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

Abstract

Parkinson's disease is a neurodegenerative disorder classically characterized by motor symptoms. Among them, hypomimia affects facial expressiveness and social communication and has a highly negative impact on patients' and relatives' quality of life. Patients also frequently experience nonmotor symptoms, including emotional‐processing impairments, leading to difficulty in recognizing emotions from faces. Aside from its theoretical importance, understanding the disruption of facial emotion recognition in PD is crucial for improving quality of life for both patients and caregivers, as this impairment is associated with heightened interpersonal difficulties. However, studies assessing abilities in recognizing facial emotions in PD still report contradictory outcomes. The origins of this inconsistency are unclear, and several questions (regarding the role of dopamine replacement therapy or the possible consequences of hypomimia) remain unanswered. We therefore undertook a fresh review of relevant articles focusing on facial emotion recognition in PD to deepen current understanding of this nonmotor feature, exploring multiple significant potential confounding factors, both clinical and methodological, and discussing probable pathophysiological mechanisms. This led us to examine recent proposals about the role of basal ganglia‐based circuits in emotion and to consider the involvement of facial mimicry in this deficit from the perspective of embodied simulation theory. We believe our findings will inform clinical practice and increase fundamental knowledge, particularly in relation to potential embodied emotion impairment in PD. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

The Mimicry Among Us: Intra- and Inter-Personal Mechanisms of Spontaneous Mimicry

“…This could reflect ASC participants using non-embodied, rule-based, descriptive strategies for standard emotion recognition tasks (Rutherford and McIntosh 2007;Nuske et al 2014;Winkielman et al 2009). Finally, the idea that impairments in facial mimicry contribute to poor emotion recognition has also been highlighted in another atypical, neurodegenerative disorder associated with social difficulties-Parkinson's disease (Argaud et al 2018). This suggests that relationships between spontaneous mimicry and other social-emotional processes are impactful across spectrums of (a)typical conditions, and worthy of examination into underlying mechanisms, with implications for improving human (social) life.…”

Effect of single‐session transcranial direct current stimulation on cognition in Parkinson's disease

“…This may be explained by the absence of concomitant dementia in our subjects. Indeed, recent studies indicate that facial emotional recognition deficit in PD may correlate positively with cognitive impairment …”

“…28 In addition, patients may exhibit subclinical impairment in recognizing others' facial emotion, leading to biased emotional judgments. 29 Considerable amount of evidence suggests that this facial emotional recognition deficit in PD may be explained by neural changes in a vast network of brain regions implicated in emotional processing and facial recognition-namely the ventrolateral prefrontal cortex, orbitofrontal cortex, striatum, amygdala, fusiform gyrus, and superior temporal sulcus. [30][31][32] The go/no-go task is frequently used to measure the ability to inhibit previously learned responses.…”

Subthalamic nucleus local field potentials recordings reveal subtle effects of promised reward during conflict resolution in Parkinson’s disease

“…Cognitive action control also depends on subcortical structures represented by the basal ganglia (BG). Their role is assumed to be crucial, since they are known to form cortical-subcortical loops involved in motor behavior, cognition, and emotional processing (Haber, 2014;Jahanshahi et al, 2015;Péron et al, 2013;Argaud et al, 2018). 25…”