The Relationship between the Experience of Hypomimia and Social Wellbeing in People with Parkinson’s Disease and their Care Partners

Gunnery, Sarah D.; Habermann, Barbara; Saint‐Hilaire, Marie; Thomas, Cathi A.; Tickle-Degnen, Linda

doi:10.3233/jpd-160782

Cited by 38 publications

(49 citation statements)

References 25 publications

(30 reference statements)

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“…20 Miller et al described how communication problems (ie, voice problems) were associated with changes in socialization such as social withdrawal. 3.3 | Narrative analysis of papers by social role category 3.3.1 | General social functioning General social functioning included papers (n = 16) that described overall socialization or social functioning but did not discuss a specific social role.…”

Section: Key Pointsmentioning

confidence: 99%

“…20,21,30,35,[74][75][76][77][78] Impaired couple relationships were related to facial masking, higher Hoehn and Yahr stage, lack of coping responses (ie, spouse "benefit finding"), and sexual dysfunction. Poor general social functioning was associated with facial masking, communication problems, and cognitive impairment.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…Gunnery et al described that facial masking was associated with social functioning problems such as social rejection, although this finding was attenuated after controlling for depression. 20…”

Section: General Social Functioningmentioning

confidence: 99%

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Social role functioning in Parkinson's disease: A mixed‐methods systematic review

Perepezko

Hinkle

Shepard

et al. 2019

Int J Geriat Psychiatry

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Objectives Parkinson's disease (PD) is a progressive neurodegenerative disease that often impedes activities of daily living (ADL) and social functioning. Impairment in these areas can alter social roles by interfering with employment status, household management, friendships, and other relationships. Understanding how PD affects social functioning can help clinicians choose management strategies that mitigate these changes. Methods We conducted a mixed‐methods systematic review of existing literature on social roles and social functioning in PD. A tailored search strategy in five databases identified 51 full‐text reports that fulfilled the inclusion criteria and passed the quality appraisal. We aggregated and analyzed the results from these studies and then created a narrative summary. Results Our review demonstrates how PD causes many people to withdraw from their accustomed social roles and experience deficits in corresponding activities. We describe how PD symptoms (eg, tremor, facial masking, and neuropsychiatric symptoms) interfere with relationships (eg, couple, friends, and family) and precipitate earlier departure from the workforce. Additionally, several studies demonstrated that conventional PD therapy has little positive effect on social role functioning. Conclusions Our report presents critical insight into how PD affects social functioning and gives direction to future studies and interventions (eg, couple counseling and recreational activities).

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Section: Key Pointsmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

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Social role functioning in Parkinson's disease: A mixed‐methods systematic review

Perepezko

Hinkle

Shepard

et al. 2019

Int J Geriat Psychiatry

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“…In diseases associated with organic neuromuscular degeneration, such as intractable neurological disease or paralysis, weakness or partial deficits in facial expressions arise . Because the disease course in a patient and its treatment may influence the emotions of the patient, attention must be paid to the extent of facial expressions and changes in them . Moreover, in diseases associated with abnormal expressions or behaviors, perception of facial emotion is altered, and cognitive intervention may therefore be necessary in some cases .…”

Section: Introductionmentioning

confidence: 99%

“…4 Because the disease course in a patient and its treatment may influence the emotions of the patient, attention must be paid to the extent of facial expressions and changes in them. 5,6 Moreover, in diseases associated with abnormal expressions or behaviors, perception of facial emotion is altered, and cognitive intervention may therefore be necessary in some cases. 7 Consequently, a multifaceted understanding that helps the subjective assessment of the observer is needed.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of facial muscle activity during voluntary facial expressions: Imaging analysis of facial expressions based on myogenic potential data

Kuramoto

Yoshinaga

Nakao

et al. 2019

Neuropsychopharm Rep

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Purpose Facial expressions are formed by the coordination of facial muscles and reflect changes in emotion. Nurses observe facial expressions as way of understanding patients. This study conducted basic research using facial myogenic potential topography to visually determine changes in the location and strength of facial muscle activity associated with voluntary facial expression to examine relationships with facial expressions. Methods Participants comprised 18 healthy adults (6 men, 12 women; mean age, 24.3 ± 4.3 years). Facial myogenic potentials were measured from 19 electrodes arranged concentrically on the face, and topographic analysis was conducted. Using potential changes and topograms, the muscle activity associated with nonvoluntary facial expression and voluntary facial expressions of happiness and disgust were classified according to the characteristics of expressions. To classify homogeneous groups among the reaction of disgust, hierarchical cluster analysis was utilized. Results One characteristic of the facial expression of happiness was activity in areas including the greater zygomatic muscle. With the facial expression of disgust, characteristic changes were seen in areas including the corrugator supercilii. Cluster analysis of the expression of disgust showed four homogeneous subgroups. Conclusion With facial myogenic potential topography, facial expressions can be evaluated objectively without being influenced by face shape or countenance. Color changes in topograms showed subtle changes in expressions that could not be supplemented with statistical processing alone, and these were useful in identifying individuality. Topography is thus expected to be utilized to supplement basic knowledge of facial expressions for a better understanding of patients.

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A Pilot Trial of Dopamine Replacement for Dynamic Facial Expressions in Parkinson's Disease

Schade

Springer

Mikos

et al. 2022

Movement Disord Clin Pract

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Background Current conflict exists regarding the potential beneficial effects of dopamine medications on facial expressivity in Parkinson's disease. Via digital video analysis software, we previously found reduced facial movement (entropy) and slower time to reach peak entropy in individuals with Parkinson's disease compared to controls. Objectives We aimed to determine whether levodopa medications improved parameters of dynamic facial expressions (amplitude, speed). Methods A total of 34 individuals with idiopathic Parkinson's disease were videotaped making voluntary facial expressions (happy, fear, anger, disgust) when “on” and “off” levodopa. Participants were 52 to 80 years old, early to mid‐stage disease, non‐demented, and included more men (65%). Expressions were digitized and analyzed using software that extracted three variables: two indices of movement change (total entropy, percent entropy change) and time to reach peak expression. Results Indices of facial movement (total entropy, peak entropy) and timing were significantly improved when patients were “on” vs “off” medication (all F's ≥ 3.00, P < 0.05). For total movement and time to reach peak entropy, levodopa‐related improvements were emotion nonspecific. Levodopa‐related improvement for peak entropy was driven primarily by happy expressions. There was no relationship between quantitative indices and clinical measures of mood (depression, anxiety) and motor disease severity. Conclusion The effects of levodopa on Parkinson's disease voluntary facial movement and on timing were robust and consistent with those of levodopa on other intentional movements in Parkinson's disease. This improvement possibly occurred because of levodopa enhanced activation of face representation areas in fronto‐cortical regions or because of less movement‐based suppression.

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The Relationship between the Experience of Hypomimia and Social Wellbeing in People with Parkinson’s Disease and their Care Partners

Cited by 38 publications

References 25 publications

Social role functioning in Parkinson's disease: A mixed‐methods systematic review

Social role functioning in Parkinson's disease: A mixed‐methods systematic review

Characteristics of facial muscle activity during voluntary facial expressions: Imaging analysis of facial expressions based on myogenic potential data

A Pilot Trial of Dopamine Replacement for Dynamic Facial Expressions in Parkinson's Disease

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