Perception of affective prosody in patients at an early stage of relapsing–remitting multiple sclerosis

Abstract

Cognitive dysfunction is well known in patients suffering from multiple sclerosis (MS) and has been described for many years. Cognitive impairment, memory, and attention deficits seem to be features of advanced MS stages, whereas depression and emotional instability already occur in early stages of the disease. However, little is known about processing of affective prosody in patients in early stages of relapsing-remitting MS (RRMS). In this study, tests assessing attention, memory, and processing of affective prosody were administered to 25 adult patients with a diagnosis of RRMS at an early stage and to 25 healthy controls (HC). Early stages of the disease were defined as being diagnosed with RRMS in the last 2 years and having an Expanded Disability Status Scale (EDSS) of 2 or lower. Patients and HC were comparable in intelligence quotient (IQ), educational level, age, handedness, and gender. Patients with early stages of RRMS performed below the control group with respect to the subtests 'discrimination of affective prosody' and 'matching of affective prosody to facial expression' for the emotion 'angry' of the 'Tübingen Affect Battery'. These deficits were not related to executive performance. Our findings suggest that emotional prosody comprehension is deficient in young patients with early stages of RRMS. Deficits in discriminating affective prosody early in the disease may make misunderstandings and poor communication more likely. This might negatively influence interpersonal relationships and quality of life in patients with RRMS.

Social cognition in multiple sclerosis

“…Although studies have also investigated vocal 47,48 and bodily affect recognition 38 in this patient group, there were too few to allow inclusion in the current review. In addition, only English-language articles were eligible for inclusion, which led to the exclusion of 2 non-English-language articles found in the electronic search.…”

Social Cognition Impairments in Patients with Multiple Sclerosis and Comparison with Imaging Studies, Disease Duration and Grade of Disability

“…Pöttgen established a deficient ability to reason about the mental state of others (ToM) and to have insight into the emotional stages and feelings of others (empathy) in the early stages of RRMS [21,22], even in patients who have no substantial neuropsychological deficits. Emotional prosody comprehension may also be disrupted in the early stages of RRMS [6]. It is argued that this is the earliest social cognitive impairment in patients with MS.…”

“…Patients gave less accurate solutions to "discrimination of affective prosody" and more incorrect responses in the subtest "matching of affective prosody to facial expression" for the emotion "anger". Paradoxically, regarding the emotion "fear" they showed better results than controls [6]. Gleichgerrcht et al found that MS subjects (patients n = 38; controls n = 38) had significantly higher self-oriented personal distress (p < 0.01) and higher levels of alexithymia compared to controls [82].…”

“…In some research, the duration of the disease did not correlate with the emotional and cognitive scores from nonverbal tests [80], while Kraemer reported positive correlation between impaired social cognitive skills and executive function deficits in the early stages of the disease in fully ambulatory patients [6].…”

“…A less studied aspect of cognition is social cognition, which is not a uniform theoretical construct. It includes emotion perception, prosody, empathy, theory of mind (ToM) and assessment of mood [6,7]. Findings in MS show disturbance not only in emotion recognition from facial expressions but in the whole area of general emotion processing.…”