Degraded Impairment of Emotion Recognition in Parkinson’s Disease Extends from Negative to Positive Emotions

Abstract

Because of dopaminergic neurodegeneration, patients with Parkinson's disease (PD) show impairment in the recognition of negative facial expressions. In the present study, we aimed to determine whether PD patients with more advanced motor problems would show a much greater deficit in recognition of emotional facial expressions than a control group and whether impairment of emotion recognition would extend to positive emotions. Twenty-nine PD patients and 29 age-matched healthy controls were recruited. Participants were asked to discriminate emotions in Experiment 1 and identify gender in Experiment 2. In Experiment 1, PD patients demonstrated a recognition deficit for negative (sadness and anger) and positive faces. Further analysis showed that only PD patients with high motor dysfunction performed poorly in recognition of happy faces. In Experiment 2, PD patients showed an intact ability for gender identification, and the results eliminated possible abilities in the functions measured in Experiment 2 as alternative explanations for the results of Experiment 1. We concluded that patients' ability to recognize emotions deteriorated as the disease progressed. Recognition of negative emotions was impaired first, and then the impairment extended to positive emotions.

Facial emotion recognition in Parkinson's disease: A review and new hypotheses

“…Although an FER deficit has been highlighted in the early stages of the disease, 21,32,66,69,70,75 it was greater in the most severely affected patients. 15,28,29,36,38,68,76 That said, when the link between deficit magnitude and disease severity was investigated with correlations, results differed. Based on these statistics, Gray and Tickle-Degnen 12 suggested that the level of FER deficit is unrelated to the level of motor disability reflected by Hoehn and Yahr staging.…”

“…From the earliest studies, authors controlled for visual functions with tasks such as the Benton Facial Recognition Test (BFRT). 90 Some found FER impairment among patients with no deficit in neutral faces recognition, 15,16,23,29,68,69,76,91 whereas others showed that face-processing impairment co-occurs with the deficit. 24,46 Gray and Tickle-Degnen 12 did not report any significant differences in FER abilities between patients who performed normally on tests like BFRT and patients with abnormal performance.…”

“…Since 2010, only Baggio et al 64 and Linn et al 76 have reported a link between depression and FER in PD. Concomitant with depression, apathy and anxiety are also frequent in PD.…”

Social Cognition Dysfunctions in Neurodegenerative Diseases: Neuroanatomical Correlates and Clinical Implications

“…A recent meta-analytic review [ 175 ], which investigated the emotion recognition from faces and voices in PD, revealed significant and modest deficits of this ability in nondemented PD patients, independently from the level of motor disability. Furthermore, several studies revealed that PD patients were more impaired in recognizing negative emotions (anger, disgust, fear, and sadness) than positive ones (happiness, surprise) [ 176 ], while other studies suggested that the recognition of negative emotions may be impaired mainly in the early stages of PD and, then, this impairment has been shown to mainly affect the positive ones [ 177 ]. In particular, Hipp et al [ 178 ] showed that, at the early stages, PD patients might be still prone to compensate the deficient input of low contrast sensitivity that is crucial for the appreciation of negative facial emotions.…”

Non-Motor Symptoms after One Week of High Cadence Cycling in Parkinson’s Disease

“…Previous research suggested that non-motor symptoms are prevalent among individuals with PD and that they may improve after aerobic exercise interventions, although this was not supported by our findings. Emerging literature has suggested that individuals with Parkinson’s disease may have a deficit in recognizing facial expression, or emotional recognition [41,42,43], hence why it was included in the non-motor assessment. Our past high cadence cycling research has primarily focused on motor symptom outcomes, such as rigidity and bradykinesia, in individuals with PD [20,21,44,45].…”