The nature of facial expression recognition deficits following orbitofrontal cortex damage.

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Orbitofrontal cortex (OFC) damage has been associated with facial expression recognition deficits in some, but not all, previous studies. The pattern of performance of a group of patients with OFC damage was assessed across a series of facial expression recognition tasks. We aimed to determine whether some tasks were more sensitive at detecting deficits than others. Seven patients with damage to the OFC, 6 control patients with frontal lesions that spared the OFC, and a group of healthy controls completed a series of facial expression recognition tasks including 2 labeling tasks and 2 matching tasks. The OFC patient group demonstrated impaired labeling of negative facial expressions (i.e., anger, disgust, fear, and sadness) shown for a short time (500 ms) relative to the comparison groups. When facial expressions were shown for a longer time (5,000 ms), the OFC patient group's performance did not differ significantly from either comparison group. The OFC patient group was impaired when matching subtle, low intensity negative facial expressions, but not when matching high intensity, prototypical facial expressions. The pattern of performance across tasks revealed that only certain facial expression recognition tasks appear to be sufficiently sensitive to detect deficits in patients with OFC damage. These findings have important implications for the assessment of facial expression recognition difficulties in patients with OFC damage and more broadly, for special populations.