Visual Behavior, Pupil Dilation, and Ability to Identify Emotions From Facial Expressions After Stroke

Abstract

Social cognition is the innate human ability to interpret the emotional state of others from contextual verbal and non-verbal information, and to self-regulate accordingly. Facial expressions are one of the most relevant sources of non-verbal communication, and their interpretation has been extensively investigated in the literature, using both behavioral and physiological measures, such as those derived from visual activity and visual responses. The decoding of facial expressions of emotion is performed by conscious and unconscious cognitive processes that involve a complex brain network that can be damaged after cerebrovascular accidents. A diminished ability to identify facial expressions of emotion has been reported after stroke, which has traditionally been attributed to impaired emotional processing. While this can be true, an alteration in visual behavior after brain injury could also negatively contribute to this ability. This study investigated the accuracy, distribution of responses, visual behavior, and pupil dilation of individuals with stroke while identifying emotional facial expressions. Our results corroborated impaired performance after stroke and exhibited decreased attention to the eyes, evidenced by a diminished time and number of fixations made in this area in comparison to healthy subjects and comparable pupil dilation. The differences in visual behavior reached statistical significance in some emotions when comparing individuals with stroke with impaired performance with healthy subjects, but not when individuals post-stroke with comparable performance were considered. The performance dependence of visual behavior, although not determinant, might indicate that altered visual behavior could be a negatively contributing factor for emotion recognition from facial expressions.

Identifying and regulating emotions after acquired brain injury: the role of interoceptive sensibility

“…First, our findings showed that participants with ABI tended to show lower emotional awareness and emotion regulation abilities and more severe depressive symptoms than their matched controls. These results are consistent with previous studies indicating that ABI usually involves deficits in emotional processing ( Cooper et al, 2015 ; Maza et al, 2020 ; Quemada, 2020 ). Similarly, a large body of research highlights the high prevalence rate of psychopathological disturbances in this clinical condition, including depressive symptomatology ( Hackett and Pickles, 2014 ; Scholten et al, 2016 ).…”

Left Anterior Insular Lesions Result in Impaired Recognition of Facial Expressions of Negative Emotions

“…We did not observe impairments in disgust recognition in our patients which is in line with previous ndings (7,31) though also impaired capabilities have been reported (32). In accordance with previous work (6, 21), happiness was the easiest expression to identify compared to negative facial expressions and accurately recognized by our patients.…”

Structural integrity of the insula and emotional facial recognition performance following stroke

“…Similar findings have been reported in a previous study. 5 Stroke patients were not impaired during the processing of disgusted expressions, which is in line with previous findings 6 , 48 though also impaired capabilities have been reported. 49 Stroke patients showed normal response times, which suggests that correct recognitions did not simply result from prolonged evaluation or decision making processes and, hence, that impairments in our stroke cohort were rather mild.…”