Behavioral and Neuroimaging Evidence for Facial Emotion Recognition in Elderly Korean Adults with Mild Cognitive Impairment, Alzheimer’s Disease, and Frontotemporal Dementia

Abstract

Background: Facial emotion recognition (FER) is impaired in individuals with frontotemporal dementia (FTD) and Alzheimer’s disease (AD) when compared to healthy older adults. Since deficits in emotion recognition are closely related to caregiver burden or social interactions, researchers have fundamental interest in FER performance in patients with dementia.Purpose: The purpose of this study was to identify the performance profiles of six facial emotions (i.e., fear, anger, disgust, sadness, surprise, and happiness) and neutral faces measured among Korean healthy control (HCs), and those with mild cognitive impairment (MCI), AD, and FTD. Additionally, the neuroanatomical correlates of facial emotions were investigated.Methods: A total of 110 (33 HC, 32 MCI, 32 AD, 13 FTD) older adult participants were recruited from two different medical centers in metropolitan areas of South Korea. These individuals underwent an FER test that was used to assess the recognition of emotions or absence of emotion (neutral) in 35 facial stimuli. Repeated measures two-way analyses of variance were used to examine the distinct profiles of emotional recognition among the four groups. We also performed brain imaging and voxel-based morphometry (VBM) on the participants to examine the associations between FER scores and gray matter volume.Results: The mean score of negative emotion recognition (i.e., fear, anger, disgust, and sadness) clearly discriminated FTD participants from individuals with MCI and AD and HC [F(3,106) = 10.829, p < 0.001, η2 = 0.235], whereas the mean score of positive emotion recognition (i.e., surprise and happiness) did not. A VBM analysis showed negative emotions were correlated with gray matter volume of anterior temporal regions, whereas positive emotions were related to gray matter volume of fronto-parietal regions.Conclusion: Impairment of negative FER in patients with FTD is cross-cultural. The discrete neural correlates of FER indicate that emotional recognition processing is a multi-modal system in the brain. Focusing on the negative emotion recognition is a more effective way to discriminate healthy aging, MCI, and AD from FTD in older Korean adults.

Empathy and Theory of Mind in Alzheimer’s Disease: A Meta-analysis

“…Failures of ToM refer to difficulties understanding the mental states of others and appreciating that these mental states might differ from our own (Poletti et al, 2012). In AD, these social cognitive deficits have been linked to both volumetric loss and white matter pathology (Dermody et al, 2016;Guntekin et al, 2019;Kanske et al, 2015;Lee et al, 2013;Park et al, 2017;Poletti et al, 2012;Sturm et al, 2013). Consequently, it is unsurprising that both types of impairment grow more severe with disease progression (Fliss et al, 2016;Kumfor et al, 2014;Sturm et al, 2013;Torres et al, 2015).…”

Neurophthalmologic and Orthoptic Ambulatory Assessments Reveal Ocular and Visual Changes in Patients With Early Alzheimer and Parkinson's Disease

“…In a quantitative MRI study, a direct correlation has been found between temporal volume and low score in negative facial expression recognition. However, while previous reports agree with the observation that negative emotions are poorly recognized in AD and PD, conflicting results have been obtained when searching for a specific emotion (39,40). Most studies on facial expression recognition have been made using a static image presentation, which is a less naturalistic and less-sensitive approach.…”

Changes in Computer-Analyzed Facial Expressions with Age

“… The facial stimuli representing the six basic emotions and the neutral emotion, adapted from [ 60 ]. …”