Facial emotion recognition in children treated for posterior fossa tumours and typically developing children: A divergence of predictors

Abstract

Facial emotion recognition (FER) deficits are evident and pervasive across neurodevelopmental, psychiatric, and acquired brain disorders in children, including children treated for brain tumours. Such deficits are thought to perpetuate challenges with social relationships and decrease quality of life. The present study combined eye-tracking, neuroimaging and cognitive assessments to evaluate if visual attention, brain structure, and general cognitive function contribute to FER in children treated for posterior fossa (PF) tumours (patients: n = 36) and typically developing children (controls: n = 18). To assess FER, all participants completed the Diagnostic Analysis of Nonverbal Accuracy (DANVA2), a computerized task that measures FER using photographs, while their eye-movements were recorded. Patients made more FER errors than controls ( p < .01). Although we detected subtle deficits in visual attention and general cognitive function in patients, we found no associations with FER. Compared to controls, patients had evidence of white matter (WM) damage, (i.e., lower fractional anisotropy [FA] and higher radial diffusivity [RD]), in multiple regions throughout the brain (all p < .05), but not in specific WM tracts associated with FER. Despite the distributed WM differences between groups, WM predicted FER in controls only. In patients, factors associated with their disease and treatment predicted FER. Our study provides insight into predictors of FER that may be unique to children treated for PF tumours, and highlights a divergence in associations between brain structure and behavioural outcomes in clinical and typically developing populations; a concept that may be broadly applicable to other neurodevelopmental and clinical populations that experience FER deficits.

Reduced Fusiform Gyrus Activation During Face Processing in Pediatric Brain Tumor Survivors

“…Additional neuroimaging research, particularly longitudinal studies and those that have sufficient samples to evaluate the effects of specific treatment variables (e.g., radiation field and dose), is needed to determine the neurobiological processes underlying the social difficulties of PBTS. Findings from the current study provide an important perspective for prior research with PBTS showing reduced facial affect recognition accuracy (Bonner et al, 2008;Moxon-Emre et al, 2019) and diminished gaze preference for faces when observing social interactions (Hocking et al, 2020). Hypoactivation in the specialized face processing areas of the fusiform gyrus may underlie these social information processing difficulties in survivors and contribute to a negative feedback loop.…”

“…Increased face processing difficulties also were related to more parent-reported social adjustment difficulties (Bonner et al, 2008). This finding of increased errors in face processing was recently replicated in youth treated for posterior fossa tumors (Moxon-Emre et al, 2019). Another study, showed face processing to be uniquely important to the social functioning of PBTS (Hocking et al, 2021).…”

“…Further, recent evidence suggests that PBTS gaze less at faces during social situations than TD youth and in a manner consistent with youth with ASD (Hocking et al, 2020) suggesting reduced experience in processing facial information. Two recent studies have evaluated the neurobiological factors associated with the face processing abilities of PBTS (Moxon-Emre et al, 2019;Moxon-Emre et al, 2020), focusing on associations between the processing of facial expressions and structural connectivity (e.g., white matter). However, no studies have used functional neuroimaging modalities to evaluate neural activity during face processing.…”

Social cognition and adjustment in adult survivors of pediatric central nervous system tumors

“…A few studies have examined specific social cognitive processes that underly and are necessary to successfully perform social tasks, 19 with a focus on facial affect or emotion recognition. [20][21][22][23][24][25] Collectively, CNS tumor survivors demonstrated difficulties identifying and interpreting facial expression of emotions, which in turn were associated with problems with friendships 26 and parent-reported social adjustment difficulties. 25 However, whether difficulties with affect recognition are also present in adult survivors or are associated with the attainment of expected functional outcomes in adulthood remain unknown.…”

“…In summary, our results address important gaps in the literature by describing social cognition and adjustment in long-term survivors of pediatric CNS tumors, identifying clinical and neurocognitive risk factors for poor social cognition, and describing its negative impact on attainment of functional outcomes. Future studies should investigate social cognition and neurocognitive functioning in high-risk subgroups such as medulloblastoma survivors, with a focus on neural underpinnings that may elucidate potential mechanisms linking brain damage and poor outcomes and informing potential targets for intervention 21,24,45. AUTHOR CONTRIBUTIONS Chiara Papini: Formal analysis, visualization, writing -original draft, and writing -review and editing.…”