Perception of Emotional Facial Expressions in Amyotrophic Lateral Sclerosis (ALS) at Behavioural and Brain Metabolic Level

• Published in: PloS one Vol. 11; no. 10; p. e0164655
• Main Authors: Aho-Özhan, Helena E A, Keller, Jürgen, Heimrath, Johanna, Uttner, Ingo, Kassubek, Jan, Birbaumer, Niels, Ludolph, Albert C, Lulé, Dorothée
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 14.10.2016; Public Library of Science (PLoS)
• Subjects: Adult; Age; Aged; Amyotrophic lateral sclerosis; Amyotrophic Lateral Sclerosis - physiopathology; Behavior - physiology; Biology and Life Sciences; Brain; Brain - diagnostic imaging; Brain - metabolism; Brain mapping; Case-Control Studies; Cognition; Dementia; Emotional behavior; Emotions; Emotions - physiology; Facial Expression; Fear; Female; Frontal gyrus; Functional magnetic resonance imaging; Humans; Magnetic resonance; Magnetic Resonance Imaging; Male; Medicine and Health Sciences; Memory; Middle Aged; Neurobiology; Neuroimaging; Neurology; Neurosciences; Patients; Photic Stimulation; Psychiatry; Regression Analysis; Replicating; Replication; Research and Analysis Methods; Social factors; Social interactions; Social Sciences; Transcranial magnetic stimulation; Germany
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0164655

Amyotrophic lateral sclerosis (ALS) primarily impairs motor abilities but also affects cognition and emotional processing. We hypothesise that subjective ratings of emotional stimuli depicting social interactions and facial expressions is changed in ALS. It was found that recognition of negative emotions and ability to mentalize other's intentions is reduced. Processing of emotions in faces was investigated. A behavioural test of Ekman faces expressing six basic emotions was presented to 30 ALS patients and 29 age-, gender and education matched healthy controls. Additionally, a subgroup of 15 ALS patients that were able to lie supine in the scanner and 14 matched healthy controls viewed the Ekman faces during functional magnetic resonance imaging (fMRI). Affective state and a number of daily social contacts were measured. ALS patients recognized disgust and fear less accurately than healthy controls. In fMRI, reduced brain activity was seen in areas involved in processing of negative emotions replicating our previous results. During processing of sad faces, increased brain activity was seen in areas associated with social emotions in right inferior frontal gyrus and reduced activity in hippocampus bilaterally. No differences in brain activity were seen for any of the other emotional expressions. Inferior frontal gyrus activity for sad faces was associated with increased amount of social contacts of ALS patients. ALS patients showed decreased brain and behavioural responses in processing of disgust and fear and an altered brain response pattern for sadness. The negative consequences of neurodegenerative processes in the course of ALS might be counteracted by positive emotional activity and positive social interactions.