Reading Facial Emotions After Traumatic Brain Injury (TBI): Implications for Social Functioning and Treatment Development

Abstract

Decreased social integration is a frequently reported clinical challenge following TBI, andfacial emotion perception (FEP) deficits have been implicated. Identifying the mechanisms that underlie FEP will help us to develop evidence-based treatments to improve FEP after TBI. Visual scanning is one candidate mechanism of particular interest. This study employed a novel eye-tracking paradigm to examine (1) how typically developing (TD) controls effectively attend to the features of emotional faces and (2) the nature of impairments to visual scanning of emotional faces after TBI. Case series, with between-group, repeated-measures design. University-affiliated rehabilitation hospital. TBI group = 7 males, with moderate-severe TBI; TD control group = 9 males (Target n = 10) Eye movements were recorded while viewing static facial expressions. Faces were presented in two blocks of fixed and self-paced presentation duration. Number, duration and proportion of foveal fixations to predetermined eye, nose and mouth areas of interest. (1a) Controls fixated the eyes of fearful faces significantly more than those of other emotions, during the self-paced task (F=10.27, p<.01); (1b) Moreover, proportional data demonstrated a significant emotion X task interaction for the eyes (F=3.13, p<.05) and mouth (F=2.80, p<.05). (2) As evidenced by a group X task interaction, the TBI group attended to the eyes of emotional faces significantly less than controls, particularly during the self-paced task (F=28.20, p<.01). This study is the first to demonstrate that TD controls fixate the eyes of fearful faces more than other emotions, and to provide emotion- and task-specific scanning patterns in patients and controls with the potential to inform treatment development.