Harold Mouras

Emotional and cognitive social processes are impaired in Parkinson's disease and are related to behavioral disorders.

OBJECTIVE Parkinsons disease (PD) is associated with behavioral disorders that can affect social functioning but are poorly understood. Since emotional and cognitive social processes are known to be crucial in social relationships, impairment of these processes may account for the emergence of behavioral disorders. METHOD We used a systematic battery of tests to assess emotional processes and social cognition in PD patients and relate our findings to conventional neuropsychological data (especially behavioral disorders). Twenty-three PD patients and 46 controls (matched for age and educational level) were included in the study and underwent neuropsychological testing, including an assessment of the behavioral and cognitive components of executive function. Emotional and cognitive social processes were assessed with the Interpersonal Reactivity Index caregiver-administered questionnaire (as a measure of empathy), a facial emotion recognition task and two theory of mind (ToM) tasks. RESULTS When compared with controls, PD patients showed low levels of empathy (p = .006), impaired facial emotion recognition (which persisted after correction for perceptual abilities) (p = .001), poor performance in a second-order ToM task (p = .008) that assessed both cognitive (p = .004) and affective (p = .03) inferences and, lastly, frequent dysexecutive behavioral disorders (in over 40% of the patients). Overall, impaired emotional and cognitive social functioning was observed in 17% of patients and was related to certain cognitive dysexecutive disorders. In terms of behavioral dysexecutive disorders, social behavior disorders were related to impaired emotional and cognitive social functioning (p = .04) but were independent of cognitive impairments. CONCLUSIONS Emotional and cognitive social processes were found to be impaired in Parkinsons disease. This impairment may account for the emergence of social behavioral disorders.

Behavioral Investigation of the Influence of Social Categorization on Empathy for Pain: A Minimal Group Paradigm Study

Research on empathy for pain has provided evidence of an empathic bias toward racial ingroup members. In this study, we used for the first time the “minimal group paradigm” in which participants were assigned to artificial groups and required to perform pain judgments of pictures of hands and feet in painful or non-painful situations from self, ingroup, and outgroup perspectives. Findings showed that the mere categorization of people into two distinct arbitrary social groups appears to be sufficient to elicit an ingroup bias in empathy for pain.

Assessment of socioemotional processes facilitates the distinction between frontotemporal lobar degeneration and Alzheimer's disease.

We explored the value of a battery of socioemotional tasks for differentiating between frontotemporal lobar degeneration (FTLD) and Alzheimer’s disease (AD). Patients with FTLD (n = 13) or AD (n = 13) and healthy controls (n = 26) underwent a neuropsychological assessment and the socioemotional battery (an empathy questionnaire, an emotion recognition task, and theory of mind tasks). Socioemotional processes were markedly impaired in FTLD but relatively unaffected in mild AD. The computed Socioemotional Index discriminated more accurately between FTLD from AD than behavioral and executive assessments did. Furthermore, impairments in socioemotional processes were correlated with indifference to others.

Postural correlates with painful situations

Background: Emotional context may play a crucial role in movement production. According to simulation theories, emotional states affect motor systems. The aim of this study was to compare postural responses assessed by posturography and electromyography when subjects were instructed to imagine themselves in a painful or a non-painful situation. Methods: Twenty-nine subjects (22.3 ± 3.7 years) participated in this study. While standing quietly on a posturographic platform, they were instructed to imagine themselves in a painful or non-painful situation. Displacement of the center of pressure (COP), leg muscle electromyographic activity, heart rate, and electrodermal activity were assessed in response to painful and non-painful situations. Results: The anteroposterior path was shorter (p < 0.05) when subjects imagined themselves in a painful situation (M = 148.0 ± 33.4 mm) compared to a non-painful situation (158.2 ± 38.7 mm). Higher tibialis anterior (TA) activity (RMS-TA = 3.38 ± 1.95% vs. 3.24 ± 1.85%; p < 0.001) and higher variability of soleus (SO) activity (variation coefficient of RMS-SO = 13.5 ± 16.2% vs. M = 9.0 ± 7.2%; p < 0.05) were also observed in painful compared to non-painful situations. No significant changes were observed for other physiological data. Conclusion: This study demonstrates that simulation of painful situations induces changes in postural control and leg muscle activation compared to non-painful situations, as increased stiffness was demonstrated in response to aversive pictures in accordance with previous results.

Empathy or ownership? evidence from corticospinal excitability modulation during pain observation

Recent studies show that motor responses similar to those present in ones own pain (freezing effect) occur as a result of observation of pain in others. This finding has been interpreted as the physiological basis of empathy. Alternatively, it can represent the physiological counterpart of an embodiment phenomenon related to the sense of body ownership. We compared the empathy and the ownership hypotheses by manipulating the perspective of the observed hand model receiving pain so that it could be a first-person perspective, the one in which embodiment occurs, or a third-person perspective, the one in which we usually perceive the others. Motor-evoked potentials (MEPs) by TMS over M1 were recorded from first dorsal interosseous muscle, whereas participants observed video clips showing (a) a needle penetrating or (b) a Q-tip touching a hand model, presented either in first-person or in third-person perspective. We found that a pain-specific inhibition of MEP amplitude (a significantly greater MEP reduction in the “pain” compared with the “touch” conditions) only pertains to the first-person perspective, and it is related to the strength of the self-reported embodiment. We interpreted this corticospinal modulation according to an “affective” conception of body ownership, suggesting that the body I feel as my own is the body I care more about.

Influence of postural threat on postural responses to aversive visual stimuli

Recent research has shown that emotion influences postural control. The objective of the present study was to establish whether or not postural threat influences postural and physiological responses to aversive visual stimuli. In order to investigate the coupling between emotional reactions, motivated behavior and postural responses, we studied the displacement of the subjects center of pressure (COP) and the changes in electrodermal activity (EDA), heart rate (HR) and postural muscle activation. Thirty-two participants (15 males, 17 females; mean ± SD age: 21.4 ± 2.3) viewed affective and neutral pictures while standing still on a force platform in the presence or absence of postural threat. The HR and EDA data revealed that the emotional state varied as a function of the postural condition. The mean displacement in the anteroposterior (AP) axis was more rearwards in response to aversive stimuli that in response to neutral stimuli, in both the absence of postural threat (-0.65 mm and +0.90 mm for aversive and neutral stimuli, respectively) and the presence of postural threat (-0.00 mm vs. +0.89 mm, respectively). An aversive stimulus was associated with a shorter AP COP sway path than a neutral stimulus in the presence of a postural threat (167.26 mm vs. 174.66 mm for aversive and neutral stimuli, respectively) but not in the latters absence (155.85 mm vs. 154.48 mm, respectively). Our results evidenced withdrawal behavior in response to an aversive stimulus (relative to a neutral stimulus) in the absence of postural threat. Withdrawal behavior was attenuated (but nevertheless active) in the presence of a postural threat.

Theory of mind and hypomanic traits in general population

Theory of Mind (ToM) is the ability to assign a set of mental states to yourself and others. In bipolar disorders, alteration of social relationship can be explained by the impairment of the functioning of ToM. Deficit in ToM could be a trait marker of bipolar disorder and people in the general population with high hypomanic personality scores would be more likely to develop bipolar disorders. This study examined 298 participants. Measures of hypomanic personality were evaluated using the Hypomanic Personality Scale. ToM was explored using the Yoni task. Participants also completed the BDI-II. Forward multiple regressions were performed to examine the effect of components of the HPS on the total score in the ToM task. In the womens group, no subscales of the HPS were included in the model. Conversely, the analyses performed on men revealed that the mood vitality and excitement subscale was a significant predictor of ToM abilities. Our study is the first to show the impact of certain dimensions of hypomanic personality on performance in ToM in a male sample. This result supports the idea that deficits in ToM can be a trait marker of bipolar disorder in a healthy male population.

Does impaired socioemotional functioning account for behavioral dysexecutive disorders? Evidence from a transnosological study

ABSTRACT Behavioral dysexecutive disorders are highly prevalent in patients with neurological diseases but cannot be explained by cognitive dysexecutive impairments. In fact, the underlying mechanisms are poorly understood. Given that socioemotional functioning underlies appropriate behavior, socioemotional impairments may contribute to the appearance of behavioral disorders. To investigate this issue, we performed a transnosological study. Seventy-five patients suffering from various neurological diseases (Alzheimer’s disease (AD), Parkinson’s disease (PD), frontotemporal lobar degeneration, and stroke) were included in the study. The patients were comprehensively assessed in terms of cognitive and behavioral dysexecutive disorders and socioemotional processes (facial emotion recognition and theory of mind). As was seen for cognitive and behavioral dysexecutive impairments, the prevalence of socioemotional impairments varied according to the diagnosis. Stepwise logistic regressions showed that (i) only cognitive executive indices predicted hypoactivity with apathy/abulia, (ii) theory of mind impairments predicted hyperactivity–distractibility–impulsivity and stereotyped/perseverative behaviors, and (iii) impaired facial emotion recognition predicted social behavior disorders. Several dysexecutive behavioral disorders are associated with an underlying impairment in socioemotional processes but not with cognitive indices of executive functioning (except for apathy). These results strongly suggest that some dysexecutive behavioral disorders are the outward signs of an underlying impairment in socioemotional processes.

Freezing behavior as a response to sexual visual stimuli as demonstrated by posturography.

Posturographic changes in motivational conditions remain largely unexplored in the context of embodied cognition. Over the last decade, sexual motivation has been used as a good canonical working model to study motivated social interactions. The objective of this study was to explore posturographic variations in response to visual sexual videos as compared to neutral videos. Our results support demonstration of a freezing-type response in response to sexually explicit stimuli compared to other conditions, as demonstrated by significantly decreased standard deviations for (i) the center of pressure displacement along the mediolateral and anteroposterior axes and (ii) center of pressure’s displacement surface. These results support the complexity of the motor correlates of sexual motivation considered to be a canonical functional context to study the motor correlates of motivated social interactions.

CONSIGNELA: A multidisciplinary patient-centered project to improve drug prescription comprehension and execution in elderly people and parkinsonian patients

Abstract Many older patients and patients with Parkinson’s disease (PD) do not respect medication prescriptions. Non-adherence is caused by several factors among which three play an important role: Treatment complexity, cognitive decline, and patient-provider communication. This article presents an ongoing multidisciplinary project, the CONSIGNELA project, which adopts a patient-centered approach for improving medication adherence in these patients. The first objective of the project is to identify the best way to communicate medication prescriptions with tablets and touch-screen devices. The second objective is to improve medication adherence by creating a collaborative application (app) designed both for older and PD patients and for healthcare professionals in charge of them. Two solutions are combined: A cognitive and a technological solutions. The cognitive solution consists in studying in real time older and PD patients while consulting and executing prescriptions presented in different formats to select the most efficient one. The technological solution aims to improve collaboration between health professionals and patients by developing System of Systems (SoS). The research model used in the project includes three phases. Only the results of phase 1 are presented in the article. A research app, CONSIGNELA-Appli-R was programmed to analyze patient cognitive processes while consulting a prescription on a tablet. A pilot study was carried out with young adults to test it. It confirmed a facilitating effect of table format. In parallel, the prototype of a second app, CONSIGNELA-Appli-P, for patients and healthcare providers was developed. It is based on an SoS architecture connecting a virtual pillbox, a Multi-Agent System (MAS) and a knowledge platform. The virtual pillbox is used by patients and providers to improve mutual understanding of medication prescriptions. The MAS provides agents that extract and analyze indicators, actions and information resulting from the interaction between patients and virtual pillboxes. All the information is capitalized and stored in the knowledge platform. Providers can receive charts and dashboards showing information about the following of the medication regimen, for instance, if patients are following it correctly or not.