Deep Brain Stimulation of the Subthalamic Nucleus Selectively Modulates Emotion Recognition of Facial Stimuli in Parkinson's Patients.

Voges Voges,Kuehne Kuehne,Wagenbreth Wagenbreth,Galazky Galazky,Zaehle Zaehle,Heinze Heinze

doi:10.3390/jcm8091335

Abstract

Background: Diminished emotion recognition is a known symptom in Parkinson (PD) patients and subthalamic nucleus deep brain stimulation (STN-DBS) has been shown to further deteriorate the processing of especially negative emotions. While emotion recognition generally refers to both, implicit and explicit processing, demonstrations of DBS-influences on implicit processing are sparse. In the present study, we assessed the impact of STN-DBS on explicit and implicit processing for emotional stimuli. Methods: Under STN-DBS ON and OFF, fourteen PD patients performed an implicit as well as an explicit emotional processing task. To assess implicit emotional processing, patients were tested with a lexical decision task (LTD) combined with an affective priming paradigm, which provides emotional content through the facial eye region. To assess explicit emotional processing, patients additionally explicitly rated the emotional status of eyes and words used in the implicit task. Results: DBS affected explicit emotional processing more than implicit processing with a more pronounced effect on error rates than on reaction speed. STN-DBS generally worsened implicit and explicit processing for disgust stimulus material but improved explicit processing of fear stimuli. Conclusions: This is the first study demonstrating influences of STN-DBS on explicit and implicit emotion processing in PD patients. While STN stimulation impeded the processing of disgust stimuli, it improved explicit discrimination of fear stimuli.

Highlights

Deviant emotion production and recognition have been shown in patients with Parkinson’s disease (PD) when compared to healthy controls and especially impaired recognition of emotional facial expressions has been demonstrated [1,2,3,4]
Emotion recognition of circumscribed facial information, e.g., emotional states portrayed only in the eye region is impaired in PD patients [9]
The authors stated that stimulation of the STN inhibits the activity in the lateral fusiform gyrus, an area which is generally activated by emotional facial expressions

Summary

Introduction

Deviant emotion production and recognition have been shown in patients with Parkinson’s disease (PD) when compared to healthy controls and especially impaired recognition of emotional facial expressions has been demonstrated [1,2,3,4]. Studies investigating the effects of STN-DBS on emotion perception in PD demonstrated rather heterogeneous results, with reports of unchanged explicit emotion recognition of facial expressions (and emotional prosody) under deep brain stimulation (DBS) [18,19,20,21] or worsening of explicit discriminating emotional faces under stimulation [22,23,24]. The authors stated that stimulation of the STN inhibits the activity in the lateral fusiform gyrus, an area which is generally activated by emotional facial expressions This would lead to significantly altered emotion perception of facial expressions while emotional assessment per se would not be affected by DBS. Explicit emotional processing would be largely diminished in PD patients under DBS, but implicit emotional processing might not be affected by stimulation. Patients and subthalamic nucleus deep brain stimulation (STN-DBS) has been shown to further deteriorate the processing of especially negative emotions. STN-DBS generally worsened implicit and explicit processing for disgust stimulus material but improved explicit processing of fear stimuli

Methods

Results

Discussion

Conclusion