The neural underpinnings of facial emotion recognition in ischemic stroke patients.

Nils S Van Den Berg,Rients B Huitema,Jacoba M Spikman,Edward H F De Haan,The Visual Brain Group

doi:10.1111/jnp.12240

Nils S Van Den Berg, Rients B Huitema + Show 3 more

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https://doi.org/10.1111/jnp.12240

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Abstract

Deficits in facial emotion recognition occur frequently after stroke, with adverse social and behavioural consequences. The aim of this study was to investigate the neural underpinnings of the recognition of emotional expressions, in particular of the distinct basic emotions (anger, disgust, fear, happiness, sadness and surprise). A group of 110 ischaemic stroke patients with lesions in (sub)cortical areas of the cerebrum was included. Emotion recognition was assessed with the Ekman 60 Faces Test of the FEEST. Patient data were compared to data of 162 matched healthy controls (HC’s). For the patients, whole brain voxel‐based lesion–symptom mapping (VLSM) on 3‐Tesla MRI images was performed. Results showed that patients performed significantly worse than HC’s on both overall recognition of emotions, and specifically of disgust, fear, sadness and surprise. VLSM showed significant lesion–symptom associations for FEEST total in the right fronto‐temporal region. Additionally, VLSM for the distinct emotions showed, apart from overlapping brain regions (insula, putamen and Rolandic operculum), also regions related to specific emotions. These were: middle and superior temporal gyrus (anger); caudate nucleus (disgust); superior corona radiate white matter tract, superior longitudinal fasciculus and middle frontal gyrus (happiness) and inferior frontal gyrus (sadness). Our findings help in understanding how lesions in specific brain regions can selectively affect the recognition of the basic emotions.

Highlights

Impairments in emotion recognition have been found in a number of patient groups with damage to these brain structures, including patients with stroke (Nijsse et al, 2019; van den Berg, Huitema, Spikman, Luijckx, & de Haan, 2020; Yuvaraj et al, 2013), and patients with brain tumours (Pertz, Okoniewski, Schlegel, & Thoma, 2020), Traumatic Brain Injury (TBI; Babbage et al, 2011; Spikman et al, 2013; Young, Newcombe, De Haan, Small, & Hay, 1993), subarachnoid haemorrhage (Buunk et al, 2017) and patients with neurodegenerative diseases (NDD), such as Alzheimer’s Disease, Parkinson’s Disease and Fronto-temporal dementia (Christidi, Migliaccio, SantamarıaGarcıa, Santangelo, & Trojsi, 2018)
The aim of the current study was to investigate the neural underpinnings of facial emotion recognition, including the brain structures involved in the processing of distinct basic emotions, in a large group of ischaemic stroke patients
The results showed that patients performed significantly worse than healthy controls in the overall recognition of emotional facial expressions, and in particular in the recognition of disgust, fear, sadness and surprise

Summary

Introduction

Social cognition comprises the cognitive and emotional functions which enable us to process social information and to behave adequately in social situations (Adolphs, 2009) It is a broad construct, consisting of different aspects, including the recognition of socially important information (such as emotional facial expressions), the understanding of behaviour of others (such as creating a Theory of Mind), and empathic behaviour (Blair, 2003). Amongst these different aspects of social cognition, impairments in the ability to recognize emotional Impairments in emotion recognition have been found in a number of patient groups with damage to these brain structures, including patients with stroke (Nijsse et al, 2019; van den Berg, Huitema, Spikman, Luijckx, & de Haan, 2020; Yuvaraj et al, 2013), and patients with brain tumours (Pertz, Okoniewski, Schlegel, & Thoma, 2020), Traumatic Brain Injury (TBI; Babbage et al, 2011; Spikman et al, 2013; Young, Newcombe, De Haan, Small, & Hay, 1993), subarachnoid haemorrhage (Buunk et al, 2017) and patients with neurodegenerative diseases (NDD), such as Alzheimer’s Disease, Parkinson’s Disease and Fronto-temporal dementia (Christidi, Migliaccio, SantamarıaGarcıa, Santangelo, & Trojsi, 2018)

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