Abstract
In addition to motor symptoms, Parkinson’s disease (PD) involves significant non-motor sequelae, including disruptions in cognitive and emotional processing. Fear recognition appears to be affected both by the course of the disease and by a common interventional therapy, deep brain stimulation of the subthalamic nucleus (STN-DBS). Here, we examined if these effects extend to other aspects of emotional processing, such as attentional capture by negative emotional stimuli. Performance on an emotional attentional blink (EAB) paradigm, a common paradigm used to study emotional capture of attention, was examined in a cohort of individuals with PD, both on and off STN-DBS therapy (n=20). To contrast effects of healthy aging and other movement disorder and DBS targets, we also examined performance in a healthy elderly (n=20) and young (n=18) sample on the same task, and a sample diagnosed with Essential Tremor (ET) undergoing therapeutic deep brain stimulation of the ventral-intermediate nucleus (VIM-DBS, n=18). All four groups showed a robust attentional capture of emotional stimuli, irrespective of aging processes, movement disorder diagnosis, or stimulation. PD patients on average had overall worse performance, but this decrement in performance was not related to the emotional capture of attention. PD patients exhibited a robust EAB, indicating that the ability of emotion to direct attention remains intact in PD. Congruent with other recent data, these findings suggest that fear recognition deficits in PD may instead reflect a highly specific problem in recognition, rather than a general deficit in emotional processing of fearful stimuli.
Highlights
Parkinson’s disease (PD) is a neurodegenerative movement disorder that has significant and increasingly appreciated non-motor symptoms
Given the evidence for fear-related emotion recognition deficits in PD, it seems reasonable to ask if emotional capture of attention is impaired in PD, and if therapeutic STN-DBS. affect it the prediction is if key processes involved in emotion recognition and the emotional attentional blink (EAB) are shared, one would expect a reduced EAB in PD relative to controls
Four groups of subjects participated in this study (Table 1): 1) Healthy young controls (HYC, n=18), 2) Healthy elderly controls (HEC; n=20), 3) Parkinson’s disease patients undergoing therapeutic bilateral deep brain stimulation of the subthalamic nucleus (PD STN-DBS; n=20), 4) Essential tremor patients undergoing bilateral deep brain stimulation of the motor thalamus ventral-intermediate nucleus (ET VIM-DBS; n=18)
Summary
Parkinson’s disease (PD) is a neurodegenerative movement disorder that has significant and increasingly appreciated non-motor symptoms. Some studies report impaired fear recognition to faces following STN-DBS [10,18,19,20], which suggests that emotion recognition is affected by stimulation of the affected motor structures in PD Highly emotional stimuli such as those conveying threat, “capture” attention This capture of attention is commonly studied using the emotional attentional blink (EAB) paradigm [22]. Given the evidence for fear-related emotion recognition deficits in PD, it seems reasonable to ask if emotional capture of attention is impaired in PD, and if therapeutic STN-DBS. If STN-DBS were shown to affect the magnitude of the EAB, it would suggest that emotion’s ability to capture attention and emotion recognition share common processing substrates. DBS of the ventral-intermediate nucleus (VIM-DBS), a motor nucleus of the thalamus, is used to improve symptoms of ET, and there are reports of anxiety/fear affected by VIM-DB [26]
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