Lucia Ricciardi1, Matteo Bologna2, Francesca Morgante3, Diego Ricciardi4, Bruno Morabito4, Daniele Volpe5, Davide Martino6, Alessandro Tessitore7, Massimiliano Pomponi4, Anna Rita Bentivoglio8, Roberto Bernabei4, Alfonso Fasano9. 1. Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, United Kingdom; Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy. Electronic address: lucia.ricciardi2@gmail.com. 2. Neuromed Institute (IRCCS), Pozzilli, Isernia, Italy. 3. Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy. 4. Department of Geriatry, Catholic University of Sacred Heart, Rome, Italy. 5. Department of Physical Medicine & Rehabilitation, S. Raffaele Arcangelo Fatebenefratelli Hospital, Venice, Italy. 6. Neuroscience & Trauma Centre, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London, United Kingdom. 7. Department of Neurology, Second University of Naples, Naples, Italy. 8. Department of Neurology, Catholic University of Sacred Heart, Rome, Italy. 9. Movement Disorders Center, TWH, UHN, Division of Neurology, University of Toronto, Toronto, ON, Canada.
Abstract
BACKGROUND AND AIMS: Impaired emotional facial expressiveness is an important feature in Parkinson's disease (PD). Although there is evidence of a possible relationship between reduced facial expressiveness and altered emotion recognition or imagery in PD, it is unknown whether other aspects of the emotional processing, such as subjective emotional experience (alexithymia), might influence hypomimia in this condition. In this study wee aimed to investigate possible relationship between reduced facial expressiveness and altered emotion processing (including facial recognition and alexithymia) in patients with PD. METHODS: Forty PD patients and seventeen healthy controls were evaluated. Facial expressiveness was rated on video recordings, according to the UPDRS-III item 19 and using an ad hoc scale assessing static and dynamic facial expression and posed emotions. Six blind raters evaluated the patients' videos. Emotion facial recognition was tested using the Ekman Test; alexithymia was assessed using Toronto Alexithymia Scale (TAS-20). RESULTS: PD patients had a significantly reduced static and dynamic facial expressiveness and a deficit in posing happiness and surprise. They performed significantly worse than healthy controls in recognizing surprise (p=0.03). The Ekman total score positively correlated with the global expressiveness (R^2=0.39, p=0.01) and with the expressiveness of disgust (R^2=0.32, p=0.01). The occurrence of alexithymia was not different between PD patients and HC; however, a significant negative correlation between the expressiveness of disgust was found for a subscore of TAS (R^2=-.447, p=0.007). CONCLUSIONS: Reduced facial expressiveness in PD may be in part related to difficulties with emotional recognition in a context of an unimpaired subjective emotional experience.
BACKGROUND AND AIMS: Impaired emotional facial expressiveness is an important feature in Parkinson's disease (PD). Although there is evidence of a possible relationship between reduced facial expressiveness and altered emotion recognition or imagery in PD, it is unknown whether other aspects of the emotional processing, such as subjective emotional experience (alexithymia), might influence hypomimia in this condition. In this study wee aimed to investigate possible relationship between reduced facial expressiveness and altered emotion processing (including facial recognition and alexithymia) in patients with PD. METHODS: Forty PDpatients and seventeen healthy controls were evaluated. Facial expressiveness was rated on video recordings, according to the UPDRS-III item 19 and using an ad hoc scale assessing static and dynamic facial expression and posed emotions. Six blind raters evaluated the patients' videos. Emotion facial recognition was tested using the Ekman Test; alexithymia was assessed using Toronto Alexithymia Scale (TAS-20). RESULTS:PDpatients had a significantly reduced static and dynamic facial expressiveness and a deficit in posing happiness and surprise. They performed significantly worse than healthy controls in recognizing surprise (p=0.03). The Ekman total score positively correlated with the global expressiveness (R^2=0.39, p=0.01) and with the expressiveness of disgust (R^2=0.32, p=0.01). The occurrence of alexithymia was not different between PDpatients and HC; however, a significant negative correlation between the expressiveness of disgust was found for a subscore of TAS (R^2=-.447, p=0.007). CONCLUSIONS: Reduced facial expressiveness in PD may be in part related to difficulties with emotional recognition in a context of an unimpaired subjective emotional experience.