Pauline Narme

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.

Older adults' configural processing of faces: role of second-order information.

Problems with face recognition are frequent in older adults. However, the mechanisms involved have only been partially discovered. In particular, it is unknown to what extent these problems may be related to changes in configural face processing. Here, we investigated the face inversion effect (FIE) together with the ability to detect modifications in the vertical or horizontal second-order relations between facial features. We used a same/different unfamiliar face discrimination task with 33 young and 33 older adults. The results showed dissociations in the performances of older versus younger adults. There was a lack of inversion effect during the recognition of original faces by older adults. However, for modified faces, older adults showed a pattern of performance similar to that of young participants, with preserved FIE for vertically modified faces and no detectable FIE for horizontally modified faces. Most importantly, the detection of vertical modifications was preserved in older relative to young adults whereas the detection of horizontal modifications was markedly diminished. We conclude that age has dissociable effects on configural face-encoding processes, with a relative preservation of vertical compared to horizontal second-order relations processing. These results help to understand some divergent results in the literature and may explain the spared familiar face identification abilities in the daily lives of older adults.

La reconnaissance des visages et de leurs expressions faciales au cours du vieillissement normal et dans les pathologies neurodégénératives

The ability to recognize facial identity and emotional facial expression is central to social relationships. This paper reviews studies concerning face recognition and emotional facial expression during normal aging as well as in neurodegenerative diseases occurring in the elderly. It focuses on Alzheimers disease, frontotemporal and semantic dementia, and also Parkinsons disease. The results of studies on healthy elderly individuals show subtle alterations in the recognition of facial identity and emotional facial expression from the age of 50 years, and increasing after 70. Studies in neurodegenerative diseases show that - during their initial stages - face recognition and facial expression can be specifically affected. Little has been done to assess these difficulties in clinical practice. They could constitute a useful marker for differential diagnosis, especially for the clinical differentiation of Alzheimers disease (AD) from frontotemporal dementia (FTD). Social difficulties and some behavioural problems observed in these patients may, at least partly, result from these deficits in face processing. Thus, it is important to specify the possible underlying anatomofunctional substrates of these deficits as well as to plan suitable remediation programs.

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.

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.

Dysexecutive disorders and their diagnosis: a position paper

Although executive function disorders are among the most prevalent cognitive impairments a consensus on diagnostic criteria has yet to be reached. With a view to harmonizing these criteria, the present position paper (i) focuses on the main dysexecutive disorders, (ii) examines recent approaches in both the behavioral and cognitive domains, (iii) defines diagnostic boundaries for frontal syndrome, (iv) reports on the frequency and profile of the executive function disorders observed in the main brain diseases, and (v) proposes an operationalization of diagnostic criteria. Future work must define the executive processes involved in human adaptive behavior, characterize their impairment in brain diseases, and improve the management of these conditions (including remediation strategies and rehabilitation).