Impaired recognition of facial expressions of anger in Parkinson's disease patients acutely withdrawn from dopamine replacement therapy

We have previously reported that acute dopaminergic blockade in healthy volunteers results in a transient disruption of the recognition of facial expressions of anger, whilst leaving intact the recognition of other facial expressions (including fear and disgust) and facial identity processing. Parkinson's disease (PD) is characterised by cell loss in dopaminergic neuronal populations, and hence we predicted that PD would be associated with impaired anger recognition. We reasoned that treatment with dopamine replacement therapy (DRT) could mask any deficit present in PD, and therefore studied facial expression recognition in a group of PD patients transiently withdrawn from DRT. Seventeen PD patients were compared to 21 age- and IQ-matched controls on the Ekman 60 task, which required the forced-choice labelling of 10 exemplars of each of six facial expressions (anger, disgust, fear, sadness, happiness, surprise). In line with our predictions, PD patients showed a selective impairment in the recognition of facial expressions of anger. This deficit was not related to the PD patients’ performance on the Benton unfamiliar-face matching task, which was normal, nor was the deficit related to overall disease severity, or to depression symptoms. However, as predicted by simulation theories, impaired anger recognition in PD was related to reduced levels of the anger-linked temperament trait, exploratory excitability. The results extend our previous findings of a role for dopamine in the processing of facial expressions of anger, and demonstrate the power of adopting a phylogenetic, comparative perspective on emotions

Apathy blunts neural response to money in Parkinson's disease

Apathy, defined as a primary deficit in motivation and manifested by the simultaneous diminution in the cognitive and emotional concomitants of goal-directed behavior, is a common and debilitating non-motor symptom of Parkinson's disease (PD). Despite the high prevalence and clinical significance of apathy, little is known about its pathophysiology, and in particular how apathy relates to alterations in the neural circuitry underpinning the cognitive and emotional components of goal-directed behavior. Here, we examined the neural coding of reward cues in patients with PD, with or without clinically significant levels of apathy, during performance of a spatial search task during H2 15O PET (positron emission tomography) functional neuroimaging. By manipulating search outcome (money reward vs valueless token), while keeping the actions of the participants constant, we examined the influence of apathy on the neural coding of money reward cues. We found that apathy was associated with a blunted response to money in the ventromedial prefrontal cortex, amygdala, striatum, and midbrain, all part of a distributed neural circuit integral to the representation of the reward value of stimuli and actions, and the influence of reward cues on behavior. Disruption of this circuitry potentially underpins the expression of the various manifestations of apathy in PD, including reduced cognitive, emotional, and behavioral facets of goal-directed behavior

The neural basis of lip-reading capabilities is altered by early visual deprivation

Putzar L, Goerendt I, Heed T, Richard G, Büchel C, Röder B. The neural basis of lip-reading capabilities is altered by early visual deprivation. Neuropsychologia. 2010;48(7):2158-2166

Sum of AEs defined by same severity, reversibility, and attribution to DBS therapy.

<p>Green, reversible; orange, non reversible; grey, unknown. The actual number of AEs is presented. The dotted area indicates AEs that were <i>severe</i> or worse and at least <i>possibly</i> related to DBS therapy and, thus, regarded the most critical. N.B. The number of affected patients may be less than the number indicated because individual patients may have suffered from more than one AE of respective groups (e.g. impairment of gait and speech rated as <i>mild</i>, <i>probably</i> related and <i>non-reversible</i>).</p

Reporting of adverse events in prospective multicentric DBS studies for movement disorders.

<p>Reporting of adverse events in prospective multicentric DBS studies for movement disorders.</p

DBS-related neurological and psychiatric adverse events.

<p>DBS-related neurological and psychiatric adverse events.</p

CTC grade of SAE vs relatedness to DBS therapy.

<p>CTC grade of SAE vs relatedness to DBS therapy.</p