Heiner Ellgring

Differential Patterns of Implicit Emotional Processing in Alzheimer's Disease and Healthy Aging

Implicit memory for emotional facial expressions (EFEs) was investigated in young adults, healthy old adults, and mild Alzheimers disease (AD) patients. Implicit memory is revealed by the effect of experience on performance by studying previously encoded versus novel stimuli, a phenomenon referred to as perceptual priming. The aim was to assess the changes in the patterns of priming as a function of aging and dementia. Participants identified EFEs taken from the Facial Action Coding System and the stimuli used represented the emotions of happiness, sadness, surprise, fear, anger, and disgust. In the study phase, participants rated the pleasantness of 36 faces using a Likert-type scale. Subsequently, the response to the 36 previously studied and 36 novel EFEs was tested when they were randomly presented in a cued naming task. The results showed that implicit memory for EFEs is preserved in AD and aging, and no specific age-related effects on implicit memory for EFEs were observed. However, different priming patterns were evident in AD patients that may reflect pathological brain damage and the effect of stimulus complexity. These findings provide evidence of how progressive neuropathological changes in the temporal and frontal areas may affect emotional processing in more advanced stages of the disease.

The role of interference in identification of emotional facial expressions in normal ageing and dementia

In normal daily life, the identification of emotional facial expressions (EFEs) usually takes place simultaneously with other demands, requiring working memory resources. In the current study, the authors investigate the role of the interference caused by a secondary task in emotional facial identification. The decline in performance in a given task when adding a secondary task may be one of the strongest variables differentiating between normal and pathological ageing. The goal of the current study was to assess to what extent processing of EFEs is affected when cognitive resources are experimentally (over)loaded. Three groups of participants (Alzheimers patients, healthy older adults, and healthy young adults) had to identify six basic emotions under two conditions: identification-only and identification with a visual secondary task. The results showed a decrease in performance of EFEs identification when the processing of this mental image was interfered by another visual stimulus, for all groups. When computing the dual-task costs, AD patients showed higher costs than older and young adults, revealing that dementia but not ageing itself, is more vulnerable to interference effects. This study reveals further data supporting the hypothesis of a top-down control in emotional processing and offers a new approach to understand EFEs identification in analogous real-life conditions and reveals how this processing is differentially affected by ageing and dementias.

The Effects of Different Attentional Demands in the Identification of Emotional Facial Expressions in Alzheimer’s Disease

Alzheimer’s disease (AD) is characterized by the progressive impairment of mental and emotional functions, including the processing of emotional facial expression (EFE). Deficits in decoding EFE are relevant in social contexts in which information from 2 or more sources may be processed simultaneously. To assess the role of contextual stimuli on EFE processing in AD, we analyzed the ability of patients with AD and healthy elderly adults to identify EFE when simultaneously performing another task. Each of the 6 basic EFEs was presented to 15 patients with AD and 35 controls in a dual task paradigm that is in parallel with a visuospatial or a semantic task. Results show that the decoding of EFEs was impaired in patients with AD when they were simultaneously processing additional visuospatial information, yet not when they were performed in conjunction with a semantic task. These findings suggest that the capacity to interpret emotional states is impaired in AD.

Decline of Executive Processes Affects the Identification of Emotional Facial Expressions in Aging

The current study examined the hypothesis that old people have a selective deficit in the identification of emotional facial expressions (EFEs) when the task conditions require the mechanism of the central executive. We have used a Dual Task (DT) paradigm to assess the role of visuo-spatial interference of working memory when processing emotional faces under two conditions: DT at encoding and DT at retrieval. Previous studies have revealed a loss of the ability to identify specific emotional facial expressions (EFEs) in old age. This has been consistently associated with a decline of the ability to coordinate the performance of two tasks concurrently. Working memory is usually tested using DT paradigms. Regarding to aging, there is evidence that with DT performance during encoding the costs are substantial. In contrast, the introduction of a secondary task after the primary task (i.e. at retrieval), had less detrimental effects on primary task performance in either younger or older adults. Our results demonstrate that aging is associated with higher DT costs when EFEs are identified concurrently with a visuo-spatial task. In contrast, there was not a significant age-related decline when the two tasks were presented sequentially. This suggests a deficit of the central executive rather than visuo-spatial memory deficits. The current data provide further support for the hypothesis that emotional processing is top-down controlled, and suggest that the deficits in emotional processing of old people depend, above all, on specific cognitive impairment.

Skilful communication: Emotional facial expressions recognition in very old adults

OBJECTIVESnThe main objective of this study was to assess the changes associated with ageing in the ability to identify emotional facial expressions and to what extent such age-related changes depend on the intensity with which each basic emotion is manifested.nnnMETHODSnA randomised controlled trial carried out on 107 subjects who performed a six alternative forced-choice emotional expressions identification task. The stimuli consisted of 270 virtual emotional faces expressing the six basic emotions (happiness, sadness, surprise, fear, anger and disgust) at three different levels of intensity (low, pronounced and maximum). The virtual faces were generated by facial surface changes, as described in the Facial Action Coding System (FACS).nnnRESULTSnA progressive age-related decline in the ability to identify emotional facial expressions was detected. The ability to recognise the intensity of expressions was one of the most strongly impaired variables associated with age, although the valence of emotion was also poorly identified, particularly in terms of recognising negative emotions.nnnCONCLUSIONSnNurses should be mindful of how ageing affects communication with older patients. In this study, very old adults displayed more difficulties in identifying emotional facial expressions, especially low intensity expressions and those associated with difficult emotions like disgust or fear.

Emotional processing in patients with mild cognitive impairment: The influence of the valence and intensity of emotional stimuli: The valence and intensity of emotional stimuli influence emotional processing in patients with mild cognitive impairment

UNLABELLEDnWe studied the ability of individuals with mild cognitive impairment (MCI) to process emotional facial expressions (EFEs). To date, no systematic study has addressed how variation in intensity affects recognition of the different type of EFEs in such subjects.nnnDESIGNnTwo groups of 50 elderly subjects, 50 healthy individuals and 50 with MCI, completed a task that involved identifying 180 EFEs prepared using virtual models. Two features of the EFEs were contemplated, their valence (operationalized in six basic emotions) and five levels of intensity.nnnRESULTSnAt all levels of intensity, elderly individuals with MCI were significantly worse at identifying each EFE than healthy subjects. Some emotions were easier to identify than others, with happiness proving to be the easiest to identify and disgust the hardest, and intensity influenced the identification of the EFEs (the stronger the intensity, the greater the number of correct identifications). Overall, elderly individuals with MCI had a poorer capacity to process EFEs, suggesting that cognitive ability modulates the processing of emotions, where features of such stimuli also seem to play a prominent role (e.g., valence and intensity). Thus, the neurological substrates involved in emotional processing appear to be affected by MCI.

Visuo-spatial interference affects the identification of emotional facial expressions in unmedicated Parkinson's patients

There is evidence that visuo-spatial capacity can become overloaded when processing a secondary visual task (Dual Task, DT), as occurs in daily life. Hence, we investigated the influence of the visuo-spatial interference in the identification of emotional facial expressions (EFEs) in early stages of Parkinsons disease (PD). We compared the identification of 24 emotional faces that illustrate six basic emotions in, unmedicated recently diagnosed PD patients (16) and healthy adults (20), under two different conditions: a) simple EFE identification, and b) identification with a concurrent visuo-spatial task (Corsi Blocks). EFE identification by PD patients was significantly worse than that of healthy adults when combined with another visual stimulus.

Age-Related Changes in the Processing of Emotional Faces in a Dual-Task Paradigm

Background/ Study Context: Age-related changes appear to affect the ability to identify emotional facial expressions in dual-task conditions (i.e., while simultaneously performing a second visual task). The level of interference generated by the secondary task depends on the phase of emotional processing affected by the interference and the nature of the secondary task. The aim of the present study was to investigate the effect of these variables on age-related changes in the processing of emotional faces. Methods: The identification of emotional facial expressions (EFEs) was assessed in a dual-task paradigm using the following variables: (a) the phase during which interference was applied (encoding vs. retrieval phase); and (b) the nature of the interfering stimulus (visuospatial vs. verbal). The sample population consisted of 24 healthy aged adults (mean age = 75.38) and 40 younger adults (mean age = 26.90). The accuracy of EFE identification was calculated for all experimental conditions. Results: Consistent with our hypothesis, the performance of the older group was poorer than that of the younger group in all experimental conditions. Dual-task performance was poorer when the interference occurred during the encoding phase of emotional face processing and when both tasks were of the same nature (i.e., when the experimental condition was more demanding in terms of attention). Conclusions: These results provide empirical evidence of age-related deficits in the identification of emotional facial expressions, which may be partially explained by the impairment of cognitive resources specific to this task. These findings may account for the difficulties experienced by the elderly during social interactions that require the concomitant processing of emotional and environmental information.