Emotion recognition in chronic treatment-resistant depression : before and after neurosurgical treatment

The neuroanatomical structures underlying Major Depressive Disorder (MDD) are not fully understood. Invasive treatment options now exist that target the brain structures associated with MDD. In part one of this study, the effects of MDD on emotion processing are being measured and discussed. Emotion processing was examined in patients with chronic, treatment resistant depression (n = 15) and a healthy control group (n = 38). Emotion processing abilities were impaired in the MDD group, especially those of disgust recognition. In part two, seven of the fifteen MDD patients that had received an Anterior Cingulotomy (ACING) and eight of the fifteen MDD patients that had received a Vagus Nerve Stimulation (VNS) as an intervention for chronic, treatment resistant depression were presented with the same series of emotional processing tasks given in part one. Their post surgical performance was compared with their pre surgical performance. After surgery, the ACING group showed decreased emotion processing abilities and the VNS group showed improvements. Findings suggest that emotional functions assumed to be associated with certain neural structures that are adversely affected in patients with MDD may be responsible for some of the clinical features of MDD

Emotion recognition is impaired across modalities in manifest Huntington’s disease

Aims There is increasing interest in the nature of the emotion recognition deficit in Huntington’s disease (HD) with conflicting reports of disproportionate impairments for some emotions in some modalities. This review aimed to clarify the pattern of emotion recognition deficits in HD. Methods A systematic review and narrative synthesis was conducted for studies investigating emotion recognition in Huntington’s disease. Embase, MEDLINE, PsychINFO and PubMed were searched from 1993 to 2010, and citation and reference list searches were also conducted. 1724 citations were identified. Results Sixteen studies met inclusion criteria. In manifest HD recognition of facial anger was found most consistently, although recognition of all negative emotions (facial and vocal) tended to be impaired. In premanifest HD impairments were inconsistent, but are seen in all facial expressions of negative emotion. Inconsistency may represent the variability inherent in HD although may also be due to between-study differences in methodology. Conclusions Current evidence supports the conclusion that recognition of all negative emotions tends to be impaired in HD, particularly in the facial domain. Future work should focus on using more ecologically-valid tests, and testing inter-modality differences

Your misery is no longer my pleasure: Reduced schadenfreude in Huntington's disease families

Schadenfreude – pleasure at others' misfortunes – has been systematically related to ventral striatum activity. This brain region is affected early in individuals with manifest and pre-manifest Huntington's disease (HD). However, the experience of schadenfreude has not yet been investigated in HD. In this study, 21 manifest HD patients, 19 first-degree asymptomatic relatives, and 23 healthy controls performed an experimental task designed to trigger schadenfreude, envy (another social emotion acting as an affective control condition), and control situations. Both HD patients and first-degree relatives experienced lower schadenfreude in response to others' misfortunes, with no group differences in ratings of envy and control conditions. These results offer unprecedented evidence of a highly specific impairment in reward processing, extending previous reports in manifest and pre-manifest HD individuals. Moreover, these findings suggest that early striatal impairments may be related to reduced feelings of schadenfreude. In sum, our work contributes to the understanding of emotional impairments in early stages of HD, while shedding light on their neural correlates.Fil: Báez Buitrago, Sandra Jimena. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: García, Adolfo Martín. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Orozco, Janni. Universidad Autónoma del Caribe; ColombiaFil: Fittipaldi, María Sol. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: García, Adolfo Martín. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Pino, Mariana. Universidad Autónoma del Caribe; ColombiaFil: Ibáñez Barassi, Agustín Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina. Universidad Autónoma del Caribe; Colombia. Universidad Adolfo Ibañez; Chil

MRI and cognitive changes in Huntington's disease.

This thesis focused on cognitive and MRI measures of early change and progression in Huntington's disease (HD). HD is clinically heterogeneous and previous findings about the location of brain atrophy in the early stages, and its relation to cognition, are equivocal. A pilot study assessed the practicality of using serial volumetric MRI in early HD and the usefulness of cognitive tasks in longitudinal assessment. A larger study investigated cross-sectional and longitudinal aspects of these domains in premanifest and early HD. Global and regional cerebral volumes were investigated using manual volumetry and voxel-based morphometry (VBM). The work describes the application of the Brain Boundary Shift Integral (BBSI) to measure of whole-brain atrophy rate. Preparatory technical work included choice of templates for optimum scan alignment and segmentation in VBM, and adjustment of BBSI parameters to obtain maximum agreement between it and manual measures. Cognitive ability was assessed using a wide-ranging battery of tests, some standard and some novel. Atrophy in early HD was found to be more extensive than previously reported, involving widespread extra-striatal loss, and not all functional deficits could be attributed to striatal damage. Emotion recognition deficits were broad and associated with striatal and extra-striatal brain regions. Executive function and memory tasks demonstrated decline over one year. Whole-brain atrophy rates were increased in early HD and associated with decline in cognition and CAG repeat length. This work elucidates the extent of, and associations of, atrophy and cognitive impairment in HD, and adds weight to the suggestion that variability in progression rates is partly explained by genetic factors. The suggestion that motor learning might be impaired even in very far-from-onset gene carriers, and that tasks other than those tapping executive function were sensitive to decline, should motivate further work aimed at detecting the very earliest signs of change in this disease

ELUCIDATING THE FUNCTIONAL NEURAL CORRELATES OF EMOTIONAL FACE PROCESSING DEFICITS IN BEHAVIOURAL VARIANT FRONTOTEMPORAL DEMENTIA

Frontotemporal dementia is a devastating neurodegenerative disorder consisting of progressive focal atrophy of the prefrontal and temporal lobes. Emotional facial expression deficits are widely acknowledged in behavioural variant frontotemporal dementia (bvFTD) and are speculated to partially account for patients’ social-cognitive deficits. To our knowledge this is the first study to delineate the functional neuroanatomy of facial expression processing in bvFTD using functional MRI, while controlling for voxel-wise atrophy. The results indicate emotion-specific functional abnormalities in frontotemporal regions in patients with bvFTD. BvFTD patients also demonstrated decreased activity in posterior ventral visual regions, perhaps suggesting reduced input from anterior frontal and limbic regions. Finally, bvFTD was associated with increased activity in the dorsal attentional network, providing some o f the first evidence of a potential compensatory response for functional deficits in frontotemporal regions. Together these findings suggest that functional MRI combined with tasks targeting social-cognitive deficits is a powerful technique to quantify neural systems involved in emotion processing in bvFTD

Exploring emotion regulation and emotion recognition in people with presymptomatic Huntington's disease:The role of emotional awareness

Interest in the role of both emotion regulation and recognition in our understanding of mental health has been steadily increasing, especially in people with chronic illness who also have psychological difficulties. One illness which belongs to this category is Huntington's disease. Huntington's disease (HD) is a chronic neurodegenerative disorder that can cause a number of cognitive and psychological difficulties, including emotion recognition deficits, even before the onset of the symptoms required to make a formal diagnosis. Despite the lack of definite evidence, recent studies have suggested that deficits of emotion regulation and recognition may be expected to play a pivotal role in the early cognitive manifestations of HD. In this study, we hypothesised that the ability to regulate emotions can be impaired in people with presymptomatic HD, and that such impairment may be associated with a deficit of emotion recognition. To test this, an online survey was carried out with 117 English and Italian-speaking people with presymptomatic HD, compared to 217 controls matched for age and education. The results suggest that, in presymptomatic participants, emotion regulation and emotion recognition are generally not significantly impaired, and no significant relationships between performances on the two constructs were observed. However, a specific impairment in emotional awareness (a subscale on the Difficulties in Emotion Regulation Scale, DERS) was observed, which appears to be enhanced by the co-occurrence of depressive symptoms, even at a subclinical level. Consequently, it is suggested that difficulties in emotional awareness may represent a precursor of more general emotion recognition impairments, which only become apparent as the disease reaches a more symptomatic level. Clinical implications of the findings are discussed and directions for future research are proposed

Psychometric Properties of a Multichannel Battery for the Assessment of Emotional Perception

Perceiving the emotions of others is an important, even critical, skill for success in social interactions. The lack of this skill has been associated with decreased social competence and poor interpersonal relationships (Shimokawa et al., 2001). It frequently co-occurs with psychopathology. Furthermore, there is a large and rapidly growing literature examining the neural substrates of emotional processing. Studies have examined the processing of particular emotions, as well as how emotions conveyed through different modalities are processed. The New York Emotion Battery (NYEB; Borod, Welkowitz, & Obler, 1992) includes tests for the perception of eight discrete emotions across three communication channels: facial, prosodic, and lexical. The NYEB has been used to study psychiatric and neurological conditions, as well as normal aging. For the current study, data were collected from 122 healthy, right-handed adults, ages 20-89. Participants completed emotion perception and nonemotional control tasks from the NYEB. Perceptual tasks included both identification and discrimination of emotion. All participants completed a screening battery which included measures of cognitive, perceptual, and affective functioning. The aims of the current study were: 1) To establish the internal consistency reliability and construct validity of the NYEB. 2) To examine the structure of its observed and latent variables and compare those structures to theory. 3) To describe any demographic or response biases of the NYEB. Results indicated that the NYEB has very good internal consistency for identification tasks, but lower internal consistency for discrimination tasks. Performance on the NYEB (both overall and in its identification subtests) is strongly determined by a general factor of emotion perception ability. Individual identification subtests often display a moderately strong second factor, but are still good measures of general emotional perception ability. Analysis of hierarchical grouping of the battery\u27s emotions provides support for the approach/withdrawal classification of emotions (as it relates to perceived emotions). Individual emotions varied in how accurately they were perceived and how frequently they were named in responses. Overall, the NYEB has good psychometric properties, should be a valid and useful instrument for assessing emotion perception deficits in psychopathology, and has potential to be adapted into an abbreviated form

Development and evaluation of biomarkers in Huntington’s Disease: furthering our understanding of the disease and preparing for clinical trials

Huntington’s Disease (HD) is a devastating hereditary neurodegenerative disease for which there are currently only symptomatic treatments. Several potentially curative pharmaceutical and genetic therapies are however in varying stages of development and therefore an increasing number of large-scale clinical trials of disease-modifying therapies are imminent. There is consequently a need for biomarkers which are sensitive to beneficial attenuation of disease-related changes. Functional, neuroimaging and biochemical biomarkers have been developed in HD (Andre et al. 2014;Weir et al. 2011). Neuroimaging biomarkers are strong candidates based on their clear relevance to the neuropathology of disease, proven precision and superior sensitivity compared with some standard functional measures (Tabrizi et al. 2011;Tabrizi et al. 2012). Their use in early-stage clinical trials, as surrogate end-points providing initial evidence of biological effect, is becoming increasingly common. Comparison of biomarkers in HD will help to clarify which measures, over varying time intervals, are most sensitive to disease progression. Additionally, the identification of robust fully-automated methods, comparable to manual and semi-automated gold-standards, would facilitate large-scale volumetric analysis. These methods however require validation in observational studies of neurodegenerative disease before they can be applied to sensitive clinical trial data. This thesis will develop and evaluate biomarkers for use in HD; both furthering our understanding of the disease and in preparation for use as end-points in clinical trials. A direct comparison of the sensitivity of diffusion and volumetric imaging biomarkers to HD-related change will be reported for the first time. Several exploratory imaging investigations are also described which enhance current knowledge of the relationship between neuroimaging metrics, brain functioning and behaviour, additionally strengthening the argument for the clinical relevance of neuroimaging measures as surrogate end-points in HD. The thesis will conclude with a comprehensive biomarker evaluation in early-stage HD, along with suggested strategies for selection of primary and secondary trial end-points based on effect sizes and corresponding sample size requirements

Facial affect recognition in context in adults with and without TBI

IntroductionSeveral studies have reported impaired emotion recognition in adults with traumatic brain injury (TBI), but studies have two major design features that limit application of results to real-world contexts: (1) participants choose from among lists of basic emotions, rather than generating emotion labels, and (2) images are typically presented in isolation rather than in context. To address these limitations, we created an open-labeling task with faces shown alone or in real-life scenes, to more closely approximate how adults with TBI label facial emotions beyond the lab.MethodsParticipants were 55 adults (29 female) with moderate to severe TBI and 55 uninjured comparison peers, individually matched for race, sex, and age. Participants viewed 60 photographs of faces, either alone or in the pictured person’s real-life context, and were asked what that person was feeling. We calculated the percent of responses that were standard forced-choice-task options, and also used sentiment intensity analysis to compare verbal responses between the two groups. We tracked eye movements for a subset of participants, to explore whether gaze duration or number of fixations helped explain any group differences in labels.ResultsOver 50% of responses in both groups were words other than basic emotions on standard affect tasks, highlighting the importance of eliciting open-ended responses. Valence of labels by participants with TBI was attenuated relative to valence of Comparison group labels, i.e., TBI group responses were less positive to positive images and the same was true for negative images, although the TBI group responses had higher lexical diversity. There were no significant differences in gaze duration or number of fixations between groups.DiscussionResults revealed qualitative differences in affect labels between adults with and without TBI that would not have emerged on standard forced-choice tasks. Verbal differences did not appear to be attributable to differences in gaze patterns, leaving open the question of mechanisms of atypical affect processing in adults with TBI