531:50-59. [PMID: 37709002 DOI: 10.1016/j.neuroscience.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/16/2023]
Abstract
Selective impairment in recognizing facial expressions of disgust was reported in patients with focal dystonia several years ago, but the basic neural mechanisms remain largely unexplored. Therefore, we investigated whether dysfunction of the brain network involved in disgust recognition processing was related to this selective impairment in blepharospasm. Facial emotion recognition evaluations and resting-state functional magnetic resonance imaging were performed in 33 blepharospasm patients and 33 healthy controls (HCs). The disgust processing network was constructed, and modularity analyses were performed to identify sub-networks. Regional functional indexes and intra- and inter-functional connections were calculated and compared between the groups. Compared to HCs, blepharospasm patients demonstrated a worse performance in disgust recognition. In addition, functional connections within the sub-network involved in perception processing rather than recognition processing of disgust were significantly decreased in blepharospasm patients compared to HCs. Specifically, decreased functional connections were noted between the left fusiform gyrus (FG) and right middle occipital gyrus (MOG), the left FG and right FG, and the right FG and left MOG. We identified decreased functional activity in these regions, as indicated by a lower amplitude of low-frequency fluctuation in the left MOG, fractional amplitude of low-frequency fluctuation in the right FG, and regional homogeneity in the right FG and left MOG in blepharospasm patients versus HCs. Our results suggest that dysfunctions of the disgust processing network exist in blepharospasm. A deficit in disgust emotion recognition may be attributed to disturbances in the early perception of visual disgust stimuli in blepharospasm patients.
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Affiliation(s)
- Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Yuhan Luo
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou 510080, China
| | - Ying Liu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou 510080, China
| | - Linchang Zhong
- Department of Medical Imaging, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Huiming Liu
- Department of Medical Imaging, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Xiaodong Zhang
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Qinxiu Cheng
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Zhengkun Yang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou 510080, China
| | - Yue Zhang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou 510080, China
| | - Ai Weng
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou 510080, China
| | - Zilin Ou
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou 510080, China
| | - Zhicong Yan
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou 510080, China
| | - Weixi Zhang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou 510080, China
| | - Qingmao Hu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China.
| | - Kangqiang Peng
- Department of Medical Imaging, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
| | - Gang Liu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou 510080, China.
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Mahady L, White J, Rafee S, Yap SM, O'Riordan S, Hutchinson M, Gough P, O'Keeffe F. Social cognition in cervical dystonia. Clin Park Relat Disord 2023; 9:100217. [PMID: 37711968 PMCID: PMC10497798 DOI: 10.1016/j.prdoa.2023.100217] [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: 07/06/2023] [Revised: 08/19/2023] [Accepted: 09/04/2023] [Indexed: 09/16/2023] Open
Abstract
Background Whilst traditionally considered a movement disorder, it is now generally accepted that cervical dystonia (CD) presents with additional non-motor symptoms which significantly impact quality of life. Our study primarily aimed to explore social cognition and levels of psychological distress in individuals with CD, in comparison to age- and sex-matched healthy controls. Methods 20 participants with CD attending a specialist movement disorders clinic were recruited. 20 age and sex matched neurologically healthy controls were recruited in parallel. Participants completed the Hospital Anxiety and Depression Scale, and two novel social cognition tasks: The Cambridge Mindreading Face-Voice Battery (CAFMB) and the Edinburgh Social Cognition Test (ESCoT). Results Participants with CD exhibited poorer complex emotion recognition abilities for visual and auditory stimuli, compared to controls on the CAFMB task. Participants with CD did not differ significantly from controls on performance on cognitive or affective Theory of Mind tasks, or interpersonal or intrapersonal understanding of social norms, as measured by the ESCoT. The proportion of depressive symptoms was significantly higher for participants with CD than controls. 40% of participants with CD reported clinically elevated depressive symptoms, and 60% reported clinically elevated anxiety. Poorer understanding of emotional facial expressions was associated with higher levels of depression in the CD group. Conclusions Significant between-group differences between participants with CD and controls suggests socio-cognitive dysfunction is an important aspect of the non-motor syndrome of CD. Findings highlight the need for assessment of and intervention for both social cognitive difficulties and psychological distress in individuals with CD.
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Affiliation(s)
- Laura Mahady
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - Jessica White
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - Shameer Rafee
- Department of Neurology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Siew-Mei Yap
- Department of Neurology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Sean O'Riordan
- Department of Neurology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Michael Hutchinson
- Department of Neurology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
- School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Patricia Gough
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - Fiadhnait O'Keeffe
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
- Department of Neurology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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Feuerstein J, Heffernan B, Holden SK, Sillau S, Berman BD. Social Cognition Deficits in Cervical Dystonia, but not Blepharospasm: Focal Dystonias Diverge. Mov Disord Clin Pract 2023; 10:1231-1232. [PMID: 37635782 PMCID: PMC10450232 DOI: 10.1002/mdc3.13808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/15/2023] [Accepted: 05/24/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Jeanne Feuerstein
- Department of NeurologyUniversity of Colorado School of MedicineAuroraColoradoUSA
- Department of NeurologyRocky Mountain Regional VA Medical CenterAuroraColoradoUSA
| | - Brooke Heffernan
- Department of NeurologyUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Samantha K. Holden
- Department of NeurologyUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Stefan Sillau
- Department of NeurologyUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Brian D. Berman
- Department of NeurologyVirginia Commonwealth UniversityRichmondVirginiaUSA
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7
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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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Monaghan R, Cogley C, Burke T, McCormack D, O'Riordan S, Ndukwe I, Hutchinson M, Pender N, O'Keeffe F. Non-motor features of cervical dystonia: Cognition, social cognition, psychological distress and quality of life. Clin Park Relat Disord 2020; 4:100084. [PMID: 34316662 PMCID: PMC8299967 DOI: 10.1016/j.prdoa.2020.100084] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/29/2020] [Accepted: 11/26/2020] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Non-motor features of cervical dystonia (CD) have been identified, including depression, anxiety, and neuropsychological deficits. The aims were: to provide a clinical neuropsychological profile of CD patients with specific focus on social cognition; assess levels of psychological distress; and investigate the relationship between non-motor features of CD, including cognitive functioning, psychological distress, CD severity, pain, and health-related quality of life (HR-QoL). METHODS A multi-domain neuropsychological assessment battery was administered to 46 participants with CD, examining cognitive and social cognitive domains. Clinical data on dystonia severity, pain, psychological distress and HR-QoL were collected. RESULTS The majority of participants with CD performed within the average range across most tests of cognition. Scores were significantly lower than standardized norms in social cognition, processing speed, and aspects of memory. High levels of anxiety (Hospital Anxiety and Depression Scale [HADS-A] ≥ 11, 30%) and depression (HADS-D ≥ 11; 29%) were observed. Psychological distress, CD severity, pain and HR-QoL were not significantly associated with neuropsychological functioning after controlling for multiple comparisons. Low HR-QoL was associated with higher levels of pain and psychological distress, but not severity of motor symptoms. CONCLUSION Results indicate that psychological distress and deficits in cognitive and social cognitive functioning are likely distinct features of CD. While motor symptoms do not appear to impact HR-QoL, pain and psychological distress were associated with low HR-QoL. Findings highlight the importance of addressing non-motor symptoms in the treatment of CD.
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Affiliation(s)
| | - Clodagh Cogley
- St Vincent’s University Hospital, Dublin, Ireland
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Tom Burke
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Ireland
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Sean O'Riordan
- St Vincent’s University Hospital, Dublin, Ireland
- School of Medicine & Health Science, University College Dublin, Dublin, Ireland
| | - Ihedinachi Ndukwe
- St Vincent’s University Hospital, Dublin, Ireland
- School of Medicine & Health Science, University College Dublin, Dublin, Ireland
| | - Michael Hutchinson
- St Vincent’s University Hospital, Dublin, Ireland
- School of Medicine & Health Science, University College Dublin, Dublin, Ireland
| | - Niall Pender
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Ireland
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Fiadhnait O'Keeffe
- St Vincent’s University Hospital, Dublin, Ireland
- School of Psychology, University College Dublin, Dublin, Ireland
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9
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Ellement B, Jasaui Y, Kathol K, Nosratmirshekarlou E, Pringsheim T, Sarna J, Callahan BL, Martino D. Social cognition in cervical dystonia: phenotype and relationship to anxiety and depression. Eur J Neurol 2020; 28:98-107. [PMID: 32896024 DOI: 10.1111/ene.14508] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/31/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE Anxiety and depression are common disabling comorbidities in cervical dystonia (CD) and may predispose to social withdrawal and social cognitive impairments. The relationship between social cognition and depressive/anxiety symptoms in CD is under-investigated. METHODS Forty-six CD patients (40 women; mean age ± SD, 55.57 ± 10.84 years) were administered the following social cognition battery: Affect Naming, Prosody Face and Pair Matching subtests from the Wechsler Adult Intelligence Scale IV and Wechsler Memory Scale IV (social perception), reality-known and reality-unknown false belief reasoning tasks (theory of mind), Empathy Quotient and Social Norms Questionnaire 22 (social behaviour), alongside the Benton Facial Recognition Task (non-emotional facial discrimination). Alongside CD severity, the Hospital Anxiety and Depression Scale measured depressive/anxiety comorbid diagnostic status and severity, and the Liebowitz Social Anxiety Scale assessed social phobia. Social cognition tasks were standardized using published normative data and a cut-off of z < -1.5 for impairment. RESULTS More than 90% of our CD patients performed normally on social perception and social behaviour tests. Performance on impaired belief reasoning (theory of mind) was impaired in 10 of 46 (21.74%); five of 46 (10.87%) were impaired on the Empathy Quotient. Better performance on the Affect Naming task was associated with comorbid anxiety (η2 = 0.09, medium-to-large effect size) and greater anxiety, depression and social phobia severity. Worse performance on the Empathy Quotient was associated with comorbid depression (η2 = 0.11, medium-to-large effect size) and greater depression severity. CD patients had significantly more difficulties with fearful face identification (P < 0.001). CONCLUSIONS Greater social perception abilities in CD patients with more severe anxiety and depression suggest efficient modulation and self-adaptation of social cognitive skills.
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Affiliation(s)
- B Ellement
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Y Jasaui
- Continuing Medical Education, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - K Kathol
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - E Nosratmirshekarlou
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, AB, Canada.,Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada
| | - T Pringsheim
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, AB, Canada.,Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - J Sarna
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - B L Callahan
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - D Martino
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
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10
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Bajenaru OL, Popescu-Olaru I, Dumitrescu L, Serban E, Cozma L, Raicu F, Cocos R, Popescu OB. Non-Motor Manifestations in Idiopathic Dystonia with Focal Onset - A Pilot Study. J Med Life 2020; 13:170-174. [PMID: 32742509 PMCID: PMC7378344 DOI: 10.25122/jml-2020-0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Recent studies emphasize an increased prevalence of non-motor symptoms in idiopathic dystonia with focal onset (IDFO), but their pathophysiological relationship is not clear. We aimed to identify the prevalence of depression and neurocognitive impairment in a group of patients with idiopathic dystonia with focal onset and their impact on the patients' quality of life. This study represents a component of an ongoing research project - GENDYS. From the database of this project, we selected 48 patients 56.62+/-14.16 years old who have been examined clinically and using specific scales: Patient Health Questionnaire-9 (for depression), Montreal Cognitive Assessment - MoCA (for cognitive impairment), and a 5-degree analog scale for subjective perception of the severity of the disease. We conducted a descriptive cross-sectional study on patients with depression and cognition evaluated by the above-mentioned scales. We also performed a nested case-control analysis on 20 IDFO patients with and without at least moderate depression matched for age and gender; the cut-offs for depression were PHQ-9 score ≥10 and PHQ9 <5, for the depression group and the control group, respectively. The cut-off for MoCA was 26 points. 22 IDFO patients (46%) had depression; 54.5% of IDFO patients with depression had cognitive impairment, indicating a slight trend of increased cognitive impairment in those with depression compared to those without; the perception of the severity of disease was the greatest in patients with depression. Depression is more prevalent in patients with IDFO and is associated with a worse perception of the disease severity.
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Affiliation(s)
- Ovidiu-Lucian Bajenaru
- Department of Clinical Neurosciences, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,"Ana Aslan" National Institute of Geriatrics and Gerontology, Bucharest, Romania
| | - Iulia Popescu-Olaru
- Department of Clinical Neurosciences, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Department of Neurology, clinical Hospital Colentina, Bucharest, Romania
| | - Laura Dumitrescu
- Department of Clinical Neurosciences, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Department of Neurology, clinical Hospital Colentina, Bucharest, Romania
| | - Elena Serban
- Department of Clinical Neurosciences, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Liviu Cozma
- Department of Clinical Neurosciences, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Department of Neurology, clinical Hospital Colentina, Bucharest, Romania
| | - Florina Raicu
- Department of Medical Genetics, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Relu Cocos
- Department of Medical Genetics, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Ovidiu Bogdan Popescu
- Department of Clinical Neurosciences, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Department of Neurology, clinical Hospital Colentina, Bucharest, Romania.,Laboratory of Molecular Biology, "Victor Babes" National Institute of Pathology, Bucharest, Romania
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11
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Burke T, Monaghan R, McCormack D, Cogley C, Pinto-Grau M, O'Connor S, Donohoe B, Murphy L, O'Riordan S, Ndukwe I, Hutchinson M, Pender N, O'Keeffe F. Social cognition in cervical dystonia: A case-control study. Clin Park Relat Disord 2020; 3:100072. [PMID: 34316651 PMCID: PMC8298799 DOI: 10.1016/j.prdoa.2020.100072] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/14/2020] [Accepted: 09/03/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Although considered a motor disorder, adult onset isolated focal dystonia has many non-motor symptoms. There is a paucity of neuropsychological research on cognitive processing in adult onset focal dystonia. METHODS We employed a battery of clinical and cognitive assessments, including basic and complex social cognition, and assessed 46 patients with adult-onset cervical dystonia, compared to 46 age-, sex-, education-, and premorbid IQ-matched healthy controls. RESULTS Significant between-group differences were observed in relation to measures of memory encoding, recall and recognition, as well as multimodal measures of basic Social Cognition (emotion recognition: face and prosody), but not complex Social Cognition (mentalising). There were no deficits observed in multimodal measures of executive function. Controlling for mood did not affect performance. CONCLUSION In this multi-dimensional assessment of cognition in cervical dystonia, we report deficits in memory encoding, and in social cognition. Further investigation of social cognitive processes, memory, and sustained attention are required. Longitudinal studies are also needed to further delineate the role of psychological distress on cognitive outcomes and document the cognitive profile over time.
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Affiliation(s)
- Tom Burke
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Ireland
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | | | | | - Marta Pinto-Grau
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Ireland
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland
| | - Sarah O'Connor
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Ireland
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland
| | - Bronagh Donohoe
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Ireland
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland
| | - Lisa Murphy
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Ireland
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland
| | - Sean O'Riordan
- St Vincent's University Hospital, Dublin, Ireland
- School of Medicine & Health Science, University College Dublin, Dublin, Ireland
| | - Ihedinachi Ndukwe
- St Vincent's University Hospital, Dublin, Ireland
- School of Medicine & Health Science, University College Dublin, Dublin, Ireland
| | - Michael Hutchinson
- St Vincent's University Hospital, Dublin, Ireland
- School of Medicine & Health Science, University College Dublin, Dublin, Ireland
| | - Niall Pender
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Ireland
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland
- Royal College of Surgeons in Ireland, Dublin, Ireland
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12
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Conte A, Rocchi L, Latorre A, Belvisi D, Rothwell JC, Berardelli A. Ten‐Year Reflections on the Neurophysiological Abnormalities of Focal Dystonias in Humans. Mov Disord 2019; 34:1616-1628. [DOI: 10.1002/mds.27859] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 08/20/2019] [Accepted: 08/23/2019] [Indexed: 12/12/2022] Open
Affiliation(s)
- Antonella Conte
- Department of Human Neurosciences Sapienza, University of Rome Rome Italy
- IRCCS Neuromed Pozzilli (IS) Italy
| | - Lorenzo Rocchi
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London UK
| | - Anna Latorre
- Department of Human Neurosciences Sapienza, University of Rome Rome Italy
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London UK
| | | | - John C. Rothwell
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London UK
| | - Alfredo Berardelli
- Department of Human Neurosciences Sapienza, University of Rome Rome Italy
- IRCCS Neuromed Pozzilli (IS) Italy
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13
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Hutchinson M, McGovern EM, Narasimham S, Beck R, Reilly RB, Walsh CD, Malone KM, Tijssen MAJ, O'Riordan S. The premotor syndrome of cervical dystonia: Disordered processing of salient environmental stimuli. Mov Disord 2017; 33:232-237. [PMID: 29205495 DOI: 10.1002/mds.27229] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 09/19/2017] [Accepted: 10/06/2017] [Indexed: 12/17/2022] Open
Affiliation(s)
- Michael Hutchinson
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Eavan M McGovern
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Shruti Narasimham
- Trinity Centre for Bioengineering, School of Engineering, Trinity College Dublin, Dublin, Ireland
| | - Rebecca Beck
- Trinity Centre for Bioengineering, School of Engineering, Trinity College Dublin, Dublin, Ireland
| | - Richard B Reilly
- Trinity Centre for Bioengineering, School of Engineering, Trinity College Dublin, Dublin, Ireland.,School of Medicine Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Cathal D Walsh
- Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
| | - Kevin M Malone
- School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.,Department of Psychiatry, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Marina A J Tijssen
- Department of Neurology, University Medical Center Groningen, Groningen, The Netherlands
| | - Sean O'Riordan
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
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14
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Frühholz S, Staib M. Neurocircuitry of impaired affective sound processing: A clinical disorders perspective. Neurosci Biobehav Rev 2017; 83:516-524. [PMID: 28919431 DOI: 10.1016/j.neubiorev.2017.09.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 06/08/2017] [Accepted: 09/05/2017] [Indexed: 12/22/2022]
Abstract
Decoding affective meaning from sensory information is central to accurate and adaptive behavior in many natural and social contexts. Human vocalizations (speech and non-speech), environmental sounds (e.g. thunder, noise, or animal sounds) and human-produced sounds (e.g. technical sounds or music) can carry a wealth of important aversive, threatening, appealing, or pleasurable affective information that sometimes implicitly influences and guides our behavior. A deficit in processing such affective information is detrimental to adaptive environmental behavior, psychological well-being, and social interactive abilities. These deficits can originate from a diversity of psychiatric and neurological disorders, and are associated with neural dysfunctions across largely distributed brain networks. Recent neuroimaging studies in psychiatric and neurological patients outline the cortical and subcortical neurocircuitry of the complimentary and differential functional roles for affective sound processing. This points to and confirms a recently proposed distributed network rather than a single brain region underlying affective sound processing, and highlights the notion of a multi-functional process that can be differentially impaired in clinical disorders.
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Affiliation(s)
- Sascha Frühholz
- Department of Psychology, University of Zürich, Zürich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Center for Integrative Human Physiology (ZIHP), University of Zurich, Switzerland.
| | - Matthias Staib
- Department of Psychology, University of Zürich, Zürich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
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15
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Ioannou CI, Furuya S, Altenmüller E. Objective Evaluation of Performance Stress in Musicians With Focal Hand Dystonia: A Case Series. J Mot Behav 2016; 48:562-572. [PMID: 27715491 DOI: 10.1080/00222895.2016.1161590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Five musicians suffering from focal dystonia participated in a pilot study that examined the feasibility of an experimental protocol designed to assess musicians' motor performance under stress. Electrocardiography, free cortisol levels, and subjective assessments were used to monitor alterations of the hypothalamic-pituitary-adrenal axis. As measures of motor outcome, temporal variability of finger movements and muscular cocontraction of the wrist flexor and extensor were assessed. Findings suggest that the specific experimental design could be successfully applied. Several methodological issues such as carryover effects, the use of free cortisol, the inclusion of a double baseline, and the classification of dystonic patients into stress responders and nonresponders are analyzed and discussed.
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Affiliation(s)
- Christos I Ioannou
- a Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media , Hanover , Germany
| | - Shinichi Furuya
- b Department of Information and Communication Science , Sophia University , Tokyo , Japan
| | - Eckart Altenmüller
- a Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media , Hanover , Germany
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16
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De Stefani E, De Marco D, Gentilucci M. The Effects of Meaning and Emotional Content of a Sentence on the Kinematics of a Successive Motor Sequence Mimiking the Feeding of a Conspecific. Front Psychol 2016; 7:672. [PMID: 27242586 PMCID: PMC4860854 DOI: 10.3389/fpsyg.2016.00672] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 04/22/2016] [Indexed: 11/23/2022] Open
Abstract
Aim: Do the emotional content and meaning of sentences affect the kinematics of successive motor sequences? Material and Methods: Participants observed video-clips of an actor pronouncing sentences expressing positive or negative emotions and meanings (related to happiness or anger in Experiment 1 and food admiration or food disgust in Experiment 2). Then, they reached-to-grasp and placed a sugar lump on the actor’s mouth. Participants acted in response to sentences whose content could convey (1) emotion (i.e., face expression and prosody) and meaning, (2) meaning alone, or (3) emotion alone. Within each condition, the kinematic effects of sentences expressing positive and negative emotions were compared. Stimuli (positive for food admiration and negative for food disgust), conveyed either by emotion or meaning affected similarly the kinematics of both grasp and reach. Results: In Experiment 1, the kinematics did not vary between positive and negative sentences either when the content was expressed by both emotion and meaning, or meaning alone. In contrast, in the case of sole emotion, sentences with positive valence made faster the approach of the conspecific. In Experiment 2, the valence of emotions (positive for food admiration and negative for food disgust) affected the kinematics of both grasp and reach, independently of the modality. Discussion: The lack of an effect of meaning in Experiment 1 could be due to the weak relevance of sentence meaning with respect to the motor sequence goal (feeding). Experiment 2 demonstrated that, indeed, this was the case, because when the meaning and the consequent emotion were related to the sequence goal, they affected the kinematics. In contrast, the sole emotion activated approach or avoidance toward the actor according to positive and negative valence. The data suggest a behavioral dissociation between effects of emotion and meaning.
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17
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Ioannou CI, Furuya S, Altenmüller E. The impact of stress on motor performance in skilled musicians suffering from focal dystonia: Physiological and psychological characteristics. Neuropsychologia 2016; 85:226-36. [DOI: 10.1016/j.neuropsychologia.2016.03.029] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 02/19/2016] [Accepted: 03/23/2016] [Indexed: 01/21/2023]
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18
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Zurowski M, McDonald WM, Fox S, Marsh L. Psychiatric comorbidities in dystonia: emerging concepts. Mov Disord 2014; 28:914-20. [PMID: 23893448 DOI: 10.1002/mds.25501] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 03/29/2013] [Accepted: 04/03/2013] [Indexed: 11/09/2022] Open
Abstract
Psychiatric disorders are highly prevalent in patients with dystonia and have a profound effect on quality of life. Patients with dystonia frequently meet criteria for anxiety disorders, especially social phobia, and major depressive disorder. Deficits in emotional processing have also been demonstrated in some dystonia populations. Onset of psychiatric disturbances in patients with dystonia often precedes onset of motor symptoms, suggesting that the pathophysiology of dystonia itself contributes to the genesis of psychiatric disturbances. This article examines the hypothesis that mood and anxiety disorders are intrinsic to the neurobiology of dystonia, citing the available literature, which is derived mostly from research on focal isolated dystonias. Limitations of studies are identified, and the role of emotional reactivity, especially in the context of pain secondary to dystonia, is recognized. Available evidence underscores the need to develop dystonia assessment tools that incorporate psychiatric measures. Such tools would allow for a better understanding of the full spectrum of dystonia presentations and facilitate research on the treatment of dystonia as well as the treatment of psychiatric illnesses in the context of dystonia. This article, solicited for a special Movement Disorders issue on novel research findings and emerging concepts in dystonia, addresses the following issues: (1) To what extent are psychiatric disturbances related to the pathophysiology of dystonia? (2) What is the impact of psychiatric disturbances on outcome measures of current assessment tools for dystonia? (3) How do psychiatric comorbidities influence the treatment of dystonia? Answers to these questions will lead to an increased appreciation of psychiatric disorders in dystonia, a better understanding of brain physiology, more nuanced research questions pertaining to this population, better clinical scales that can be used to further patient management and research, and improved patient outcomes. © 2013 Movement Disorder Society.
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Affiliation(s)
- Mateusz Zurowski
- Department of Psychiatry, University of Toronto, University Health Network, Toronto, Ontario, Canada.
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19
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20
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Agrawal D, Timm L, Viola FC, Debener S, Büchner A, Dengler R, Wittfoth M. ERP evidence for the recognition of emotional prosody through simulated cochlear implant strategies. BMC Neurosci 2012; 13:113. [PMID: 22994867 PMCID: PMC3479061 DOI: 10.1186/1471-2202-13-113] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 07/10/2012] [Indexed: 11/26/2022] Open
Abstract
Background Emotionally salient information in spoken language can be provided by variations in speech melody (prosody) or by emotional semantics. Emotional prosody is essential to convey feelings through speech. In sensori-neural hearing loss, impaired speech perception can be improved by cochlear implants (CIs). Aim of this study was to investigate the performance of normal-hearing (NH) participants on the perception of emotional prosody with vocoded stimuli. Semantically neutral sentences with emotional (happy, angry and neutral) prosody were used. Sentences were manipulated to simulate two CI speech-coding strategies: the Advance Combination Encoder (ACE) and the newly developed Psychoacoustic Advanced Combination Encoder (PACE). Twenty NH adults were asked to recognize emotional prosody from ACE and PACE simulations. Performance was assessed using behavioral tests and event-related potentials (ERPs). Results Behavioral data revealed superior performance with original stimuli compared to the simulations. For simulations, better recognition for happy and angry prosody was observed compared to the neutral. Irrespective of simulated or unsimulated stimulus type, a significantly larger P200 event-related potential was observed for happy prosody after sentence onset than the other two emotions. Further, the amplitude of P200 was significantly more positive for PACE strategy use compared to the ACE strategy. Conclusions Results suggested P200 peak as an indicator of active differentiation and recognition of emotional prosody. Larger P200 peak amplitude for happy prosody indicated importance of fundamental frequency (F0) cues in prosody processing. Advantage of PACE over ACE highlighted a privileged role of the psychoacoustic masking model in improving prosody perception. Taken together, the study emphasizes on the importance of vocoded simulation to better understand the prosodic cues which CI users may be utilizing.
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Affiliation(s)
- Deepashri Agrawal
- Department of Neurology, Hannover Medical School, Hannover, Germany.
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