Emotion recognition and processing in patients with mild cognitive impairment: A systematic review

Mini-SEA: Validity and Normative Data for the French-Quebec Population Aged 50 Years and Above

OBJECTIVE

The mini Social cognition & Emotional Assessment (mini-SEA) is a social cognition battery which assesses theory of mind and emotion recognition. Currently, no psychometrically validated measure of social cognition with adapted normative data exists for the middle-aged and elderly French-Quebec population. This project aims to determine the known-group discriminant validity of a cultural and linguistic adaptation of the mini-SEA between cognitively healthy people, those with mild cognitive impairment (MCI) or living with Alzheimer's Disease (AD). This study also aims to examine the stability of mini-SEA's performance over a 3-4-month time period, as well as to produce normative data for French-Quebec people aged 50 years. Normative data are derived for the full and an abbreviated version of the Faux Pas subtest.

METHOD

The sample included 211 French-speaking participants from Quebec (Canada) aged 50 to 89 years. Mini-SEA's performance between a sub-sample of cognitively healthy people (n = 20), those with MCI (n = 20) or with AD (n = 20) was compared. A sub-sample of cognitively healthy people (n = 30) performed the task twice to estimate test-retest reliability. Socio-demographic variables' effects on scores were examined to produce normative data in the form of regression equations or percentile ranks.

RESULTS

Significant differences emerged between cognitively healthy people and those with MCI or AD. Moreover, scores were relatively stable over a period of 3 to 4 months. Finally, for the normative data, age, gender, and education were associated with performance on the mini-SEA or its subtests.

CONCLUSIONS

This study improves and standardizes social cognition's assessment among French-Quebec individuals, which will help characterize their cognitive profile.

Relationship between Laterality and Theory of Mind among Typical Adults - A Systematic Literature Review

Theory of Mind (ToM) is a fundamental social-cognitive ability that enables individuals to comprehend the thoughts, intentions, desires, emotions, and beliefs of others, facilitating effective communication. Any behavior can be explained by laterality; hence, ToM has been extensively examined to determine hemispheric dominance. However, empirical evidence on hemispheric dominance in ToM ability is mixed, with some studies supporting right hemisphere dominance while others suggest left hemisphere dominance. To address this contradiction, the study aims to synthesize existing evidence and provide a comprehensive understanding of the relationship between ToM and laterality to draw a collective conclusion based on the available evidence. A systematic literature review was conducted using Scopus, Web of Science, and PubMed databases to explore the stated relationship among typical adults. The review followed PRISMA guidelines toward shortlisting 37 publications for full-text review published between 2010 and 2020. Subsequently, based on the review findings, we can conclude that a greater number of studies support the involvement of the right hemisphere in the ToM ability of typical adults. Overall, the study enhances understanding of the relationship between task domains, laterality techniques, and hemisphere dominance in ToM research, offering a foundation for future empirical work.

Social cognition in mild cognitive impairment and dementia: A systematic review and meta-analysis

Social cognition is impaired in people with dementia but the differences in social cognitive impairment between mild cognitive impairment (MCI) and dementia and its subtypes remain unclear. We therefore aimed to systematically review and meta-analyze differences in emotion recognition, theory of mind (ToM), and empathy between individuals with MCI and dementia. Across 28 cross-sectional studies (n = 2409), people with MCI had better emotion recognition (Cohen's d = 0.69) and ToM (d = 0.70) than individuals with Alzheimer's disease (AD) dementia, and larger effect sizes were observed for people with frontotemporal dementia (FTD) (emotion recognition (d = 2.09), ToM (d = 1.49), but emotional empathy was higher in AD than in MCI in included studies. Our findings suggest a progressive decline of aspects of social cognition across the MCI-dementia continuum. Longitudinal studies should investigate the diagnostic role of social cognition deficits in MCI progression to dementia, and interventions for social cognition in MCI should be developed and tested. HIGHLIGHTS: First systematic review and meta-analysis comparing social cognition between mild cognitive impairment (MCI) and dementia subtypes. Findings from 28 studies with 2409 participants show people with MCI outperform those with Alzheimer's disease (AD) and frontotemporal dementia (FTD) in emotion recognition and theory of mind. Empathy appears intact in AD dementia, suggesting that this cognitive domain is preserved throughout disease progression. Evaluation of social cognition should be built into dementia assessment as it may hold diagnostic value.

Age-related reduction in anxiety and neural encoding of negative emotional memory

Introduction

Older adults experience less anxiety. We examined how memory of negative emotional images varied with age and may reflect age-related differences in anxiety.

Methods

Fifty-one adults, age 22-80 years, underwent imaging with a memory task where negative and neutral images were displayed pseudo-randomly. They were queried post-scan about the images inter-mixed with an equal number of images never displayed. Sensitivity (d') and reporting bias (Z-score of false alarm rate; Z[FAR]) were quantified with signal detection theory.

Results

Age was negatively correlated with both Spielberg State Trait Anxiety Inventory (STAI) state score and d' (negative - neutral) and positively with Z[FAR] (negative - neutral). However, STAI score and d' or Z[FAR] (negative - neutral) were not significantly correlated. In whole-brain regression, STAI score was correlated with higher activity of the right middle/superior temporal gyri/temporal parietal junction (MTG/STG/TPJ) for "negative correct - incorrect" - "neutral correct - incorrect" trials. Further, the MTG/STG/TPJ activity (β) was also negatively correlated with age. Mediation analyses supported a complete mediation model of age → less anxiety → less MTG/STG/TPJ β.

Discussion

Together, the findings demonstrated age-related changes in negative emotional memory and how age-related reduction in anxiety is reflected in diminished temporoparietal cortical activities during encoding of negative emotional memory.

Facial emotion recognition in individuals with mild cognitive impairment: An exploratory study

Understanding facial emotions is fundamental to interact in social environments and modify behavior accordingly. Neurodegenerative processes can progressively transform affective responses and affect social competence. This exploratory study examined the neurocognitive correlates of face recognition, in individuals with two mild cognitive impairment (MCI) etiologies (prodromal to dementia - MCI, or consequent to Parkinson's disease - PD-MCI). Performance on the identification and memorization of neutral and emotional facial expressions was assessed in 31 individuals with MCI, 26 with PD-MCI, and 30 healthy controls (HC). Individuals with MCI exhibited selective impairment in recognizing faces expressing fear, along with difficulties in remembering both neutral and emotional faces. Conversely, individuals with PD-MCI showed no differences compared with the HC in either emotion recognition or memory. In MCI, no significant association emerged between the memory for facial expressions and cognitive difficulties. In PD-MCI, regression analyses showed significant associations with higher-level cognitive functions in the emotional memory task, suggesting the presence of compensatory mechanisms. In a subset of participants, voxel-based morphometry revealed that the performance on emotional tasks correlated with regional changes in gray matter volume. The performance in the matching of negative expressions was predicted by volumetric changes in brain areas engaged in face and emotional processing, in particular increased volume in thalamic nuclei and atrophy in the right parietal cortex. Future studies should leverage on neuroimaging data to determine whether differences in emotional recognition are mediated by pathology-specific atrophic patterns.

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

Facial movements are crucial for social and emotional interaction and well-being. Reduced facial expressions (i.e., hypomimia) is a common feature in patients with Parkinson's disease (PD) and previous studies linked this manifestation to both motor symptoms of the disease and altered emotion recognition and processing. Nevertheless, research on facial motor impairment in PD has been rather scarce and only a limited number of clinical evaluation tools are available, often suffering from poor validation processes and high inter- and intra-rater variability. In recent years, the availability of technology-enhanced quantification methods of facial movements, such as automated video analysis and machine learning application, led to increasing interest in studying hypomimia in PD. In this narrative review, we summarize the current knowledge on pathophysiological hypotheses at the basis of hypomimia in PD, with particular focus on the association between reduced facial expressions and emotional processing and analyze the current evaluation tools and management strategies for this symptom, as well as future research perspectives.

Eye-tracking paradigms for the assessment of mild cognitive impairment: a systematic review

Mild cognitive impairment (MCI), representing the 'transitional zone' between normal cognition and dementia, has become a novel topic in clinical research. Although early detection is crucial, it remains logistically challenging at the same time. While traditional pen-and-paper tests require in-depth training to ensure standardized administration and accurate interpretation of findings, significant technological advancements are leading to the development of procedures for the early detection of Alzheimer's disease (AD) and facilitating the diagnostic process. Some of the diagnostic protocols, however, show significant limitations that hamper their widespread adoption. Concerns about the social and economic implications of the increasing incidence of AD underline the need for reliable, non-invasive, cost-effective, and timely cognitive scoring methodologies. For instance, modern clinical studies report significant oculomotor impairments among patients with MCI, who perform poorly in visual paired-comparison tasks by ascribing less attentional resources to novel stimuli. To accelerate the Global Action Plan on the Public Health Response to Dementia 2017-2025, this work provides an overview of research on saccadic and exploratory eye-movement deficits among older adults with MCI. The review protocol was drafted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases were systematically searched to identify peer-reviewed articles published between 2017 and 2022 that examined visual processing in older adults with MCI and reported gaze parameters as potential biomarkers. Moreover, following the contemporary trend for remote healthcare technologies, we reviewed studies that implemented non-commercial eye-tracking instrumentation in order to detect information processing impairments among the MCI population. Based on the gathered literature, eye-tracking-based paradigms may ameliorate the screening limitations of traditional cognitive assessments and contribute to early AD detection. However, in order to translate the findings pertaining to abnormal gaze behavior into clinical applications, it is imperative to conduct longitudinal investigations in both laboratory-based and ecologically valid settings.