Luca Marsili1, Rocco Agostino1, Matteo Bologna2, Daniele Belvisi2, Adalgisa Palma1, Giovanni Fabbrini3, Alfredo Berardelli4. 1. Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy. 2. Neuromed Institute IRCCS, Pozzilli (Is), Italy. 3. Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Neuromed Institute IRCCS, Pozzilli (Is), Italy. 4. Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Neuromed Institute IRCCS, Pozzilli (Is), Italy. Electronic address: alfredo.berardelli@uniroma1.it.
Abstract
OBJECTIVE: Impaired facial expression, including spontaneous and emotional movements such as smiling, has been often reported in Parkinson's disease (PD). There is a general consensus that spontaneous smiling is abnormal in PD. Investigations on posed smiling yield contrasting results. Moreover, no study has yet addressed the relationship between posed smiling and abnormalities of voluntary movements of the lower face, global motor impairment and the effects of dopaminergic medication. METHODS: We investigated the kinematics of posed smiling (mimicking a smile shown in a picture) and those of voluntary movements of the lower face (showing the teeth as fast as possible - voluntary grinning) in 15 patients with PD (ON and OFF therapy) and in 16 healthy controls. Facial movements were recorded using a 3D optoelectronic system and analyzed using dedicated software. RESULTS: Some kinematic parameters of both posed smiling and voluntary grinning were abnormally lower in PD patients in comparison to healthy subjects. The kinematics of posed smiling correlated with those of voluntary grinning in PD patients but not in healthy controls. Posed smiling and voluntary grinning abnormalities were related to global motor severity but did not significantly improve upon L-dopa administration. CONCLUSIONS: These results suggest that posed smiling and voluntary grinning are both abnormal in PD patients and that they are likely mediated by a common pathophysiological mechanism.
OBJECTIVE: Impaired facial expression, including spontaneous and emotional movements such as smiling, has been often reported in Parkinson's disease (PD). There is a general consensus that spontaneous smiling is abnormal in PD. Investigations on posed smiling yield contrasting results. Moreover, no study has yet addressed the relationship between posed smiling and abnormalities of voluntary movements of the lower face, global motor impairment and the effects of dopaminergic medication. METHODS: We investigated the kinematics of posed smiling (mimicking a smile shown in a picture) and those of voluntary movements of the lower face (showing the teeth as fast as possible - voluntary grinning) in 15 patients with PD (ON and OFF therapy) and in 16 healthy controls. Facial movements were recorded using a 3D optoelectronic system and analyzed using dedicated software. RESULTS: Some kinematic parameters of both posed smiling and voluntary grinning were abnormally lower in PDpatients in comparison to healthy subjects. The kinematics of posed smiling correlated with those of voluntary grinning in PDpatients but not in healthy controls. Posed smiling and voluntary grinning abnormalities were related to global motor severity but did not significantly improve upon L-dopa administration. CONCLUSIONS: These results suggest that posed smiling and voluntary grinning are both abnormal in PDpatients and that they are likely mediated by a common pathophysiological mechanism.
Authors: Adrianna M Ratajska; Anne N Nisenzon; Francesca V Lopez; Alexandra L Clark; Didem Gokcay; Michael S Okun; Dawn Bowers Journal: Laterality Date: 2021-07-05