Facial Emotion Recognition Impairment in Patients with Parkinson's Disease and Isolated Apathy

Carmen García-Sánchez,Jaime Kulisevsky,Javier Pagonabarraga,Gisela Llebaria,Mercè Martínez-Corral,Berta Pascual-Sedano,Alexandre Gironell

doi:10.4061/2010/930627

Abstract

Apathy is a frequent feature of Parkinson's disease (PD), usually related with executive dysfunction. However, in a subgroup of PD patients apathy may represent the only or predominant neuropsychiatric feature. To understand the mechanisms underlying apathy in PD, we investigated emotional processing in PD patients with and without apathy and in healthy controls (HC), assessed by a facial emotion recognition task (FERT). We excluded PD patients with cognitive impairment, depression, other affective disturbances and previous surgery for PD. PD patients with apathy scored significantly worse in the FERT, performing worse in fear, anger, and sadness recognition. No differences, however, were found between nonapathetic PD patients and HC. These findings suggest the existence of a disruption of emotional-affective processing in cognitive preserved PD patients with apathy. To identify specific dysfunction of limbic structures in PD, patients with isolated apathy may have therapeutic and prognostic implications.

Highlights

Apathy has been defined as a lack of motivation evidenced by diminished goal-directed behavior, cognition, and emotion [1]
To understand the mechanisms underlying apathy in Parkinson’s disease (PD), we investigated emotional processing in PD patients with and without apathy and in healthy controls (HC), assessed by a facial emotion recognition task (FERT)
No differences were found between nonapathetic PD patients and HC. These findings suggest the existence of a disruption of emotional-affective processing in cognitive preserved PD patients with apathy

Summary

Introduction

Apathy has been defined as a lack of motivation evidenced by diminished goal-directed behavior, cognition, and emotion [1]. Another definition, focusing on observable aspects, is a quantitative reduction of self-generated voluntary and purposeful behaviors [2]. Apathy and depression frequently coexist in PD, they can develop separately [5, 6]. Disruption of emotional-affective functional circuits seems to be present since the early stages of the disease, and may play an additional role in the development of apathy in patients with otherwise no apparent cognitive deficits

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