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Roßkopf S, Wechsler TF, Tucha S, Mühlberger A. Effects of facial biofeedback on hypomimia, emotion recognition, and affect in Parkinson's disease. J Int Neuropsychol Soc 2024; 30:360-369. [PMID: 38017615 DOI: 10.1017/s1355617723000747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
OBJECTIVES Facial expressions are a core component of emotions and nonverbal social communication. Therefore, hypomimia as secondary symptom of Parkinson's disease (PD) has adverse effects like social impairment, stigmatization, under-diagnosis and under-treatment of depression, and a generally lower quality of life. Beside unspecific dopaminergic treatment, specific treatment options for hypomimia in PD are rarely investigated. This quasi-randomized controlled trial evaluated the short-term effects of facial electromyogram (EMG) based biofeedback to enhance facial expression and emotion recognition as nonverbal social communication skills in PD patients. Furthermore effects on affect are examined. METHOD A sample of 34 in-patients with PD were allocated either to facial EMG-biofeedback as experimental group or non-facial exercises as control group. Facial expression during posing of emotions (measured via EMG), facial emotion recognition, and positive and negative affect were assessed before and after treatment. Stronger improvements were expected in the EMG-biofeedback in comparison to the control group. RESULTS The facial EMG-biofeedback group showed significantly greater improvements in overall facial expression, and especially for happiness and disgust. Also, overall facial emotion recognition abilities improved significantly stronger in the experimental group. Positive affect was significantly increased in both groups with no significant differences between them, while negative affect did not change within both groups. CONCLUSIONS The study provides promising evidence for facial EMG-biofeedback as a tool to improve facial expression and emotion recognition in PD. Embodiment theories are discussed as working mechanism.
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Affiliation(s)
- Sarah Roßkopf
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Theresa Friederike Wechsler
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Stefanie Tucha
- Schön Klinik München Schwabing - Neurologie München, München, Germany
- Schön Klinik MVZ, München, Germany
| | - Andreas Mühlberger
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Regensburg, Regensburg, Germany
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2
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Doskas T, Vadikolias K, Ntoskas K, Vavougios GD, Tsiptsios D, Stamati P, Liampas I, Siokas V, Messinis L, Nasios G, Dardiotis E. Neurocognitive Impairment and Social Cognition in Parkinson's Disease Patients. Neurol Int 2024; 16:432-449. [PMID: 38668129 PMCID: PMC11054167 DOI: 10.3390/neurolint16020032] [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: 01/03/2024] [Revised: 04/06/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024] Open
Abstract
In addition to motor symptoms, neurocognitive impairment (NCI) affects patients with prodromal Parkinson's disease (PD). NCI in PD ranges from subjective cognitive complaints to dementia. The purpose of this review is to present the available evidence of NCI in PD and highlight the heterogeneity of NCI phenotypes as well as the range of factors that contribute to NCI onset and progression. A review of publications related to NCI in PD up to March 2023 was performed using PubMed/Medline. There is an interconnection between the neurocognitive and motor symptoms of the disease, suggesting a common underlying pathophysiology as well as an interconnection between NCI and non-motor symptoms, such as mood disorders, which may contribute to confounding NCI. Motor and non-motor symptom evaluation could be used prognostically for NCI onset and progression in combination with imaging, laboratory, and genetic data. Additionally, the implications of NCI on the social cognition of afflicted patients warrant its prompt management. The etiology of NCI onset and its progression in PD is multifactorial and its effects are equally grave as the motor effects. This review highlights the importance of the prompt identification of subjective cognitive complaints in PD patients and NCI management.
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Affiliation(s)
- Triantafyllos Doskas
- Department of Neurology, Athens Naval Hospital, 11521 Athens, Greece;
- Department of Neurology, General University Hospital of Alexandroupoli, 68100 Alexandroupoli, Greece; (K.V.); (D.T.)
| | - Konstantinos Vadikolias
- Department of Neurology, General University Hospital of Alexandroupoli, 68100 Alexandroupoli, Greece; (K.V.); (D.T.)
| | | | - George D. Vavougios
- Department of Neurology, Athens Naval Hospital, 11521 Athens, Greece;
- Department of Neurology, Faculty of Medicine, University of Cyprus, 1678 Lefkosia, Cyprus
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Dimitrios Tsiptsios
- Department of Neurology, General University Hospital of Alexandroupoli, 68100 Alexandroupoli, Greece; (K.V.); (D.T.)
| | - Polyxeni Stamati
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (P.S.); (I.L.); (V.S.); (E.D.)
| | - Ioannis Liampas
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (P.S.); (I.L.); (V.S.); (E.D.)
| | - Vasileios Siokas
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (P.S.); (I.L.); (V.S.); (E.D.)
| | - Lambros Messinis
- School of Psychology, Laboratory of Neuropsychology and Behavioural Neuroscience, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Grigorios Nasios
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece;
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (P.S.); (I.L.); (V.S.); (E.D.)
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3
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Gobbo S, Urso E, Colombo A, Menghini M, Perin C, Isaias IU, Daini R. Facial expressions and identities recognition in Parkinson disease. Heliyon 2024; 10:e26860. [PMID: 38463872 PMCID: PMC10923660 DOI: 10.1016/j.heliyon.2024.e26860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 03/12/2024] Open
Abstract
Parkinson's Disease (PD) is associated with motor and non-motor symptoms. Among the latter are deficits in matching, identification, and recognition of emotional facial expressions. On one hand, this deficit has been attributed to a dysfunction in emotion processing. Another explanation (which does not exclude the former) links this deficit with reduced facial expressiveness in these patients, which prevents them from properly understanding or embodying emotions. To disentangle the specific contribution of emotion comprehension and that of facial expression processing in PD's observed deficit with emotions we performed two experiments on non-emotional facial expressions. In Experiment 1, a group of PD patients and a group of Healthy Controls (HC) underwent a task of non-emotional expression recognition in faces of different identity and a task of identity recognition in faces with different expression. No differences were observed between the two groups in accuracies. In Experiment 2, PD patients and Healthy Controls underwent a task where they had to recognize the identity of faces encoded through a non-emotional facial expression, through a rigid head movement, or as neutral. Again, no group differences were observed. In none of the two experiments hypomimia scores had a specific effect on expression processing. We conclude that in PD patients the observed impairment with emotional expressions is likely due to a specific deficit for emotions to a greater extent than for facial expressivity processing.
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Affiliation(s)
- Silvia Gobbo
- University of Milan-Bicocca, Department of Psychology, Milan, Italy
| | | | - Aurora Colombo
- Centro Parkinson e Parkinsonismi, ASST “Gaetano Pini-Cto”, Milano, Italy
- Fondazione Grigioni per il Morbo di Parkinson, Milano, Italy
| | - Matilde Menghini
- University of Milan-Bicocca, Department of Psychology, Milan, Italy
| | - Cecilia Perin
- Istituti Clinici Zucchi-GSD, Italy
- Università Milano Bicocca, Department of Medicine and Surgery, Milano, Italy
| | - Ioannis Ugo Isaias
- Centro Parkinson e Parkinsonismi, ASST “Gaetano Pini-Cto”, Milano, Italy
- Department of Neurology, University Hospital of Würzburg and Julius Maximilian University of Würzburg, Würzburg, Germany
| | - Roberta Daini
- University of Milan-Bicocca, Department of Psychology, Milan, Italy
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4
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Bianchini E, Rinaldi D, Alborghetti M, Simonelli M, D’Audino F, Onelli C, Pegolo E, Pontieri FE. The Story behind the Mask: A Narrative Review on Hypomimia in Parkinson's Disease. Brain Sci 2024; 14:109. [PMID: 38275529 PMCID: PMC10814039 DOI: 10.3390/brainsci14010109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
Facial movements are crucial for social and emotional interaction and well-being. Reduced facial expressions (i.e., hypomimia) is a common feature in patients with Parkinson's disease (PD) and previous studies linked this manifestation to both motor symptoms of the disease and altered emotion recognition and processing. Nevertheless, research on facial motor impairment in PD has been rather scarce and only a limited number of clinical evaluation tools are available, often suffering from poor validation processes and high inter- and intra-rater variability. In recent years, the availability of technology-enhanced quantification methods of facial movements, such as automated video analysis and machine learning application, led to increasing interest in studying hypomimia in PD. In this narrative review, we summarize the current knowledge on pathophysiological hypotheses at the basis of hypomimia in PD, with particular focus on the association between reduced facial expressions and emotional processing and analyze the current evaluation tools and management strategies for this symptom, as well as future research perspectives.
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Affiliation(s)
- Edoardo Bianchini
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- AGEIS, Université Grenoble Alpes, 38000 Grenoble, France
- Sant’Andrea University Hospital, 00189 Rome, Italy;
| | - Domiziana Rinaldi
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- Sant’Andrea University Hospital, 00189 Rome, Italy;
| | - Marika Alborghetti
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- Sant’Andrea University Hospital, 00189 Rome, Italy;
| | - Marta Simonelli
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- Ospedale dei Castelli, ASL Rome 6, 00040 Ariccia, Italy
| | | | - Camilla Onelli
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy;
| | - Elena Pegolo
- Department of Information Engineering, University of Padova, 35131 Padova, Italy;
| | - Francesco E. Pontieri
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- Sant’Andrea University Hospital, 00189 Rome, Italy;
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
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5
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Kuehne M, Polotzek L, Haghikia A, Zaehle T, Lobmaier JS. I spy with my little eye: The detection of changes in emotional faces and the influence of facial feedback in Parkinson disease. Eur J Neurol 2023; 30:622-630. [PMID: 36435983 DOI: 10.1111/ene.15647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/27/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Parkinson disease (PD) is a progressive neurodegenerative disorder that affects the motor system but also involves deficits in emotional processing such as facial emotion recognition. In healthy participants, it has been shown that facial mimicry, the automatic imitation of perceived facial expressions, facilitates the interpretation of the emotional states of our counterpart. In PD patients, recent studies revealed reduced facial mimicry and consequently reduced facial feedback, suggesting that this reduction might contribute to the prominent emotion recognition deficits found in PD. METHODS We investigated the influence of facial mimicry on facial emotion recognition. Twenty PD patients and 20 healthy controls (HCs) underwent a classical facial mimicry manipulation (holding a pen with the lips, teeth, or nondominant hand) while performing an emotional change detection task with faces. RESULTS As expected, emotion recognition was significantly influenced by facial mimicry manipulation in HCs, further supporting the hypothesis of facial feedback and the related theory of embodied simulation. Importantly, patients with PD, generally and independent from the facial mimicry manipulation, were impaired in their ability to detected emotion changes. Our data further show that PD patients' facial emotional recognition abilities are completely unaffected by mimicry manipulation, suggesting that PD patients cannot profit from an artificial modulation of the already impaired facial feedback. CONCLUSIONS These findings suggest that it is not the hypomimia and the absence of facial feedback per se, but a disruption of the facial feedback loop, that leads to the prominent emotion recognition deficit in PD patients.
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Affiliation(s)
- Maria Kuehne
- Department of Social Neuroscience and Social Psychology, Institute of Psychology, University of Bern, Bern, Switzerland
- Department of Neurology, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Laura Polotzek
- Department of Neurology, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Aiden Haghikia
- Department of Neurology, Otto von Guericke University Magdeburg, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Tino Zaehle
- Department of Neurology, Otto von Guericke University Magdeburg, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Janek S Lobmaier
- Department of Social Neuroscience and Social Psychology, Institute of Psychology, University of Bern, Bern, Switzerland
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6
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Habibi A, Kreutz G, Russo F, Tervaniemi M. Music-based interventions in community settings: Navigating the tension between rigor and ecological validity. Ann N Y Acad Sci 2022; 1518:47-57. [PMID: 36200590 PMCID: PMC10092011 DOI: 10.1111/nyas.14908] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Empirical research of community-based music interventions has advanced to investigate the individual, social, and educational implications of arts-for-wellbeing practices. Here, we present the motivations, aims, hypotheses, and implications of this complex field of inquiry. We describe examples of recent large-scale investigations to reflect on the major methodological challenges. Community-based music interventions strike a balance between the empirical rigor of clinical trials and the demands of ecological validity. We argue that this balance should be viewed as an asset rather than a mere pragmatic compromise. We also offer some perspectives on best-practice models for effectively engaging in this type of work.
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Affiliation(s)
- Assal Habibi
- Brain and Creativity Institute, University of Southern California, Los Angeles, California, USA
| | - Gunter Kreutz
- Department of Music, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Frank Russo
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Mari Tervaniemi
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Centre of Excellence in Music, Mind, Body and Brain (MMBB), Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland
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7
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Xu F, Zou XW, Yang LQ, Mo SC, Guo QH, Zhang J, Weng X, Xing GG. Facial muscle movements in patients with Parkinson's disease undergoing phonation tests. Front Neurol 2022; 13:1018362. [DOI: 10.3389/fneur.2022.1018362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 10/12/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeParkinson's disease (PD) is a serious neurodegenerative disease affecting the elderly. In general, the locomotion deficit, which seriously affects the daily life of patients with PD, usually occurs at a later stage. The mask face symptom meanwhile progressively worsens. However, facial muscle disorders and changes involved in the freezing mask are unclear.MethodIn this study, we recruited 35 patients with PD and 26 age- and sex-balanced controls to undergo phonation tests, while the built-in camera on the laptop recorded their facial expressions during the whole pronunciation process. Furthermore, FaceReader (version 7.0; Noldus Information Technology, Wageningen, Netherlands) was used to analyze changes in PD facial landmark movement and region movement.ResultsThe two-tailed Student's t-test showed that the changes in facial landmark movement among 49 landmarks were significantly lower in patients with PD than in the control group (P < 0.05). The data on facial region movement revealed that the eyes and upper lip of patients with PD differed significantly from those in the control group.ConclusionPatients with PD had defects in facial landmark movement and regional movement when producing a single syllable, double syllable, and multiple syllables, which may be related to reduced facial expressions in patients with PD.
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8
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Chuang YH, Tan CH, Su HC, Chien CY, Sung PS, Lee TL, Yu RL. Hypomimia May Influence the Facial Emotion Recognition Ability in Patients with Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2022; 12:185-197. [PMID: 34569974 DOI: 10.3233/jpd-212830] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hypomimia is a clinical feature of Parkinson's disease (PD). Based on the embodied simulation theory, the impairment of facial mimicry may worsen facial emotion recognition; however, the empirical results are inconclusive. OBJECTIVE We aimed to explore the worsening of emotion recognition by hypomimia. We further explored the relationship between the hypomimia, emotion recognition, and social functioning. METHODS A total of 114 participants were recruited. The patients with PD and normal controls (NCs) were matched for demographic characteristics. All the participants completed the Mini-Mental State Examination and the Chinese Multi-modalities Emotion Recognition Test. In addition to the above tests, the patients were assessed with the Movement Disorder Society-Unified Parkinson's Disease Rating Scale and Parkinson's Disease Social Functioning Scale (PDSFS). RESULTS Patients with PD with hypomimia had worse recognition of disgust than NCs (p = 0.018). The severity of hypomimia was predictive of the recognition of disgust (β= -0.275, p = 0.028). Facial emotion recognition was predictive of the PDSFS score of PD patients (β= 0.433, p = 0.001). We also found that recognizing disgust could mediate the relationship between hypomimia and the PDSFS score (β= 0.264, p = 0.045). CONCLUSION Patients with hypomimia had the worst disgust facial recognition. Hypomimia may affect the social function of PD patients, which is related to recognizing the expression of disgust. Emotion recognition training may improve the social function of patients with PD.
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Affiliation(s)
- Yu-Han Chuang
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Hsiang Tan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hui-Chen Su
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Yao Chien
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Pi-Shan Sung
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tsung-Lin Lee
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Rwei-Ling Yu
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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9
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Rovetti J, Copelli F, Russo FA. Audio and visual speech emotion activate the left pre-supplementary motor area. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2022; 22:291-303. [PMID: 34811708 DOI: 10.3758/s13415-021-00961-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/03/2021] [Indexed: 06/13/2023]
Abstract
Sensorimotor brain areas have been implicated in the recognition of emotion expressed on the face and through nonverbal vocalizations. However, no previous study has assessed whether sensorimotor cortices are recruited during the perception of emotion in speech-a signal that includes both audio (speech sounds) and visual (facial speech movements) components. To address this gap in the literature, we recruited 24 participants to listen to speech clips produced in a way that was either happy, sad, or neutral in expression. These stimuli also were presented in one of three modalities: audio-only (hearing the voice but not seeing the face), video-only (seeing the face but not hearing the voice), or audiovisual. Brain activity was recorded using electroencephalography, subjected to independent component analysis, and source-localized. We found that the left presupplementary motor area was more active in response to happy and sad stimuli than neutral stimuli, as indexed by greater mu event-related desynchronization. This effect did not differ by the sensory modality of the stimuli. Activity levels in other sensorimotor brain areas did not differ by emotion, although they were greatest in response to visual-only and audiovisual stimuli. One possible explanation for the pre-SMA result is that this brain area may actively support speech emotion recognition by using our extensive experience expressing emotion to generate sensory predictions that in turn guide our perception.
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Affiliation(s)
- Joseph Rovetti
- Department of Psychology, Ryerson University, Toronto, ON, M5B 2K3, Canada
- Department of Psychology, Western University, London, ON, Canada
| | - Fran Copelli
- Department of Psychology, Ryerson University, Toronto, ON, M5B 2K3, Canada
| | - Frank A Russo
- Department of Psychology, Ryerson University, Toronto, ON, M5B 2K3, Canada.
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10
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Pegolo E, Volpe D, Cucca A, Ricciardi L, Sawacha Z. Quantitative Evaluation of Hypomimia in Parkinson's Disease: A Face Tracking Approach. SENSORS 2022; 22:s22041358. [PMID: 35214255 PMCID: PMC8963098 DOI: 10.3390/s22041358] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/04/2022] [Accepted: 02/06/2022] [Indexed: 02/01/2023]
Abstract
Parkinson’s disease (PD) is a neurological disorder that mainly affects the motor system. Among other symptoms, hypomimia is considered one of the clinical hallmarks of the disease. Despite its great impact on patients’ quality of life, it remains still under-investigated. The aim of this work is to provide a quantitative index for hypomimia that can distinguish pathological and healthy subjects and that can be used in the classification of emotions. A face tracking algorithm was implemented based on the Facial Action Coding System. A new easy-to-interpret metric (face mobility index, FMI) was defined considering distances between pairs of geometric features and a classification based on this metric was proposed. Comparison was also provided between healthy controls and PD patients. Results of the study suggest that this index can quantify the degree of impairment in PD and can be used in the classification of emotions. Statistically significant differences were observed for all emotions when distances were taken into account, and for happiness and anger when FMI was considered. The best classification results were obtained with Random Forest and kNN according to the AUC metric.
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Affiliation(s)
- Elena Pegolo
- Department of Information Engineering, University of Padova, 35131 Padova, Italy;
| | - Daniele Volpe
- Fresco Parkinson Center, Villa Margherita, Santo Stefano Riabilitazione, 36057 Arcugnano, Italy; (D.V.); (A.C.)
| | - Alberto Cucca
- Fresco Parkinson Center, Villa Margherita, Santo Stefano Riabilitazione, 36057 Arcugnano, Italy; (D.V.); (A.C.)
- Department of Life Sciences, University of Trieste, 34127 Trieste, Italy
- Department of Neurology, School of Medicine, New York University, New York, NY 10016, USA
| | - Lucia Ricciardi
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St. George’s University of London, London SW17 0RE, UK;
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK
| | - Zimi Sawacha
- Department of Information Engineering, University of Padova, 35131 Padova, Italy;
- Department of Medicine, University of Padova, 35131 Padova, Italy
- Correspondence:
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11
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Bogdanova OV, Bogdanov VB, Miller LE, Hadj-Bouziane F. Simulated proximity enhances perceptual and physiological responses to emotional facial expressions. Sci Rep 2022; 12:109. [PMID: 34996925 PMCID: PMC8741866 DOI: 10.1038/s41598-021-03587-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 12/02/2021] [Indexed: 11/29/2022] Open
Abstract
Physical proximity is important in social interactions. Here, we assessed whether simulated physical proximity modulates the perceived intensity of facial emotional expressions and their associated physiological signatures during observation or imitation of these expressions. Forty-four healthy volunteers rated intensities of dynamic angry or happy facial expressions, presented at two simulated locations, proximal (0.5 m) and distant (3 m) from the participants. We tested whether simulated physical proximity affected the spontaneous (in the observation task) and voluntary (in the imitation task) physiological responses (activity of the corrugator supercilii face muscle and pupil diameter) as well as subsequent ratings of emotional intensity. Angry expressions provoked relative activation of the corrugator supercilii muscle and pupil dilation, whereas happy expressions induced a decrease in corrugator supercilii muscle activity. In proximal condition, these responses were enhanced during both observation and imitation of the facial expressions, and were accompanied by an increase in subsequent affective ratings. In addition, individual variations in condition related EMG activation during imitation of angry expressions predicted increase in subsequent emotional ratings. In sum, our results reveal novel insights about the impact of physical proximity in the perception of emotional expressions, with early proximity-induced enhancements of physiological responses followed by an increased intensity rating of facial emotional expressions.
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Affiliation(s)
- Olena V Bogdanova
- IMPACT Team, Lyon Neuroscience Research Center, INSERM, U1028, CNRS, UMR5292, University of Lyon, Bron Cedex, France. .,INCIA, CNRS UMR 5287, Université de Bordeaux, Bordeaux, France.
| | - Volodymyr B Bogdanov
- IMPACT Team, Lyon Neuroscience Research Center, INSERM, U1028, CNRS, UMR5292, University of Lyon, Bron Cedex, France.,Université de Bordeaux, Collège Science de la Sante, Institut Universitaire des Sciences de la Réadaptation, Handicap Activité Cognition Santé EA 4136, Bordeaux, France
| | - Luke E Miller
- Donders Centre for Cognition of Radboud University in Nijmegen, Nijmegen, The Netherlands
| | - Fadila Hadj-Bouziane
- IMPACT Team, Lyon Neuroscience Research Center, INSERM, U1028, CNRS, UMR5292, University of Lyon, Bron Cedex, France
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12
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Picou EM, Rakita L, Buono GH, Moore TM. Effects of Increasing the Overall Level or Fitting Hearing Aids on Emotional Responses to Sounds. Trends Hear 2021; 25:23312165211049938. [PMID: 34866509 PMCID: PMC8825634 DOI: 10.1177/23312165211049938] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Adults with hearing loss demonstrate a reduced range of emotional responses to nonspeech
sounds compared to their peers with normal hearing. The purpose of this study was to
evaluate two possible strategies for addressing the effects of hearing loss on emotional
responses: (a) increasing overall level and (b) hearing aid use (with and without
nonlinear frequency compression, NFC). Twenty-three adults (mean age = 65.5 years) with
mild-to-severe sensorineural hearing loss and 17 adults (mean age = 56.2 years) with
normal hearing participated. All adults provided ratings of valence and arousal without
hearing aids in response to nonspeech sounds presented at a moderate and at a high level.
Adults with hearing loss also provided ratings while using individually fitted study
hearing aids with two settings (NFC-OFF or NFC-ON). Hearing loss and hearing aid use
impacted ratings of valence but not arousal. Listeners with hearing loss rated pleasant
sounds as less pleasant than their peers, confirming findings in the extant literature.
For both groups, increasing the overall level resulted in lower ratings of valence. For
listeners with hearing loss, the use of hearing aids (NFC-OFF) also resulted in lower
ratings of valence but to a lesser extent than increasing the overall level. Activating
NFC resulted in ratings that were similar to ratings without hearing aids (with a moderate
presentation level) but did not improve ratings to match those from the listeners with
normal hearing. These findings suggest that current interventions do not ameliorate the
effects of hearing loss on emotional responses to sound.
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Affiliation(s)
- Erin M Picou
- Department of Hearing and Speech Sciences, 12328Vanderbilt University School of Medicine, Nashville TN, USA
| | - Lori Rakita
- Department of Otolaryngology, 1866Massachusetts Ear and Eye Infirmary, Harvard Medical School, Boston, MA, USA
| | - Gabrielle H Buono
- Department of Hearing and Speech Sciences, 12328Vanderbilt University School of Medicine, Nashville TN, USA
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13
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Saçmacı H, Erkoç MF, Aktürk T. Measurement of the facial nerve thickness and its correlation with freezing phenomenon and hypomimia in Parkinson's disease. Clin Neurol Neurosurg 2021; 210:106960. [PMID: 34571338 DOI: 10.1016/j.clineuro.2021.106960] [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: 02/14/2021] [Revised: 05/25/2021] [Accepted: 09/15/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Hypomimia is one of the diagnostic features in Parkinson's disease, and freezing blocks may also occur with the degenerative process. We investigated that the thickness of the cranial facial nerve that innervates facial expressions, and the relationship between bradymimia and freezing phenomena in these patients. METHODS We included 70 patients and healthy participants in this cross-sectional study. Clinical characteristics, modified Hoehn and Yahr (mHY) stages, Unified Parkinson's Disease Rating Scale (UPDRS) scores and Freezing of Gait Questionnaire (FOG-Q) scores of Parkinson's patients were recorded. FOG-Q was scored between 1 and 4 points. The thickness of the facial nerve and its neighborhoods of numerically equal groups were measured radiologically in the internal acoustic channel (IAC) with magnetic resonance imaging of temporal lobe. Right and left facial nerve thicknesses were compared. RESULTS The right facial nerve thicknesses of the patient and control groups were measured as 0.97 ± 0.12 mm and 1.20 ± 0.10 mm at the proximal level and 0.71 (0.69-0.81) mm and 1.21 (1.13-1.24) mm at the distal level, respectively (P < 0.001). Notably, the facial nerve was more atrophied on the right than on the left (P < 0.001). Facial nerve to IAC ratio (%) was significantly lower and cerebrospinal fluid thickness distance (%) measurement was significantly higher (P < 0.001). Also, the FOG-Q and facial nerve to IAC ratio were negatively correlated (P = 0.049, rho = -0.335). CONCLUSIONS Our study provides new information about the facial nerve and its neighborhoods and clinical relationships in individuals with PD. In studies investigating hypomimia and FOG in Parkinson's, neuroimaging of the facial nerve can also be used. These results need to be proven with more comprehensive studies.
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Affiliation(s)
| | | | - Tülin Aktürk
- Bozok University Medical School, Yozgat, Turkey.
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14
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Aristotelidou V, Tsatali M, Overton PG, Vivas AB. Autonomic factors do not underlie the elevated self-disgust levels in Parkinson's disease. PLoS One 2021; 16:e0256144. [PMID: 34473758 PMCID: PMC8412376 DOI: 10.1371/journal.pone.0256144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/30/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Parkinson's disease (PD) is manifested along with non-motor symptoms such as impairments in basic emotion regulation, recognition and expression. Yet, self-conscious emotion (SCEs) such as self-disgust, guilt and shame are under-investigated. Our previous research indicated that Parkinson patients have elevated levels of self-reported and induced self-disgust. However, the cause of that elevation-whether lower level biophysiological factors, or higher level cognitive factors, is unknown. METHODS To explore the former, we analysed Skin Conductance Response (SCR, measuring sympathetic activity) amplitude and high frequency Heart Rate Variability (HRV, measuring parasympathetic activity) across two emotion induction paradigms, one involving narrations of personal experiences of self-disgust, shame and guilt, and one targeting self-disgust selectively via images of the self. Both paradigms had a neutral condition. RESULTS Photo paradigm elicited significant changes in physiological responses in patients relative to controls-higher percentages of HRV in the high frequency range but lower SCR amplitudes, with patients to present lower responses compared to controls. In the narration paradigm, only guilt condition elicited significant SCR differences between groups. CONCLUSIONS Consequently, lower level biophysiological factors are unlikely to cause elevated self-disgust levels in Parkinson's disease, which by implication suggests that higher level cognitive factors may be responsible.
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Affiliation(s)
| | - Marianna Tsatali
- Greek Alzheimer Association Day Care Centre “Saint John”, Thessaloniki, Greece
- Department of Psychology, CITY College, University of York Europe Campus, Thessaloniki, Greece
| | - Paul G. Overton
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Ana B. Vivas
- Department of Psychology, CITY College, University of York Europe Campus, Thessaloniki, Greece
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15
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Tăuţan AM, Ionescu B, Santarnecchi E. Artificial intelligence in neurodegenerative diseases: A review of available tools with a focus on machine learning techniques. Artif Intell Med 2021; 117:102081. [PMID: 34127244 DOI: 10.1016/j.artmed.2021.102081] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 02/21/2021] [Accepted: 04/26/2021] [Indexed: 10/21/2022]
Abstract
Neurodegenerative diseases have shown an increasing incidence in the older population in recent years. A significant amount of research has been conducted to characterize these diseases. Computational methods, and particularly machine learning techniques, are now very useful tools in helping and improving the diagnosis as well as the disease monitoring process. In this paper, we provide an in-depth review on existing computational approaches used in the whole neurodegenerative spectrum, namely for Alzheimer's, Parkinson's, and Huntington's Diseases, Amyotrophic Lateral Sclerosis, and Multiple System Atrophy. We propose a taxonomy of the specific clinical features, and of the existing computational methods. We provide a detailed analysis of the various modalities and decision systems employed for each disease. We identify and present the sleep disorders which are present in various diseases and which represent an important asset for onset detection. We overview the existing data set resources and evaluation metrics. Finally, we identify current remaining open challenges and discuss future perspectives.
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Affiliation(s)
- Alexandra-Maria Tăuţan
- University "Politehnica" of Bucharest, Splaiul Independenţei 313, 060042 Bucharest, Romania.
| | - Bogdan Ionescu
- University "Politehnica" of Bucharest, Splaiul Independenţei 313, 060042 Bucharest, Romania.
| | - Emiliano Santarnecchi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Harvard Medical School, 330 Brookline Avenue, Boston, United States.
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16
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Abrami A, Gunzler S, Kilbane C, Ostrand R, Ho B, Cecchi G. Automated Computer Vision Assessment of Hypomimia in Parkinson Disease: Proof-of-Principle Pilot Study. J Med Internet Res 2021; 23:e21037. [PMID: 33616535 PMCID: PMC7939934 DOI: 10.2196/21037] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/30/2020] [Accepted: 12/18/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Facial expressions require the complex coordination of 43 different facial muscles. Parkinson disease (PD) affects facial musculature leading to "hypomimia" or "masked facies." OBJECTIVE We aimed to determine whether modern computer vision techniques can be applied to detect masked facies and quantify drug states in PD. METHODS We trained a convolutional neural network on images extracted from videos of 107 self-identified people with PD, along with 1595 videos of controls, in order to detect PD hypomimia cues. This trained model was applied to clinical interviews of 35 PD patients in their on and off drug motor states, and seven journalist interviews of the actor Alan Alda obtained before and after he was diagnosed with PD. RESULTS The algorithm achieved a test set area under the receiver operating characteristic curve of 0.71 on 54 subjects to detect PD hypomimia, compared to a value of 0.75 for trained neurologists using the United Parkinson Disease Rating Scale-III Facial Expression score. Additionally, the model accuracy to classify the on and off drug states in the clinical samples was 63% (22/35), in contrast to an accuracy of 46% (16/35) when using clinical rater scores. Finally, each of Alan Alda's seven interviews were successfully classified as occurring before (versus after) his diagnosis, with 100% accuracy (7/7). CONCLUSIONS This proof-of-principle pilot study demonstrated that computer vision holds promise as a valuable tool for PD hypomimia and for monitoring a patient's motor state in an objective and noninvasive way, particularly given the increasing importance of telemedicine.
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Affiliation(s)
- Avner Abrami
- IBM Research - Computational Biology Center, Yorktown Heights, NY, United States
| | - Steven Gunzler
- Parkinson's and Movement Disorders Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Camilla Kilbane
- Parkinson's and Movement Disorders Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Rachel Ostrand
- IBM Research - Computational Biology Center, Yorktown Heights, NY, United States
| | - Bryan Ho
- Department of Neurology, Tufts Medical Center, Boston, MA, United States
| | - Guillermo Cecchi
- IBM Research - Computational Biology Center, Yorktown Heights, NY, United States
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17
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Social Symptoms of Parkinson's Disease. PARKINSONS DISEASE 2020; 2020:8846544. [PMID: 33489081 PMCID: PMC7790585 DOI: 10.1155/2020/8846544] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/05/2020] [Accepted: 12/03/2020] [Indexed: 12/28/2022]
Abstract
Parkinson's disease (PD) is typically well recognized by its characteristic motor symptoms (e.g., bradykinesia, rigidity, and tremor). The cognitive symptoms of PD are increasingly being acknowledged by clinicians and researchers alike. However, PD also involves a host of emotional and communicative changes which can cause major disruptions to social functioning. These incude problems producing emotional facial expressions (i.e., facial masking) and emotional speech (i.e., dysarthria), as well as difficulties recognizing the verbal and nonverbal emotional cues of others. These social symptoms of PD can result in severe negative social consequences, including stigma, dehumanization, and loneliness, which might affect quality of life to an even greater extent than more well-recognized motor or cognitive symptoms. It is, therefore, imperative that researchers and clinicans become aware of these potential social symptoms and their negative effects, in order to properly investigate and manage the socioemotional aspects of PD. This narrative review provides an examination of the current research surrounding some of the most common social symptoms of PD and their related social consequences and argues that proactively and adequately addressing these issues might improve disease outcomes.
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18
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Arias JA, Williams C, Raghvani R, Aghajani M, Baez S, Belzung C, Booij L, Busatto G, Chiarella J, Fu CH, Ibanez A, Liddell BJ, Lowe L, Penninx BWJH, Rosa P, Kemp AH. The neuroscience of sadness: A multidisciplinary synthesis and collaborative review. Neurosci Biobehav Rev 2020; 111:199-228. [PMID: 32001274 DOI: 10.1016/j.neubiorev.2020.01.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/17/2019] [Accepted: 01/05/2020] [Indexed: 02/06/2023]
Abstract
Sadness is typically characterized by raised inner eyebrows, lowered corners of the mouth, reduced walking speed, and slumped posture. Ancient subcortical circuitry provides a neuroanatomical foundation, extending from dorsal periaqueductal grey to subgenual anterior cingulate, the latter of which is now a treatment target in disorders of sadness. Electrophysiological studies further emphasize a role for reduced left relative to right frontal asymmetry in sadness, underpinning interest in the transcranial stimulation of left dorsolateral prefrontal cortex as an antidepressant target. Neuroimaging studies - including meta-analyses - indicate that sadness is associated with reduced cortical activation, which may contribute to reduced parasympathetic inhibitory control over medullary cardioacceleratory circuits. Reduced cardiac control may - in part - contribute to epidemiological reports of reduced life expectancy in affective disorders, effects equivalent to heavy smoking. We suggest that the field may be moving toward a theoretical consensus, in which different models relating to basic emotion theory and psychological constructionism may be considered as complementary, working at different levels of the phylogenetic hierarchy.
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Affiliation(s)
- Juan A Arias
- Department of Psychology, Swansea University, United Kingdom; Department of Statistics, Mathematical Analysis, and Operational Research, Universidade de Santiago de Compostela, Spain
| | - Claire Williams
- Department of Psychology, Swansea University, United Kingdom
| | - Rashmi Raghvani
- Department of Psychology, Swansea University, United Kingdom
| | - Moji Aghajani
- Department of Psychiatry, Amsterdam UMC, Location VUMC, GGZ InGeest Research & Innovation, Amsterdam Neuroscience, the Netherlands
| | | | | | - Linda Booij
- Department of Psychology, Concordia University Montreal, Canada; CHU Sainte-Justine, University of Montreal, Montreal, Canada
| | | | - Julian Chiarella
- Department of Psychology, Concordia University Montreal, Canada; CHU Sainte-Justine, University of Montreal, Montreal, Canada
| | - Cynthia Hy Fu
- School of Psychology, University of East London, United Kingdom; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Agustin Ibanez
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile; Universidad Autonoma del Caribe, Barranquilla, Colombia; Centre of Excellence in Cognition and its Disorders, Australian Research Council (ARC), New South Wales, Australia
| | | | - Leroy Lowe
- Neuroqualia (NGO), Turo, Nova Scotia, Canada
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Location VUMC, GGZ InGeest Research & Innovation, Amsterdam Neuroscience, the Netherlands
| | - Pedro Rosa
- Department of Psychiatry, University of Sao Paulo, Brazil
| | - Andrew H Kemp
- Department of Psychology, Swansea University, United Kingdom; Department of Psychiatry, University of Sao Paulo, Brazil; Discipline of Psychiatry, and School of Psychology, University of Sydney, Sydney, Australia.
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19
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Impairments in face discrimination and emotion recognition are related to aging and cognitive dysfunctions in Parkinson's disease with dementia. Sci Rep 2020; 10:4367. [PMID: 32152359 PMCID: PMC7062803 DOI: 10.1038/s41598-020-61310-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 02/16/2020] [Indexed: 11/27/2022] Open
Abstract
Patients with Parkinson’s disease (PD) suffer from motor and non-motor symptoms; 40% would develop dementia (PD-D). Impaired face and emotion processing in PD has been reported; however, the deficits of face processing in PD-D remain unclear. We investigated three essential aspects of face processing capacity in PD-D, and the associations between cognitive, neuropsychiatric assessments and task performances. Twenty-four PD-D patients (mean age: 74.0 ± 5.55) and eighteen age-matched healthy controls (HC) (mean age: 71.0 ± 6.20) received three computerized tasks, morphing-face discrimination, dynamic facial emotion recognition, and expression imitation. Compared to HC, PD-D patients had lower sensitivity (d’) and greater neural internal noises in discriminating faces; responded slower and had difficulties with negative emotions; imitated some expressions but with lower strength. Correlation analyses revealed that patients with advancing age, slow mentation, and poor cognition (but not motor symptoms) showed stronger deterioration in face perception. Importantly, these correlations were absent in the age-matched HC. The present study is among the first few examined face processing in patients with PD-D, and found consistent deficits correlated with advancing age and slow mentation. We propose that face discrimination task could be included as a potential test for the early detection of dementia in PD.
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20
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Farina E, Borgnis F, Pozzo T. Mirror neurons and their relationship with neurodegenerative disorders. J Neurosci Res 2020; 98:1070-1094. [DOI: 10.1002/jnr.24579] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 12/12/2022]
Affiliation(s)
| | | | - Thierry Pozzo
- INSERM UMR1093‐CAPS, Université Bourgogne Franche‐Comté Dijon France
- IT@UniFe Center for Translational Neurophysiology Istituto Italiano di Tecnologia Ferrara Italy
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21
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Okamoto R, Adachi K, Mizukami K. [Effects of facial rehabilitation exercise on the mood, facial expressions, and facial muscle activities in patients with Parkinson's disease]. Nihon Ronen Igakkai Zasshi 2019; 56:478-486. [PMID: 31761854 DOI: 10.3143/geriatrics.56.478] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM Facial expressions are often impaired in patients with Parkinson's disease (PD). Few studies have examined the effects of head and neck rehabilitation in patients with PD using a facial expression analysis. In the present study, to further elucidate the effects of facial rehabilitation exercise in patients with PD, a three-dimensional facial expression analysis with FaceReader™ and surface electromyography (EMG) were performed in order to assess the facial expressions and muscle activities, respectively. The effects of such exercises on the mood and mental health were also evaluated. METHOD Twenty-one patients with PD (63.3±12.1 years) participated in the present study and were randomly assigned to an intervention group and non-intervention group. Facial rehabilitation exercise was performed for 60 minutes once a week for 12 weeks in the intervention group. GHQ-12, the facial expression analysis with FaceReader™, surface EMG, and the VAS scale for mood changes were used to evaluate the effects of the program. The results from both groups were compared. RESULTS The results from eight patients in the intervention group and five in the non-intervention group were analyzed. FaceReader™ revealed a higher "Happy" index and lower "Sad" index in the intervention group than in the non-intervention group, and a significant interaction "Happy" index by an analysis of variance was noted between the two groups. EMG also showed increases in the activity of facial muscles in the intervention group. The subjects' mood improved after each facial rehabilitation exercise session. CONCLUSION The results of the present study suggest that the facial rehabilitation exercise affected the mood, facial expression, and facial muscle activities in patients with PD and indicate that the expression analysis with the FaceReader™ and surface EMG are useful for evaluating the effects of facial rehabilitation exercise.
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Affiliation(s)
- Rumiko Okamoto
- Graduate School of Comprehensive Human Science, Department of Social Health and Stress Management, University of Tsukuba
| | | | - Katsuyoshi Mizukami
- Graduate School of Comprehensive Human Science, Department of Social Health and Stress Management, University of Tsukuba.,Faculty of Health and Sport Sciences, University of Tsukuba
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22
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Yolcu G, Oztel I, Kazan S, Oz C, Palaniappan K, Lever TE, Bunyak F. Facial expression recognition for monitoring neurological disorders based on convolutional neural network. MULTIMEDIA TOOLS AND APPLICATIONS 2019; 78:31581-31603. [PMID: 35693322 PMCID: PMC9181900 DOI: 10.1007/s11042-019-07959-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 06/13/2019] [Accepted: 07/10/2019] [Indexed: 06/15/2023]
Abstract
Facial expressions are a significant part of non-verbal communication. Recognizing facial expressions of people with neurological disorders is essential because these people may have lost a significant amount of their verbal communication ability. Such an assessment requires time consuming examination involving medical personnel, which can be quite challenging and expensive. Automated facial expression recognition systems that are low-cost and noninvasive can help experts detect neurological disorders. In this study, an automated facial expression recognition system is developed using a novel deep learning approach. The architecture consists of four-stage networks. The first, second and third networks segment the facial components which are essential for facial expression recognition. Owing to the three networks, an iconize facial image is obtained. The fourth network classifies facial expressions using raw facial images and iconize facial images. This four-stage method combines holistic facial information with local part-based features to achieve more robust facial expression recognition. Preliminary experimental results achieved 94.44% accuracy for facial expression recognition on RaFD database. The proposed system produced 5% improvement than the facial expression recognition system by using raw images. This study presents a quantitative, objective and non-invasive facial expression recognition system to help in the monitoring and diagnosis of neurological disorders influencing facial expressions.
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Affiliation(s)
- Gozde Yolcu
- Department of Computer Engineering, Sakarya University, 54050 Serdivan, Sakarya, Turkey
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO 65211, USA
| | - Ismail Oztel
- Department of Computer Engineering, Sakarya University, 54050 Serdivan, Sakarya, Turkey
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO 65211, USA
| | - Serap Kazan
- Department of Computer Engineering, Sakarya University, 54050 Serdivan, Sakarya, Turkey
| | - Cemil Oz
- Department of Computer Engineering, Sakarya University, 54050 Serdivan, Sakarya, Turkey
| | - Kannappan Palaniappan
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO 65211, USA
| | - Teresa E. Lever
- Department of Otolaryngology, University of Missouri, Columbia, MO 65211, USA
| | - Filiz Bunyak
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO 65211, USA
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23
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Kuehne M, Siwy I, Zaehle T, Heinze HJ, Lobmaier JS. Out of Focus: Facial Feedback Manipulation Modulates Automatic Processing of Unattended Emotional Faces. J Cogn Neurosci 2019; 31:1631-1640. [PMID: 31274394 DOI: 10.1162/jocn_a_01445] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Facial expressions provide information about an individual's intentions and emotions and are thus an important medium for nonverbal communication. Theories of embodied cognition assume that facial mimicry and resulting facial feedback plays an important role in the perception of facial emotional expressions. Although behavioral and electrophysiological studies have confirmed the influence of facial feedback on the perception of facial emotional expressions, the influence of facial feedback on the automatic processing of such stimuli is largely unexplored. The automatic processing of unattended facial expressions can be investigated by visual expression-related MMN. The expression-related MMN reflects a differential ERP of automatic detection of emotional changes elicited by rarely presented facial expressions (deviants) among frequently presented facial expressions (standards). In this study, we investigated the impact of facial feedback on the automatic processing of facial expressions. For this purpose, participants (n = 19) performed a centrally presented visual detection task while neutral (standard), happy, and sad faces (deviants) were presented peripherally. During the task, facial feedback was manipulated by different pen holding conditions (holding the pen with teeth, lips, or nondominant hand). Our results indicate that automatic processing of facial expressions is influenced and thus dependent on the own facial feedback.
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Affiliation(s)
| | | | - Tino Zaehle
- Otto-von-Guericke-University Magdeburg.,Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Hans-Jochen Heinze
- Otto-von-Guericke-University Magdeburg.,Center for Behavioral Brain Sciences, Magdeburg, Germany
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24
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Maremmani C, Monastero R, Orlandi G, Salvadori S, Pieroni A, Baschi R, Pecori A, Dolciotti C, Berchina G, Rovini E, Cuddemi F, Cavallo F. Objective assessment of blinking and facial expressions in Parkinson's disease using a vertical electro-oculogram and facial surface electromyography. Physiol Meas 2019; 40:065005. [PMID: 31018181 DOI: 10.1088/1361-6579/ab1c05] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Hypomimia is a common and early symptom of Parkinson's disease (PD), which reduces the ability of PD patients to manifest emotions. Currently, it is visually evaluated by the neurologist during neurological examinations for PD diagnosis, as described in task 3.2 of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Since such an evaluation is semi-quantitative and affected by inter-variability, this paper aims to measure the physiological parameters related to eye blink and facial expressions extracted from a vertical electro-oculogram (VEOG) and facial surface electromyography (fsEMG) to differentiate PD patients from healthy control subjects (HCs). APPROACH The spontaneous eye blink rate-minute (sEBR), its maximum amplitude (BMP), and facial cutaneous muscle activity were measured in 24 PD patients and 24 HCs while the subjects looked at a visual-tester composed of three main parts: static vision, dynamic vision and reading silently. Specificity and sensitivity for each parameter were calculated. MAIN RESULTS The VEOG and the fsEMG allowed the identification of some parameters related to eye blink and facial expressions (i.e. sEBR, BMP, frontal and peribuccal muscular activities), being able to distinguish between PD patients and HCs with high sensitivity and specificity. SIGNIFICANCE The demonstration that the combination of parameters related to eye blink and facial expressions can discriminate (with high accuracy) between PD patients versus HCs, thus resulting in a useful tool to support the neurologist in objective assessment of hypomimia for improving PD diagnosis.
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Affiliation(s)
- Carlo Maremmani
- Unità Operativa di Neurologia, Laboratorio Congiunto di Neuro-Biorobotica, Ospedale delle Apuane, Azienda USL Toscana Nord Ovest, Massa, Italia
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25
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Kang J, Derva D, Kwon DY, Wallraven C. Voluntary and spontaneous facial mimicry toward other's emotional expression in patients with Parkinson's disease. PLoS One 2019; 14:e0214957. [PMID: 30973893 PMCID: PMC6459535 DOI: 10.1371/journal.pone.0214957] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/23/2019] [Indexed: 01/31/2023] Open
Abstract
A "masked face", that is, decreased facial expression is considered as one of the cardinal symptoms among individuals with Parkinson's disease (PD). Both spontaneous and voluntary mimicry toward others' emotional expressions is essential for both social communication and emotional sharing with others. Despite many studies showing impairments in facial movements in PD in general, it is still unclear whether voluntary, spontaneous, or both types of mimicry are affected and how the impairments affect the patients' quality of life. We investigated to verify whether impairments in facial movements happen for spontaneous as well as for voluntary expressions by quantitatively comparing muscle activations using surface electromyography. Dynamic facial expressions of Neutral, Anger, Joy, and Sad were presented during recordings in corrugator and zygomatic areas. In the spontaneous condition, participants were instructed to simply watch clips, whereas in the voluntary condition they were instructed to actively mimic the stimuli. We found that PD patients showed decreased mimicry in both spontaneous and voluntary conditions compared to a matched control group, although movement patterns in each emotion were similar in the two groups. Moreover, whereas the decrease in mimicry correlated with the decrease not in a health-related quality of life index (PDQ), it did so in a more subjective measurement of general quality of life index (SWB). The correlation between facial mimicry and subjective well-being index suggests that the 'masked face' symptom deteriorates patients' quality of life in a complex way affecting social and psychological aspects, which in turn may be linked to the increased depression risk among individuals with PD.
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Affiliation(s)
- June Kang
- Korea University, Department of Brain and Cognitive Engineering, Seoul, South Korea
- Empathy Research Institute, Seoul, South Korea
| | - Dilara Derva
- Korea University, Department of Brain and Cognitive Engineering, Seoul, South Korea
| | - Do-Young Kwon
- Korea University Ansan hospital, Department of Neurology, Ansan City, South Korea
| | - Christian Wallraven
- Korea University, Department of Brain and Cognitive Engineering, Seoul, South Korea
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Problems with Facial Mimicry Might Contribute to Emotion Recognition Impairment in Parkinson's Disease. PARKINSONS DISEASE 2018; 2018:5741941. [PMID: 30534356 PMCID: PMC6252194 DOI: 10.1155/2018/5741941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 10/23/2018] [Indexed: 12/17/2022]
Abstract
Difficulty with emotion recognition is increasingly being recognized as a symptom of Parkinson's disease. Most research into this area contends that progressive cognitive decline accompanying the disease is to be blamed. However, facial mimicry (i.e., the involuntary congruent activation of facial expression muscles upon viewing a particular facial expression) might also play a role and has been relatively understudied in this clinical population. In healthy participants, facial mimicry has been shown to improve recognition of observed emotions, a phenomenon described by embodied simulation theory. Due to motor disturbances, Parkinson's disease patients frequently show reduced emotional expressiveness, which translates into reduced mimicry. Therefore, it is likely that facial mimicry problems in Parkinson's disease contribute at least partly to the emotional recognition deficits that these patients experience and might greatly influence their social cognition abilities and quality of life. The present review aims to highlight the need for further inquiry into the motor mechanisms behind emotional recognition in Parkinson's disease by synthesizing behavioural, physiological, and neuroanatomical evidence.
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Rizzo G, Milardi D, Bertino S, Basile GA, Di Mauro D, Calamuneri A, Chillemi G, Silvestri G, Anastasi G, Bramanti A, Cacciola A. The Limbic and Sensorimotor Pathways of the Human Amygdala: A Structural Connectivity Study. Neuroscience 2018; 385:166-180. [DOI: 10.1016/j.neuroscience.2018.05.051] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 05/28/2018] [Accepted: 05/31/2018] [Indexed: 12/21/2022]
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Wootton A, Starkey NJ, Barber CC. Unmoving and unmoved: experiences and consequences of impaired non-verbal expressivity in Parkinson’s patients and their spouses. Disabil Rehabil 2018; 41:2516-2527. [DOI: 10.1080/09638288.2018.1471166] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Adrienne Wootton
- School of Psychology, Faculty of Arts and Social Sciences, The University of Waikato, Hamilton, New Zealand
| | - Nicola J. Starkey
- School of Psychology, Faculty of Arts and Social Sciences, The University of Waikato, Hamilton, New Zealand
| | - Carol C. Barber
- School of Psychology, Faculty of Arts and Social Sciences, The University of Waikato, Hamilton, New Zealand
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Assessing Normal Smiling Function Through 3D-3D Surfaces Registration: An Innovative Method for the Assessment of Facial Mimicry. Aesthetic Plast Surg 2018; 42:456-463. [PMID: 29264683 DOI: 10.1007/s00266-017-1028-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 10/29/2017] [Indexed: 10/18/2022]
Abstract
Smiling has a great importance, both from a functional and an aesthetic point of view. The introduction of modern 3D acquisition and elaboration methods may provide additional help in the evaluation of facial mimicry. This study aims at proposing an innovative method to assess facial and labial movements in different types of smiles. Twenty healthy subjects (10 males, 10 females, mean age 27.5 years, SD 4.5 years), were recorded through a stereophotogrammetric system in neutral position and in three types of smiles: Mona-Lisa smile, canine smile, full-denture smile. All the 3D smiling models were superimposed on the corresponding neutral one and point-to-point root mean square (RMS) differences were computed. Labial surface areas in rest position and during each smile were calculated as well, together with the percentage modification in different types of smile. RMS values (facial and labial models), labial surface areas and percentage modifications were compared through ANCOVA tests to verify possible statistically significant differences according to sex and type of smile (p < 0.05). Intercanthal labial width was considered a covariate. RMS values progressively increased from Mona-Lisa to full-denture smile; statistically significant differences were found among all types of smiles, both for facial and labial models (p < 0.05), while no statistically significant sex and sex × smile interactions were found (p > 0.05). Labial surface and percentage of modification showed statistically significant differences according to both sex and type of smile (p < 0.05). The study provides a novel contribution to the field of sexual dimorphism in smiling. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Argaud S, Vérin M, Sauleau P, Grandjean D. Facial emotion recognition in Parkinson's disease: A review and new hypotheses. Mov Disord 2018; 33:554-567. [PMID: 29473661 PMCID: PMC5900878 DOI: 10.1002/mds.27305] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 12/21/2017] [Accepted: 12/22/2017] [Indexed: 02/02/2023] Open
Abstract
Parkinson's disease is a neurodegenerative disorder classically characterized by motor symptoms. Among them, hypomimia affects facial expressiveness and social communication and has a highly negative impact on patients' and relatives' quality of life. Patients also frequently experience nonmotor symptoms, including emotional-processing impairments, leading to difficulty in recognizing emotions from faces. Aside from its theoretical importance, understanding the disruption of facial emotion recognition in PD is crucial for improving quality of life for both patients and caregivers, as this impairment is associated with heightened interpersonal difficulties. However, studies assessing abilities in recognizing facial emotions in PD still report contradictory outcomes. The origins of this inconsistency are unclear, and several questions (regarding the role of dopamine replacement therapy or the possible consequences of hypomimia) remain unanswered. We therefore undertook a fresh review of relevant articles focusing on facial emotion recognition in PD to deepen current understanding of this nonmotor feature, exploring multiple significant potential confounding factors, both clinical and methodological, and discussing probable pathophysiological mechanisms. This led us to examine recent proposals about the role of basal ganglia-based circuits in emotion and to consider the involvement of facial mimicry in this deficit from the perspective of embodied simulation theory. We believe our findings will inform clinical practice and increase fundamental knowledge, particularly in relation to potential embodied emotion impairment in PD. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Soizic Argaud
- Behavior and Basal Ganglia Research Unit (EA4712)University of Rennes 1RennesFrance
- Neuroscience of Emotion and Affective Dynamics laboratory, Department of Psychology and Educational SciencesUniversity of GenevaGenevaSwitzerland
| | - Marc Vérin
- Behavior and Basal Ganglia Research Unit (EA4712)University of Rennes 1RennesFrance
- Department of NeurologyRennes University HospitalRennesFrance
| | - Paul Sauleau
- Behavior and Basal Ganglia Research Unit (EA4712)University of Rennes 1RennesFrance
- Department of NeurophysiologyRennes University HospitalRennesFrance
| | - Didier Grandjean
- Neuroscience of Emotion and Affective Dynamics laboratory, Department of Psychology and Educational SciencesUniversity of GenevaGenevaSwitzerland
- Swiss Center for Affective SciencesCampus BiotechGenevaSwitzerland
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Adamaszek M, D’Agata F, Steele CJ, Sehm B, Schoppe C, Strecker K, Woldag H, Hummelsheim H, Kirkby KC. Comparison of visual and auditory emotion recognition in patients with cerebellar and Parkinson´s disease. Soc Neurosci 2018; 14:195-207. [DOI: 10.1080/17470919.2018.1434089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Michael Adamaszek
- Department of Clinical and Cognitive Neurorehabilitation, Klinik Bavaria Kreischa, Kreischa, Germany
| | - Federico D’Agata
- Department of Neuroscience, AOU San Giovanni Battista Turin, Turin, Italy
| | - Christopher J. Steele
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Bernhard Sehm
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Cornelia Schoppe
- Department of Neurology, Neuropsychology, Sachsenklinik Bad Lausick, Bad Lausick, Germany
| | - Karl Strecker
- Department of Neurology, Neuropsychology, Sachsenklinik Bad Lausick, Bad Lausick, Germany
- Center for Neurological Rehabilitation, Leipzig University, Bennewitz, Germany
| | - Hartwig Woldag
- Department of Neurology, Neuropsychology, Sachsenklinik Bad Lausick, Bad Lausick, Germany
- Center for Neurological Rehabilitation, Leipzig University, Bennewitz, Germany
| | - Horst Hummelsheim
- Department of Neurology, Neuropsychology, Sachsenklinik Bad Lausick, Bad Lausick, Germany
- Center for Neurological Rehabilitation, Leipzig University, Bennewitz, Germany
| | - Kenneth C. Kirkby
- Psychiatry, School of Medicine, University of Tasmania, Hobart, Australia
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Rymarczyk K, Żurawski Ł, Jankowiak-Siuda K, Szatkowska I. Neural Correlates of Facial Mimicry: Simultaneous Measurements of EMG and BOLD Responses during Perception of Dynamic Compared to Static Facial Expressions. Front Psychol 2018; 9:52. [PMID: 29467691 PMCID: PMC5807922 DOI: 10.3389/fpsyg.2018.00052] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 01/12/2018] [Indexed: 11/13/2022] Open
Abstract
Facial mimicry (FM) is an automatic response to imitate the facial expressions of others. However, neural correlates of the phenomenon are as yet not well established. We investigated this issue using simultaneously recorded EMG and BOLD signals during perception of dynamic and static emotional facial expressions of happiness and anger. During display presentations, BOLD signals and zygomaticus major (ZM), corrugator supercilii (CS) and orbicularis oculi (OO) EMG responses were recorded simultaneously from 46 healthy individuals. Subjects reacted spontaneously to happy facial expressions with increased EMG activity in ZM and OO muscles and decreased CS activity, which was interpreted as FM. Facial muscle responses correlated with BOLD activity in regions associated with motor simulation of facial expressions [i.e., inferior frontal gyrus, a classical Mirror Neuron System (MNS)]. Further, we also found correlations for regions associated with emotional processing (i.e., insula, part of the extended MNS). It is concluded that FM involves both motor and emotional brain structures, especially during perception of natural emotional expressions.
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Affiliation(s)
- Krystyna Rymarczyk
- Department of Experimental Psychology, Institute of Cognitive and Behavioural Neuroscience, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Łukasz Żurawski
- Laboratory of Psychophysiology, Department of Neurophysiology, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Warsaw, Poland
| | - Kamila Jankowiak-Siuda
- Department of Experimental Psychology, Institute of Cognitive and Behavioural Neuroscience, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Iwona Szatkowska
- Laboratory of Psychophysiology, Department of Neurophysiology, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Warsaw, Poland
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Picou EM, Singh G, Goy H, Russo F, Hickson L, Oxenham AJ, Buono GH, Ricketts TA, Launer S. Hearing, Emotion, Amplification, Research, and Training Workshop: Current Understanding of Hearing Loss and Emotion Perception and Priorities for Future Research. Trends Hear 2018; 22:2331216518803215. [PMID: 30270810 PMCID: PMC6168729 DOI: 10.1177/2331216518803215] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 08/18/2018] [Accepted: 09/03/2018] [Indexed: 12/19/2022] Open
Abstract
The question of how hearing loss and hearing rehabilitation affect patients' momentary emotional experiences is one that has received little attention but has considerable potential to affect patients' psychosocial function. This article is a product from the Hearing, Emotion, Amplification, Research, and Training workshop, which was convened to develop a consensus document describing research on emotion perception relevant for hearing research. This article outlines conceptual frameworks for the investigation of emotion in hearing research; available subjective, objective, neurophysiologic, and peripheral physiologic data acquisition research methods; the effects of age and hearing loss on emotion perception; potential rehabilitation strategies; priorities for future research; and implications for clinical audiologic rehabilitation. More broadly, this article aims to increase awareness about emotion perception research in audiology and to stimulate additional research on the topic.
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Affiliation(s)
- Erin M. Picou
- Vanderbilt University School of
Medicine, Nashville, TN, USA
| | - Gurjit Singh
- Phonak Canada, Mississauga, ON,
Canada
- Department of Speech-Language Pathology,
University of Toronto, ON, Canada
- Department of Psychology, Ryerson
University, Toronto, ON, Canada
| | - Huiwen Goy
- Department of Psychology, Ryerson
University, Toronto, ON, Canada
| | - Frank Russo
- Department of Psychology, Ryerson
University, Toronto, ON, Canada
| | - Louise Hickson
- School of Health and Rehabilitation
Sciences, University of Queensland, Brisbane, Australia
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Pohl A, Anders S, Chen H, Patel HJ, Heller J, Reetz K, Mathiak K, Binkofski F. Impaired Emotional Mirroring in Parkinson's Disease-A Study on Brain Activation during Processing of Facial Expressions. Front Neurol 2017; 8:682. [PMID: 29326646 PMCID: PMC5741645 DOI: 10.3389/fneur.2017.00682] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 11/29/2017] [Indexed: 11/23/2022] Open
Abstract
Background Affective dysfunctions are common in patients with Parkinson’s disease, but the underlying neurobiological deviations have rarely been examined. Parkinson’s disease is characterized by a loss of dopamine neurons in the substantia nigra resulting in impairment of motor and non-motor basal ganglia-cortical loops. Concerning emotional deficits, some studies provide evidence for altered brain processing in limbic- and lateral-orbitofrontal gating loops. In a second line of evidence, human premotor and inferior parietal homologs of mirror neuron areas were involved in processing and understanding of emotional facial expressions. We examined deviations in brain activation during processing of facial expressions in patients and related these to emotion recognition accuracy. Methods 13 patients and 13 healthy controls underwent an emotion recognition task and a functional magnetic resonance imaging (fMRI) measurement. In the Emotion Hexagon test, participants were presented with blends of two emotions and had to indicate which emotion best described the presented picture. Blended pictures with three levels of difficulty were included. During fMRI scanning, participants observed video clips depicting emotional, non-emotional, and neutral facial expressions or were asked to produce these facial expressions themselves. Results Patients performed slightly worse in the emotion recognition task, but only when judging the most ambiguous facial expressions. Both groups activated inferior frontal and anterior inferior parietal homologs of mirror neuron areas during observation and execution of the emotional facial expressions. During observation, responses in the pars opercularis of the right inferior frontal gyrus, in the bilateral inferior parietal lobule and in the bilateral supplementary motor cortex were decreased in patients. Furthermore, in patients, activation of the right anterior inferior parietal lobule was positively related to accuracy in the emotion recognition task. Conclusion Our data provide evidence for a contribution of human homologs of monkey mirror areas to the emotion recognition deficit in Parkinson’s disease.
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Affiliation(s)
- Anna Pohl
- Department of Psychology, University of Cologne, Cologne, Germany.,Division of Clinical Cognitive Sciences, RWTH Aachen University, Aachen, Germany
| | - Silke Anders
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Hong Chen
- Division of Clinical Cognitive Sciences, RWTH Aachen University, Aachen, Germany
| | - Harshal Jayeshkumar Patel
- Division of Clinical Cognitive Sciences, RWTH Aachen University, Aachen, Germany.,Institute of Neuroscience and Medicine (INM-4), Research Center Jülich GmbH, Jülich, Germany
| | - Julia Heller
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,Jülich Aachen Research Alliance (JARA), Translational Brain Medicine, Aachen, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,Jülich Aachen Research Alliance (JARA), Translational Brain Medicine, Aachen, Germany
| | - Klaus Mathiak
- Jülich Aachen Research Alliance (JARA), Translational Brain Medicine, Aachen, Germany.,Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - Ferdinand Binkofski
- Division of Clinical Cognitive Sciences, RWTH Aachen University, Aachen, Germany.,Institute of Neuroscience and Medicine (INM-4), Research Center Jülich GmbH, Jülich, Germany.,Jülich Aachen Research Alliance (JARA), Translational Brain Medicine, Aachen, Germany
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Jin Y, Mao Z, Ling Z, Xu X, Zhang Z, Yu X. Altered emotional recognition and expression in patients with Parkinson's disease. Neuropsychiatr Dis Treat 2017; 13:2891-2902. [PMID: 29225467 PMCID: PMC5708195 DOI: 10.2147/ndt.s149227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) patients exhibit deficits in emotional recognition and expression abilities, including emotional faces and voices. The aim of this study was to explore emotional processing in pre-deep brain stimulation (pre-DBS) PD patients using two sensory modalities (visual and auditory). METHODS Fifteen PD patients who needed DBS surgery and 15 healthy, age- and gender-matched controls were recruited as participants. All participants were assessed by the Karolinska Directed Emotional Faces database 50 Faces Recognition test. Vocal recognition was evaluated by the Montreal Affective Voices database 50 Voices Recognition test. For emotional facial expression, the participants were asked to imitate five basic emotions (neutral, happiness, anger, fear, and sadness). The subjects were required to express nonverbal vocalizations of the five basic emotions. Fifteen Chinese native speakers were recruited as decoders. We recorded the accuracy of the responses, reaction time, and confidence level. RESULTS For emotional recognition and expression, the PD group scored lower on both facial and vocal emotional processing than did the healthy control group. There were significant differences between the two groups in both reaction time and confidence level. A significant relationship was also found between emotional recognition and emotional expression when considering all participants between the two groups together. CONCLUSION The PD group exhibited poorer performance on both the recognition and expression tasks. Facial emotion deficits and vocal emotion abnormalities were associated with each other. In addition, our data allow us to speculate that emotional recognition and expression may share a common system.
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Affiliation(s)
- Yazhou Jin
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Zhiqi Mao
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Zhipei Ling
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Xin Xu
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Zhiyuan Zhang
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Xinguang Yu
- Department of Neurosurgery, People's Liberation Army General Hospital, Beijing, People's Republic of China
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Bologna M, Berardelli I, Paparella G, Marsili L, Ricciardi L, Fabbrini G, Berardelli A. Altered Kinematics of Facial Emotion Expression and Emotion Recognition Deficits Are Unrelated in Parkinson's Disease. Front Neurol 2016; 7:230. [PMID: 28018287 PMCID: PMC5155007 DOI: 10.3389/fneur.2016.00230] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 12/01/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Altered emotional processing, including reduced emotion facial expression and defective emotion recognition, has been reported in patients with Parkinson's disease (PD). However, few studies have objectively investigated facial expression abnormalities in PD using neurophysiological techniques. It is not known whether altered facial expression and recognition in PD are related. OBJECTIVE To investigate possible deficits in facial emotion expression and emotion recognition and their relationship, if any, in patients with PD. METHODS Eighteen patients with PD and 16 healthy controls were enrolled in this study. Facial expressions of emotion were recorded using a 3D optoelectronic system and analyzed using the facial action coding system. Possible deficits in emotion recognition were assessed using the Ekman test. Participants were assessed in one experimental session. Possible relationship between the kinematic variables of facial emotion expression, the Ekman test scores, and clinical and demographic data in patients were evaluated using the Spearman's test and multiple regression analysis. RESULTS The facial expression of all six basic emotions had slower velocity and lower amplitude in patients in comparison to healthy controls (all Ps < 0.05). Patients also yielded worse Ekman global score and disgust, sadness, and fear sub-scores than healthy controls (all Ps < 0.001). Altered facial expression kinematics and emotion recognition deficits were unrelated in patients (all Ps > 0.05). Finally, no relationship emerged between kinematic variables of facial emotion expression, the Ekman test scores, and clinical and demographic data in patients (all Ps > 0.05). CONCLUSION The results in this study provide further evidence of altered emotional processing in PD. The lack of any correlation between altered facial emotion expression kinematics and emotion recognition deficits in patients suggests that these abnormalities are mediated by separate pathophysiological mechanisms.
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Affiliation(s)
- Matteo Bologna
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Neuromed Institute IRCCS, Pozzilli, Isernia, Italy
| | - Isabella Berardelli
- Department of Neurology and Psychiatry, Sapienza University of Rome , Rome , Italy
| | - Giulia Paparella
- Department of Neurology and Psychiatry, Sapienza University of Rome , Rome , Italy
| | - Luca Marsili
- Department of Neurology and Psychiatry, Sapienza University of Rome , Rome , Italy
| | | | - Giovanni Fabbrini
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Neuromed Institute IRCCS, Pozzilli, Isernia, Italy
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Neuromed Institute IRCCS, Pozzilli, Isernia, Italy
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