An Exploratory Study on Facial Emotion Recognition Capacity in Beginning Alzheimer’s Disease

Abstract

Objective: It was the aim of this study to investigate facial emotion recognition (FER) in the elderly with cognitive impairment. Method: Twelve patients with Alzheimer’s disease (AD) and 12 healthy control subjects were asked to name dynamic or static pictures of basic facial emotions using the Multimodal Emotion Recognition Test and to assess the degree of their difficulty in the recognition task, while their electrodermal conductance was registered as an unconscious processing measure. Results: AD patients had lower objective recognition performances for disgust and fear, but only disgust was accompanied by decreased subjective FER in AD patients. The electrodermal response was similar in all groups. No significant effect of dynamic versus static emotion presentation on FER was found. Conclusion: Selective impairment in recognizing facial expressions of disgust and fear may indicate a nonlinear decline in FER capacity with increasing cognitive impairment and result from progressive though specific damage to neural structures engaged in emotional processing and facial emotion identification. Although our results suggest unchanged unconscious FER processing with increasing cognitive impairment, further investigations on unconscious FER and self-awareness of FER capacity in neurodegenerative disorders are required.

Learning from Normal Aging:Preserved Emotional Functioning Facilitates Adaptation among Early Alzheimer’s Disease Patient

“…Compared with mood disorders patients and healthy older adults, AD patients tend to select happy but not negative labels in emotion recognition tasks [66]. Consistently, Wiechetek and his colleagues [67] also found that AD patients preserved the recognitions of happy but not fear or disgust faces. By adopting a sophisticated matching task, a recent study [68] showed that only the abilities to recognize happy but not sad or angry faces were relatively preserved among early AD patients.…”

Perception of emotions in mild cognitive impairment and Alzheimer’s dementia: does intensity matter?

“…Diagnosis of possible or probable Alzheimer’s disease in seventeen studies were made according to criteria of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimers Disease and Related Disorders Association (NINCDS/ADRDA) [ 4 , 12 , 13 , 15 – 17 , 19 , 21 , 23 , 25 , 27 , 28 , 31 , 33 , 35 , 38 , 39 ], or based on the DMS-IV TR criteria [ 18 , 22 , 24 , 31 ]. Other studies also used biomarkers [ 14 ] or a geriatric evaluation [ 18 ] and in one study the specific criteria used to isolate possible or probable AD were unclear [ 26 ].…”

“…Control participants included informal caregivers of the AD patients [ 15 , 25 , 26 ], spouses [ 25 ], other relatives [ 4 , 39 ], community-based healthy elderly [ 4 , 15 , 16 , 17 , 19 , 24 , 25 , 29 , 30 , 35 , 38 , 39 ], non-demented patients from (neurological) hospitals [ 13 , 22 , 34 , 37 ], outpatient clinics [ 22 , 23 ], research centres [ 36 ], paid volunteers [ 20 ] or residents of a long-term care facility [ 12 , 33 ]. In some studies the control group was not specified [ 14 , 18 , 21 , 27 , 28 , 31 , 32 ].…”

“…One study also matched a semantic dementia patient group with an AD patient group on Clinical Dementia Rating (CDR) scores and frontotemporal dementia (FTD) rating scale scores [ 25 ] and another study matched participants on depressive symptoms and attentional performance [ 39 ]. Four studies had a significantly older patient group compared to the controls [ 21 , 22 , 26 , 38 ] and one study had a control group with higher levels of education [ 4 ].…”

Personality and social cognition in neurodegenerative disease

“…While decreased recognition of static emotions has often been reported in AD patients [15–17], these studies either did not control for patients’ general cognitive impairment [17], or reported that emotion labeling was predicted by executive functions (EF) and MMSE scores [16]. Variable results in such studies over the past decade suggest that AD patients’ failure on tests measuring facial emotion identification may often reflect general cognitive or perceptual impairment rather than a focal emotion processing deficit.…”