Role of the prefrontal cortex and executive functions in basic emotions recognition: evidence from patients with focal damage to the prefrontal cortex

Few studies have examined the specific contribution of focal damage of the prefrontal cortex and executive dysfunction to emotion recognition deficits, with results reporting controversial findings. This study investigated the performance of 30 patients with prefrontal cortex damage and 30 matched controls on a battery of executive measures assessing processes of inhibition, flexibility, and planning and a task of emotion recognition with also a particular attention to the examination of the association between these domains. The results showed that compared with control participants, patients with prefrontal cortex damage were impaired in recognizing the three negative emotions of fear, sadness, and anger and were also impaired on all executive measures. Moreover, by examining the association between both these domains, using correlation and regression analyses, we noted that impaired performance in recognizing emotions of fear, sadness, and anger was predicted by impaired performances on the measures of inhibition and flexibility or "set-shifting" suggesting that the ability to recognize emotions could be at least to some extent cognitively mediated. Finally, using a voxel-based lesion technique, we identified a partially common prefrontal network underlying deficits on executive functions and emotions recognition centered on the ventral and medial parts of the prefrontal cortex, reflecting beyond the neural network involved in recognizing negative emotions per se that of the cognitive processes elicited by this emotion task.