Facial Emotion Recognition and Faux Pas Interpretation in Multiple Sclerosis

Abstract

Multiple sclerosis (MS) is an inflammatory disease of the central nervous system leading to physical and cognitive disability. The impact of the disease on social cognition has only come to light quite recently. The aim of this study was to evaluate the social cognition abilities of MS patients and their links with characteristics of the disease, such as physical disability, cognitive impairment and disease duration. The performances of a group of 64 MS patients were compared with that of 30 matched healthy individuals in facial emotion recognition and Faux Pas tasks as well as on a battery of standardized neuropsychological tests. The MS patients performed worse than the control group in the recognition of the expressions of fear and anger and in the interpretation of faux pas. The impairment in social cognition increased with overall disease course. Executive impairment did not correlate with the performance in the social cognition tests. Our results show that emotional impairment is observed at early stages of the disease in the absence of cognitive dysfunction, even if social cognition abilities worsen with the progression of MS. These data highlight the need to attempt to identify these impairments in clinical practice.

Social Cognition Abilities in Patients With Different Multiple Sclerosis Subtypes

“…In our study, patients also had difficulty recognizing the facial emotions of fear and sadness, and a statistical trend was observed for disgust recognition. In contrast to previous reports, no deficit was observed for anger recognition in the MS sample relative to controls (Henry et al, 2015, 2011, 2009; Krause et al, 2009; Lenne et al, 2014; Prochnow et al, 2011). These deficits cannot simply be explained by a facial recognition deficit, as patients with MS were only included in our study if their BFRT score was within the normal range.…”

“…The present study was designed to (a) confirm ToM and facial emotion recognition deficits in MS, (b) explore ToM and facial emotion recognition in patients with three MS subtypes, and (c) examine the impact of clinical disease characteristics and cognitive deficits, in particular executive deficits, on these processes. Consistent with previous studies, patients with MS performed significantly worse than healthy controls on the measures of facial emotion recognition (Henry et al, 2009;Phillips et al, 2011;Prochnow et al, 2011) and ToM (Banati et al, 2010;Henry et al, 2015Henry et al, , 2011Ouellet et al, 2010;Roca et al, 2014). Patients scored lower than healthy participants for all three levels of ToM, suggesting that individuals with MS have a specific ToM impairment even for simple inferences such as first-order mental state attributions.…”

“…Furthermore, one study found a small deficit in the recognition of bodily expressions of emotion (Cecchetto et al, 2014) and two impairments in affective prosody (Berneiser et al, 2014), suggesting that the emotion processing deficit is not restricted to faces in MS. A ToM deficit has also been reported by several studies (Henry et al, 2015, 2011, 2009; Ouellet et al, 2010; Pottgen et al, 2013; Roca et al, 2014). This deficit is found in both verbal and nonverbal tasks (Banati et al, 2010).…”

“…A small number of studies have examined emotion perception in patients with MS. The majority reported impaired recognition of facial emotions (Berneiser et al, 2014; Prochnow et al, 2011), especially anger and fear (Henry et al, 2015, 2011, 2009; Krause et al, 2009; Phillips et al, 2011) and, to a lesser extent, sadness (Krause et al, 2009).…”

Cognitive but Not Affective Theory of Mind Deficits in Progressive MS

“…An additional goal of the current study is to characterize the relationship between cognitive deficits and social cognitive deficits in MS, which is currently debated (Cotter et al, 2016). Although some studies have shown that social cognition in MS is significantly correlated with one's general cognition, and thus, social cognitive deficits may be explained by underlying impairments in processing speed or executive function (Ciampi et al, 2018;Henry et al, 2015Henry et al, , 2017, other studies have found cognition and social cognition to be dissociable in MS (Batista et al, 2018;Raimo et al, 2017). As there is still limited research in this area, a better understanding of the specific mechanisms contributing to social cognitive impairments in MS will allow for more refined treatments and interventions.…”