Facial Emotion Recognition and Discrimination Deficit in Idiopatic Parkinson Patients

Objective: Motor symptoms are the primary focus in diagnosis and treatment of idiopathic Parkinson disease (IPD). But facial emotion recognition disorder, one of non-motor symptoms of the disease, reduces quality of life significantly by disrupting social interaction. Facial emotion recognition and discrimination ability is an important part of social interaction. Neuroimaging studies highlight amigdala as the locus of facial emotion recognition disorder in IPD. The aim of this study is to investigate the relationship between clinical features and impairments in facial emotion recognition and discrimination ability. Materials and Methods: This study involves 41 patients followed with IPD in neurology outpatient clinic and 38 healthy controls. Facial Emotion Identification Test (FEIT) and Facial Emotion Discrimination Test (FEDT) were carried out for both groups. Clinical and demographic features of patient and control groups were recorded. Hoehn-Yahr (H and Y) scale was used for staging of disease and Unified Parkinson's Disease Rating Scale (UPDRS) was used for assessment of clinical severity. The results of both groups were compared with Kruskal Wallis and Pearson's Chi Square tests. Results: Average of FEIT and FEDT in patients with IPD are 12.64 +/- 5.55 and 17.84 +/- 4.94, respectively. When these values were compared with control group, they were worse than control group (p<0.01). This impairment was correlated with H and Y and UPDRS stages. The most impaired one among facial exogenous sensations was fear sensation with 2.29 +/- 1.26. Conclusion: This study shows that patients with IPD have more difficulty than normal population in recognition and discrimination of facial exogenous emotions. This difficulty was correlated with stage and clinical severity of disease. We hope that these findings will be an important step in regulation of impaired social intercourse and functionality in IPD and will help determining rehabilitation targets.