Can the Ability to Recognize Facial Emotions in Individuals With Neurodegenerative Disease be Improved? A Systematic Review and Meta-analysis.

BACKGROUND: Facial emotion recognition (FER) is commonly impaired in individuals with neurodegenerative disease (NDD). This impairment has been linked to an increase in behavioral disorders and caregiver burden. OBJECTIVE: To identify interventions targeting the improvement of FER ability in individuals with NDD and investigate the magnitude of the efficacy of the interventions. We also wanted to explore the duration of the effects of the intervention and their possible impacts on behavioral and psychological symptoms of dementia and caregiver burden. METHOD: We included 15 studies with 604 individuals who had been diagnosed with NDD. The identified interventions were categorized into three types of approach (cognitive, neurostimulation, and pharmacological) as well as a combined approach (neurostimulation with pharmacological). RESULTS: The three types of approaches pooled together had a significant large effect size for FER ability improvement (standard mean difference: 1.21, 95% CI = 0.11, 2.31, z = 2.15, P = 0.03). The improvement lasted post intervention, in tandem with a decrease in behavioral disorders and caregiver burden. CONCLUSION: A combination of different approaches for FER ability improvement may be beneficial for individuals with NDD and their caregivers.

Eye-gaze Strategies During Facial Emotion Recognition in Neurodegenerative Diseases and Links With Neuropsychiatric Disorders.

BACKGROUND: Facial emotion recognition (FER) is primarily and severely impaired in individuals with the behavioral variant of frontotemporal dementia (bvFTD) and is often mildy impaired in individuals with Alzheimer disease (AD) or Parkinson disease (PD). Such impairment is associated with inappropriate social behaviors. OBJECTIVE: To determine whether FER impairment is linked to the use of inappropriate eye-gaze strategies to decode facial emotions, leading to misinterpretation of others' intentions and then to behavioral disorders. METHOD: We assessed FER in 9 individuals with bvFTD, 23 with AD, and 20 with PD, as well as 22 healthy controls (HC), using the Reading the Mind in the Eyes (RME) Test and the Ekman Faces Test. Eye movements (number and duration of fixations) were recorded with an eye-tracking device. Behavior was assessed using the Neuropsychiatric Inventory. RESULTS: FER was mildly impaired in the AD and PD groups and severely impaired in the bvFTD group. FER impairment was accompanied by an increase in the number of fixations and a more attracted gaze toward the lower part of one's face. FER impairment and an increase in the number of fixations were positively correlated with behavioral disorders. CONCLUSION: Our study demonstrated a link between FER impairment, modification of eye-gaze strategies during the observation of emotional faces, and behavioral disorders in individuals with bvFTD and those with AD or PD. These results suggest that an eye-gaze strategy rehabilitation program could have beneficial effects on emotion recognition and behavioral disorders in individuals with these diseases.

Theory of mind, empathy and eye gaze strategies during observation of a work of art: neurodegenerative pathologies.

OBJECTIVE: Theory of mind (ToM) and empathy are severely impaired in the behavioural variant of frontotemporal dementia (bvFTD) and more mildly in Alzheimer's (AD) and Parkinson's diseases (PD). Such impairments are associated with behavioural disorders. Modification of visual scanning strategies of complex visual scenes is also found in these pathologies. We hypothesised that these patients applied atypical gaze strategies when observing social events, which does not allow them to properly process social cues and results in the production of erroneous inferences and lack of empathy towards others. METHODS: Fifty-five participants were divided into four groups: five bvFTD subjects, 19 AD subjects, 17 PD subjects and 14 matched control subjects. ToM and empathy were assessed by eye movement recording (eye-tracking) and by a questionnaire during a painting observation. Scores obtained were compared between each group and to social cognition reference tests and correlated to the NeuroPsychiatric Inventory. RESULTS: Our paradigm was suitable for assessing cognitive ToM while it lacked sensitivity for empathy assessment. Severe ToM impairment was highlighted in bvFTD, while milder difficulties were observed in AD and for PD. Subjects with bvFTD and AD produced erroneous inferences from cognitive mental states. ToM performances were linked to visual exploration strategies of the painting. Atypical visual observation was highlighted in the bvFTD and AD groups causing a time delay in taking the perspective of the other person. Finally, we highlighted that social cognition performances, gaze strategies and behavioural disorders were correlated. CONCLUSION: Observing a painting in association with eye-tracking technology can be a good support for social cognition assessment. We highlighted a link between atypical visual scanning strategies, ToM impairment and behavioural disorders in these pathologies. ToM skills could be improved by training in the search for visual social cues. Therefore, this kind of remediation could have positive effects on behavioural disorders.

[Theory of mind, empathy and eye gaze strategies during an artwork observation in neurodegenerative pathologies]. / Théorie de l'esprit, empathie et stratégies de regard durant l'observation d'une œuvre d'art dans les pathologies neurodégénératives.

OBJECTIVE: Theory of mind (ToM) and empathy are severely impaired in the behavioral-variant of frontotemporal dementia (bvFTD) and more mildly in Alzheimer's (AD) and Parkinson's diseases (PD). Such impairments are associated with behavioral disorders (BD). Modification of visual scanning strategies of complex visual scenes is also found in these pathologies. We hypothesized that these patients applied atypical gaze strategies when observing social events, which would not allow to properly process social cues and would result in the production of erroneous inferences and lack of empathy towards others. METHODS: Fifty-five participants were divided into four groups: five bvFTD, 19 AD, 17 PD and 14 matched controls subjects. ToM and empathy were assessed by eye movements recording (eye-tracking) and by a questionnaire during a painting observation. Scores obtained were compared between each group and to social cognition reference tests, and correlated to the NeuroPsychiatric Inventory. RESULTS: Our paradigm was suitable for assessing cognitive ToM while it lacked sensitivity for empathy assessment. Severe ToM impairment was highlighted in bvFTD while milder difficulties were observed in AD and for PD. bvFTD and AD groups produced erroneous inferences from cognitive mental states. ToM performances were linked to visual exploration strategies of the painting. Atypical visual observation was highlighted in bvFTD and AD groups causing a time shift in perspective taking of the character. Finally, we have highlighted that social cognition performances, gaze strategies and BD were correlated. CONCLUSION: The observation of a painting in association with eye-tracking technology can be a good support for social cognition assessment. We highlighted a link between atypical visual scanning strategies, ToM impairment and BD in these pathologies. ToM skills could be improved by training in the search for visual social cues. Therefore, this kind of remediation could have positive effects on BD.

Socio-demographic and Clinical Correlates of Facial Expression Recognition Disorder in the Euthymic Phase of Bipolar Patients.

OBJECTIVE: Bipolar patients show social cognitive disorders. The objective of this study is to review facial expression recognition (FER) disorders in bipolar patients (BP) and explore clinical heterogeneity factors that could affect them in the euthymic phase: socio-demographic level, clinical and changing characteristics of the disorder, history of suicide attempt, and abuse. METHOD: Thirty-four euthymic bipolar patients and 29 control subjects completed a computer task of explicit facial expression recognition and were clinically evaluated. RESULTS: Compared with control subjects, BP patients show: a decrease in fear, anger, and disgust recognition; an extended reaction time for disgust, surprise and neutrality recognition; confusion between fear and surprise, anger and disgust, disgust and sadness, sadness and neutrality. In BP patients, age negatively affects anger and neutrality recognition, as opposed to education level which positively affects recognizing these emotions. The history of patient abuse negatively affects surprise and disgust recognition, and the number of suicide attempts negatively affects disgust and anger recognition. CONCLUSIONS: Cognitive heterogeneity in euthymic phase BP patients is affected by several factors inherent to bipolar disorder complexity that should be considered in social cognition study.

Electrophysiological correlates of emotional meaning in context in relation to facets of schizotypal personality traits: A dimensional study.

AIMS: The aim of this study was to investigate the neurocognitive processes mediating the processing of emotional information during the integration of contextual and social information in a schizotypal population. METHODS: One hundred and thirty-one healthy participants were evaluated using the Schizotypal Personality Questionnaire and event-related potentials were recorded during a linguistic task in which participants read sentence pairs describing short social situations to themselves. The first sentence implicitly conveyed the positive or negative emotional state of a character. The second sentence was emotionally congruent or incongruent with the first sentence. RESULTS: Across our overall sample, our results revealed a greater N400 effect at right sites than left sites, whereas the late positive component effect was only observed at left sites. Concerning the correlation results, we observed a negative link between positive and global schizotypy and N400 modulation in response to congruent targets for positive context sentences. Results also showed a positive correlation between negative schizotypy and late positive component modulation in response to congruent targets for negative context sentences. CONCLUSIONS: These results suggest that the different facets of the schizotypal personality traits influenced the integration of emotional context at the level of both early and later-mobilized neurocognitive processes.

Emotional Meaning in Context in Relation to Hypomanic Personality Traits: An ERP Study.

The ability to integrate contextual information is important for the comprehension of emotional and social situations. While some studies have shown that emotional processes and social cognition are impaired in people with hypomanic personality trait, no results have been reported concerning the neurophysiological processes mediating the processing of emotional information during the integration of contextual social information in this population. We therefore chose to conduct an ERP study dealing with the integration of emotional information in a population with hypomanic personality trait. Healthy participants were evaluated using the Hypomanic Personality Scale (HPS), and ERPs were recorded during a linguistic task in which participants silently read sentence pairs describing short social situations. The first sentence implicitly conveyed the positive or negative emotional state of a character. The second sentence was emotionally congruent or incongruent with the first sentence. We analyzed the difference in the modulation of two components (N400 and LPC) in response to the emotional word present at the end of the "target" sentences as a function of the HPS score and the emotional valence of the context. Our results showed a possible modulation of the N400 component in response to both positive and negative context among the participants who scored high on the Mood Volatility subscale of the Hypomanic Personality Scale. These results seem to indicate that the participants with hypomanic personality traits exhibited specificities in the integration of emotions at the level of the early-mobilized neurocognitive processes (N400). Participants with hypomanic personality traits found it difficult to integrate negative emotional contexts, while simultaneously exhibiting an enhanced integration of positive emotional contexts.

Semantic processing during morphological priming: an ERP study.

Previous research has yielded conflicting results regarding the onset of semantic processing during morphological priming. The present study was designed to further explore the time-course of morphological processing using event-related potentials (ERPs). We conducted a primed lexical decision study comparing a morphological (LAVAGE - laver [washing - wash]), a semantic (LINGE - laver [laundry - wash]), an orthographic (LAVANDE - laver [lavender - wash]), and an unrelated control condition (HOSPICE - laver [nursing home - wash]), using the same targets across the four priming conditions. The behavioral data showed significant effects of morphological and semantic priming, with the magnitude of morphological priming being significantly larger than the magnitude of semantic priming. The ERP data revealed significant morphological but no semantic priming at 100-250 ms. Furthermore, a reduction of the N400 amplitude in the morphological condition compared to the semantic and orthographic condition demonstrates that the morphological priming effect was not entirely due to the semantic or orthographic overlap between the prime and the target. The present data reflect an early process of semantically blind morphological decomposition, and a later process of morpho-semantic decomposition, which we discuss in the context of recent morphological processing theories.

Facing the challenge of teaching emotions to individuals with low- and high-functioning autism using a new Serious game: a pilot study.

BACKGROUND: It is widely accepted that emotion processing difficulties are involved in Autism Spectrum Conditions (ASC). An increasing number of studies have focused on the development of training programs and have shown promising results. However, most of these programs are appropriate for individuals with high-functioning ASC (HFA) but exclude individuals with low-functioning ASC (LFA). We have developed a computer-based game called JeStiMulE based on logical skills to teach emotions to individuals with ASC, independently of their age, intellectual, verbal and academic level. The aim of the present study was to verify the usability of JeStiMulE (which is its adaptability, effectiveness and efficiency) on a heterogeneous ASC group. We hypothesized that after JeStiMulE training, a performance improvement would be found in emotion recognition tasks. METHODS: A heterogeneous group of thirty-three children and adolescents with ASC received two one-hour JeStiMulE sessions per week over four weeks. In order to verify the usability of JeStiMulE, game data were collected for each participant. Furthermore, all participants were presented before and after training with five emotion recognition tasks, two including pictures of game avatars (faces and gestures) and three including pictures of real-life characters (faces, gestures and social scenes). RESULTS: Descriptive data showed suitable adaptability, effectiveness and efficiency of JeStiMulE. Results revealed a significant main effect of Session on avatars (ANOVA: F (1,32) = 98.48, P < .001) and on pictures of real-life characters (ANOVA: F (1,32) = 49.09, P < .001). A significant Session × Task × Emotion interaction was also found for avatars (ANOVA: F (6,192) = 2.84, P = .01). This triple interaction was close to significance for pictures of real-life characters (ANOVA: F (12,384) = 1.73, P = .057). Post-hoc analyses revealed that 30 out of 35 conditions found a significant increase after training. CONCLUSIONS: JeStiMulE appears to be a promising tool to teach emotion recognition not only to individuals with HFA but also those with LFA. JeStiMulE is thus based on ASC-specific skills, offering a model of logical processing of social information to compensate for difficulties with intuitive social processing. TRIAL REGISTRATION: Comité de Protection des Personnes Sud Méditerranée V (CPP): reference number 11.046 (https://cpp-sud-mediterranee-v.fr/).

Behavioral and brain measures (N400) of semantic priming in patients with schizophrenia: test-retest effect in a longitudinal study.

AIM: The purpose of this study was to investigate whether deficits in the behavioral and/or N400 semantic priming (SP) effect observed in patients with schizophrenia constitute a stable cognitive feature of the disorder or whether they may be influenced by the severity of each individual's symptomatology. METHODS: A 1-year test-retest study was conducted on 15 patients with schizophrenia and 10 healthy participants who performed an SP task. Both behavioral measures and event-related potentials measures of SP were recorded twice (test and retest sessions). RESULTS: At test, patients exhibited a deficit in SP as was revealed by both the behavioral and the event-related potentials measures of the amplitude of the N400 component. At retest, behavioral SP remained impaired, whereas N400 SP was significantly improved. CONCLUSION: These results provide evidence that SP impairments in schizophrenia as measured by N400 should not be considered as stable cognitive markers of the disorder. The behavioral and the N400 measures of SP indicated different levels of sensitivity to subtle cognitive and brain processes, which are subject to change over the clinical course of schizophrenic disorder.

Early word segmentation in infants acquiring Parisian French: task-dependent and dialect-specific aspects.

Six experiments explored Parisian French-learning infants' ability to segment bisyllabic words from fluent speech. The first goal was to assess whether bisyllabic word segmentation emerges later in infants acquiring European French compared to other languages. The second goal was to determine whether infants learning different dialects of the same language have partly different segmentation abilities, and whether segmenting a non-native dialect has a cost. Infants were tested on standard European or Canadian French stimuli, in the word-passage or passage-word order. Our study first establishes an early onset of segmentation abilities: Parisian infants segment bisyllabic words at age 0;8 in the passage-word order only (revealing a robust order of presentation effect). Second, it shows that there are differences in segmentation abilities across Parisian and Canadian French infants, and that there is a cost for cross-dialect segmentation for Parisian infants. We discuss the implications of these findings for understanding word segmentation processes.

The influence of idiomatic salience during the comprehension of ambiguous idioms by patients with schizophrenia.

This study investigates whether figurative comprehension in schizophrenia is influenced by the salience of idiomatic meaning, and whether it is affected by clinical and demographic factors and IQ. Twenty-seven schizophrenic patients and 25 healthy participants performed a semantic relatedness judgement task which required the comprehension of idioms with two plausible meanings (literal and figurative). The study also used literal expressions. The figurative meaning of the idioms was less salient (ILS), more salient (IFS), or equally salient (IES) compared to the literal meaning. The results showed "a salience effect" (i.e., all participants understood the salient meanings better than the less salient meanings). There was also a "figurativeness effect" (i.e., healthy individuals understood the figurative meaning of IES better than the literal meaning but not schizophrenic patients). In patients, their thought disorder influenced the figurative comprehension of IFS. The verbal IQ influenced the figurative comprehension of ILS. The thought disorder, the verbal IQ, and the educational level influenced the figurative comprehension of IES. The patients' clinically evaluated concretism was associated with a reduced figurative comprehension of IFS and IES evaluated at a cognitive level. The results are discussed in relation to cognitive mechanisms which underscore figurative comprehension in schizophrenia.

Interpretation of ambiguous idiomatic statements in schizophrenic and depressive patients. Evidence for common and differential cognitive patterns.

BACKGROUND: This study is concerned with the comprehension of ambiguous idiomatic statements in schizophrenic and depressive patients. AIMS: Using a multiple-choice procedure, we simultaneously tested the presence of concrete and literal elements in the understanding of idiomatic statements. METHOD: Fourteen schizophrenic and 10 patients undergoing a major depressive episode as well as 14 control subjects completed a questionnaire with 10 idiomatic expressions with two possible interpretations (figurative and literal) of equivalent prominence. The participants had to choose one word linked with the different interpretations of these idioms (figurative, literal, concrete or inappropriate meaning). RESULTS: The main results show that, in all the subjects, the contextual characteristics of the task induced a bias in favor of figurative interpretations despite the equivalent prominence of the literal interpretations of the idioms. The selection of responses relating to the concrete meaning of a single word in the idiom constituted a response mode common to both the schizophrenic and depressed patients. Despite the contextual constraints of the task, the schizophrenics opted for the literal responses more often than the other participants. The descriptive analysis argues in favor of a cognitive and clinical heterogeneity of schizophrenic patients. CONCLUSION: Results support the idea that literality and concreteness in idiomatic interpretation are possibly due to distinct cognitive impairments, though only some are specific to schizophrenic patients.

On understanding idiomatic language: The salience hypothesis assessed by ERPs.

Giora's [Giora, R., 1997. Understanding figurative and literal language: the Graded Salience Hypothesis. Cogn. Linguist. 7 (1), 183-206; Giora, R., 2003. On Our Mind: Salience Context and Figurative Language. Oxford Univ. Press, New York] Graded Salience Hypothesis states that more salient meanings-coded meanings foremost on our mind due to conventionality, frequency, familiarity, or prototypicality-are accessed faster than and reach sufficient levels of activation before less salient ones. This research addresses predictions derived from this model by examining the salience of familiar and predictable idioms, presented out of context. ERPs recorded from 30 subjects involved in reading and lexical decision tasks to (strongly/weakly) salient idioms and (figurative/literal) targets indicate that N400 amplitude was smaller for the last word of the strongly salient idioms than for the weakly salient idioms. Moreover, N400 amplitude of probes related to the salient meaning of strongly salient idioms was smaller than those of the 3 other conditions. In addition, response times to salient interpretations (the idiomatic meanings of highly salient idioms and the literal interpretations of less salient idioms) were shorter compared to the other conditions. These findings support Giora's Graded Salience Hypothesis. They show that salient meanings are accessed automatically, regardless of figurativity.

ERPs of metaphoric, literal, and incongruous semantic processing in schizophrenia.

The ability of schizophrenia patients to access metaphorical meaning was studied on the basis of psycholinguistic models of metaphor processing. ERPs were recorded from 20 schizophrenic and 20 control participants who were asked to read metaphorical, literal, and incongruous sentences and to judge their meaningfulness. In all participants, incongruous endings to sentences evoked the most negative N400 amplitude, whereas literal endings evoked more negative N400 amplitude than metaphorical ones, consistent with the direct model of metaphor processing. Although the patients had ERPs patterns that were similar to controls, they exhibited a more negative N400 amplitude for all sentences, LPC amplitude reduction, and latency delay in both components. The results suggest that schizophrenics have no specific anomalies in accessing the meaning of metaphors but are less efficient in integrating the semantic context of all sentences--both figurative and literal.