Facial expression decoding in early Parkinson's disease.

The ability to derive emotional and non-emotional information from unfamiliar, static faces was evaluated in 21 adults with idiopathic Parkinson's disease (PD) and 21 healthy control subjects. Participants' sensitivity to emotional expressions was comprehensively assessed in tasks of discrimination, identification, and rating of five basic emotions: happiness, (pleasant) surprise, anger, disgust, and sadness. Subjects also discriminated and identified faces according to underlying phonemic ("facial speech") cues and completed a neuropsychological test battery. Results uncovered limited evidence that the processing of emotional faces differed between the two groups in our various conditions, adding to recent arguments that these skills are frequently intact in non-demented adults with PD [R. Adolphs, R. Schul, D. Tranel, Intact recognition of facial emotion in Parkinson's disease, Neuropsychology 12 (1998) 253-258]. Patients could also accurately interpret facial speech cues and discriminate the identity of unfamiliar faces in a normal manner. There were some indications that basal ganglia pathology in PD contributed to selective difficulties recognizing facial expressions of disgust, consistent with a growing literature on this topic. Collectively, findings argue that abnormalities for face processing are not a consistent or generalized feature of medicated adults with mild-moderate PD, prompting discussion of issues that may be contributing to heterogeneity within this literature. Our results imply a more limited role for the basal ganglia in the processing of emotion from static faces relative to speech prosody, for which the same PD patients exhibited pronounced deficits in a parallel set of tasks [M.D. Pell, C. Leonard, Processing emotional tone from speech in Parkinson's disease: a role for the basal ganglia, Cogn. Affect. Behav. Neurosci. 3 (2003) 275-288]. These diverging patterns allow for the possibility that basal ganglia mechanisms are more engaged by temporally-encoded social information derived from cue sequences over time.