Emotion recognition in early Parkinson’s disease patients undergoing deep brain stimulation or dopaminergic therapy: a comparison to healthy participants

Abstract

Parkinson’s disease (PD) is traditionally regarded as a neurodegenerative movement disorder, however, nigrostriatal dopaminergic degeneration is also thought to disrupt non-motor loops connecting basal ganglia to areas in frontal cortex involved in cognition and emotion processing. PD patients are impaired on tests of emotion recognition, but it is difficult to disentangle this deficit from the more general cognitive dysfunction that frequently accompanies disease progression. Testing for emotion recognition deficits early in the disease course, prior to cognitive decline, better assesses the sensitivity of these non-motor corticobasal ganglia-thalamocortical loops involved in emotion processing to early degenerative change in basal ganglia circuits. In addition, contrasting this with a group of healthy aging individuals demonstrates changes in emotion processing specific to the degeneration of basal ganglia circuitry in PD. Early PD patients (EPD) were recruited from a randomized clinical trial testing the safety and tolerability of deep brain stimulation (DBS) of the subthalamic nucleus (STN-DBS) in early-staged PD. EPD patients were previously randomized to receive optimal drug therapy only (ODT), or drug therapy plus STN-DBS (ODT + DBS). Matched healthy elderly controls (HEC) and young controls (HYC) also participated in this study. Participants completed two control tasks and three emotion recognition tests that varied in stimulus domain. EPD patients were impaired on all emotion recognition tasks compared to HEC. Neither therapy type (ODT or ODT + DBS) nor therapy state (ON/OFF) altered emotion recognition performance in this study. Finally, HEC were impaired on vocal emotion recognition relative to HYC, suggesting a decline related to healthy aging. This study supports the existence of impaired emotion recognition early in the PD course, implicating an early disruption of fronto-striatal loops mediating emotional function.

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

“…Although we are usually exposed to dynamic expressions in real‐life situations, very few studies investigating FER in PD used dynamic stimuli 30, 48, 49, 50. Because emotions are defined as transitory changes in several components of the organism, the dynamism of facial expressions plays a major role in emotion perception with a beneficial effect on FER accuracy 51.…”

“…Although we are usually exposed to dynamic expressions in real-life situations, very few studies investigating FER in PD used dynamic stimuli. 30,[48][49][50] Because emotions are defined as transitory changes in several components of the organism, the dynamism of facial expressions plays a major role in emotion perception with a beneficial effect on FER accuracy. 51 Moreover, neuroimaging studies have highlighted differential neural activity for static versus dynamic facial emotions, with higher activation in response to dynamic stimuli in regions processing socioemotional information, motion and faces and that belong to the mirror neuron system: superior temporal sulcus (STS), visual area, fusiform gyrus, inferior frontal gyrus, amygdala, and orbitofrontal cortex (OFC).…”

“…[32][33][34]94 Others failed to find any difference between patients without DRT and HCs. 18., 49 Only Sprengelmeyer et al 68 directly compared medicated and unmedicated patients on FER. They reported a deficit in patients whatever the treatment condition, but found a greater one among unmedicated patients.…”

Different effects of levodopa and subthalamic stimulation on emotional conflict in Parkinson's disease

“…However, the mood and behavioral changes after surgery remain somewhat unclear, as does the influence of STN DBS on the affective domain of Parkinson's disease (Castrioto, Lhommée, Moro, & Krack, 2014). While several studies comparing patients before and after surgery highlight a further deterioration in facial emotion and prosody recognition (Aiello et al, 2014;Biseul et al, 2005;Drapier et al, 2008;Dujardin, Blairy, Defebvre, Krystkowiak, et al, 2004b;Le Jeune et al, 2008;Peron, Biseul, et al, 2010a;Peron, Grandjean, et al, 2010b;Vicente et al, 2009), others found no such effect of STN DBS (Albuquerque et al, 2014;McIntosh et al, 2014). Likewise, while enhanced mood and emotional processing has been reported (Bruck, Wildgruber, Kreifelts, Krüger, & Wächter, 2011;Castner et al, 2007;Schneider et al, 2003), so has worsening (Schroeder et al, 2004;Serranova et al, 2011) or no change (Berney et al, 2007).…”

Selenomethionine Ameliorates Neuropathology in the Olfactory Bulb of a Triple Transgenic Mouse Model of Alzheimer’s Disease

“…In AD mice, olfactory deficits also occurred before the clinical onset of cognitive deficits and coincided with AD pathology [5,6,7]. Olfactory dysfunction is prevalent in patients with AD and mild cognitive impairment [8], as the neuropathological abnormalities in both central and peripheral olfactory systems have been described in AD patients. Thus, olfactory dysfunction has been proposed as a potential biomarker for AD diagnosis [9,10].…”