Abstract
Introduction: Studies of brain-damaged patients revealed that amygdala lesions cause deficits in the processing and recognition of emotional faces. Patients with autism spectrum disorders (ASD) have similar deficits also related to dysfunctions of the limbic system including the amygdala.Methods: We investigated a male patient who had been diagnosed with Asperger's syndrome. He also presented with a lesion of the right mesial temporal cortex, including the amygdala. We used functional magnetic resonance imaging (fMRI) to investigate neuronal processing during a passive viewing task of implicit and explicit emotional faces. Clinical assessment included a facial emotion recognition task.Results: There was no amygdala activation on both sides during the presentation of masked emotional faces compared to the no-face control condition. Presentation of unmasked happy and angry faces activated the left amygdala compared to the no-face control condition. There was no amygdala activation in response to unmasked fearful faces on both sides. In the facial emotion recognition task, the patient biased positive and neutral expressions as negative.Conclusions: This case report describes a male patient with right amygdala damage and an ASD. He displayed a non-response of the amygdala to fearful faces and tended to misinterpret fearful expressions. Moreover, a non-reactivity of both amygdalae to emotional facial expressions at an implicit processing level was revealed. It is discussed whether the deficient implicit processing of facial emotional information and abnormalities in fear processing could contribute and aggravate the patient's impairments in social behavior and interaction.
Highlights
Studies of brain-damaged patients revealed that amygdala lesions cause deficits in the processing and recognition of emotional faces
In the unmasked condition, Region of interest (ROI) analyses revealed a unilateral activation of the left amygdala on the contrast of angry vs. no-face condition (X = −18, Y = 0, Z = −12, df = 294, T = 5.19, Z-score, = 5.08, cluster size 11, p uncorr. < 0.001) as well as on the contrast of happy vs. no-face condition (X = −26, Y = 2, Z = −20, df = 294, T = 3.58, Z-score = 3.54, cluster size = 6, p uncorr. < 0.001)
We presented a case report of a patient with unilateral amygdala damage and autism spectrum disorders (ASD)
Summary
Studies of brain-damaged patients revealed that amygdala lesions cause deficits in the processing and recognition of emotional faces. Previous studies revealed deficient emotion processing capacities in patients with unilateral (Adolphs et al, 2002) and bilateral (Adolphs et al, 1994, 1999; Adolphs and Tranel, 2004) damage of the amygdala. This holds especially true for the processing of threat-related stimuli, whereas the recognition of happy faces seems to be undisrupted
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