Altered emotional recognition and expression in patients with Parkinson’s disease

Yazhou Jin,* Zhiqi Mao,* Zhipei Ling, Xin Xu, Zhiyuan Zhang, Xinguang Yu Department of Neurosurgery, People’s Liberation Army General Hospital, Beijing, People’s Republic of China *These authors contributed equally to this work Background: Parkinson’s disease (PD) patients exhibit deficits in emotional recognition and expression abilities, including emotional faces and voices. The aim of this study was to explore emotional processing in pre-deep brain stimulation (pre-DBS) PD patients using two sensory modalities (visual and auditory). Methods: Fifteen PD patients who needed DBS surgery and 15 healthy, age- and gender-matched controls were recruited as participants. All participants were assessed by the Karolinska Directed Emotional Faces database 50 Faces Recognition test. Vocal recognition was evaluated by the Montreal Affective Voices database 50 Voices Recognition test. For emotional facial expression, the participants were asked to imitate five basic emotions (neutral, happiness, anger, fear, and sadness). The subjects were required to express nonverbal vocalizations of the five basic emotions. Fifteen Chinese native speakers were recruited as decoders. We recorded the accuracy of the responses, reaction time, and confidence level. Results: For emotional recognition and expression, the PD group scored lower on both facial and vocal emotional processing than did the healthy control group. There were significant differences between the two groups in both reaction time and confidence level. A significant relationship was also found between emotional recognition and emotional expression when considering all participants between the two groups together. Conclusion: The PD group exhibited poorer performance on both the recognition and expression tasks. Facial emotion deficits and vocal emotion abnormalities were associated with each other. In addition, our data allow us to speculate that emotional recognition and expression may share a common system. Keywords: Parkinson’s disease, emotional recognition, emotional expression, visual, auditor