Abstract
Background: Facial emotion recognition (FER) is impaired in individuals with frontotemporal dementia (FTD) and Alzheimer’s disease (AD) when compared to healthy older adults. Since deficits in emotion recognition are closely related to caregiver burden or social interactions, researchers have fundamental interest in FER performance in patients with dementia.Purpose: The purpose of this study was to identify the performance profiles of six facial emotions (i.e., fear, anger, disgust, sadness, surprise, and happiness) and neutral faces measured among Korean healthy control (HCs), and those with mild cognitive impairment (MCI), AD, and FTD. Additionally, the neuroanatomical correlates of facial emotions were investigated.Methods: A total of 110 (33 HC, 32 MCI, 32 AD, 13 FTD) older adult participants were recruited from two different medical centers in metropolitan areas of South Korea. These individuals underwent an FER test that was used to assess the recognition of emotions or absence of emotion (neutral) in 35 facial stimuli. Repeated measures two-way analyses of variance were used to examine the distinct profiles of emotional recognition among the four groups. We also performed brain imaging and voxel-based morphometry (VBM) on the participants to examine the associations between FER scores and gray matter volume.Results: The mean score of negative emotion recognition (i.e., fear, anger, disgust, and sadness) clearly discriminated FTD participants from individuals with MCI and AD and HC [F(3,106) = 10.829, p < 0.001, η2 = 0.235], whereas the mean score of positive emotion recognition (i.e., surprise and happiness) did not. A VBM analysis showed negative emotions were correlated with gray matter volume of anterior temporal regions, whereas positive emotions were related to gray matter volume of fronto-parietal regions.Conclusion: Impairment of negative FER in patients with FTD is cross-cultural. The discrete neural correlates of FER indicate that emotional recognition processing is a multi-modal system in the brain. Focusing on the negative emotion recognition is a more effective way to discriminate healthy aging, MCI, and AD from FTD in older Korean adults.
Highlights
The study of social cognition indicates serial information processing about others’ behaviors or thinking in social situations
We simultaneously considered healthy controls (HCs), mild cognitive impairment (MCI), Alzheimer’s disease (AD), and frontotemporal dementia (FTD) participants in order to understand the distinct functioning of emotion recognition processing in the neural system, depending on emotional content
A post hoc analysis revealed that the AD group had a higher mean age than the HC group, while the HC group had a longer duration of education than the AD group
Summary
The study of social cognition indicates serial information processing about others’ behaviors or thinking in social situations. Recognition of others’ emotions, understanding of others’ mental state, and attributional orientations in explaining social situations are presented as the three domains of social cognition (e.g., Harvey and Penn, 2009). Among these social cognitive domains, how well individuals identify and recognize others’ emotions is the most popular research topic, and it reflects human instinctive function (Ekman and Friesen, 1971; Ekman, 1999; Elfenbein and Ambady, 2002). Since deficits in emotion recognition are closely related to caregiver burden or social interactions, researchers have fundamental interest in FER performance in patients with dementia.
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