Emotional and non-emotional facial behaviour in patients with unilateral brain damage.

Aspects of emotional facial expression (responsivity, appropriateness, intensity) were examined in brain-damaged adults with right or left hemisphere cerebrovascular lesions and in normal controls. Subjects were videotaped during experimental procedures designed to elicit emotional facial expression and non-emotional facial movement (paralysis, mobility, praxis). On tasks of emotional facial expression, patients with right hemisphere pathology were less responsive and less appropriate than patients with left hemisphere pathology or normal controls. These results corroborate other research findings that the right cerebral hemisphere is dominant for the expression of facial emotion. Both brain-damaged groups had substantial facial paralysis and impairment in muscular mobility on the hemiface contralateral to site of lesion, and the left brain-damaged group had bucco-facial apraxia. Performance measures of emotional expression and non-emotional movement were uncorrelated, suggesting a dissociation between these two systems of facial behaviour.     

Spontaneous facial expression of emotions in brain-damaged patients

Spontaneous facial expression of emotion was studied in two groups of right (N = 23) and left (N = 39) brain-damaged patients and in a control group of normal subjects (N = 28). To elicit emotions four short movies, constructed to produce positive, negative or neutral emotional responses, were used. The method used to assess the facial expression of emotions was the Facial Action Coding System. Brain-damaged patients showed less facial responses to emotional stimuli than normal controls, but no difference was observed between subjects with right and left-sided lesions either with global or disaggregated data analyses, inconsistent with the hypothesis of a specialization of the right hemisphere for facial emotional expressions. An unexpected difference was observed in response to the unpleasant movie. Both normal controls and left brain-damaged patients often averted their gaze from the screen when unpleasant material was displayed, whereas right brain-damaged patients rarely showed gaze aversion. This finding suggests that the degree of emotional involvement or manner of coping with stressful input may be reduced as a result of right brain damage.     

Brain dysfunctions during facial discrimination in schizophrenia: Selective association to affect decoding

Schizophrenia patients exhibit impaired facial affect perception, yet the exact nature of this impairment remains unclear. We investigated neural activity related to processing facial emotional and non-emotional information and complex images in 12 schizophrenia patients and 15 healthy controls using functional magnetic resonance imaging. All subjects performed a facial information processing task with three conditions: matching facial emotion, matching facial identity, and matching complex visual patterns. Patients and controls showed comparable behavioral performance in all task conditions. The neural activation patterns in schizophrenia patients and healthy controls were distinctly different while processing affect-related facial information but not other non-emotional facial features. During emotion matching, orbital frontal cortex and left amydala activations were found in controls but not in patients. When comparing emotion versus identity matching, controls activated the fusiform and middle temporal gyri, left superior temporal gyrus, and right inferior and middle frontal gyrus, whereas schizophrenia patients only activated the middle and inferior frontal gyri, the frontal operculi and the right insular cortex. Our findings suggest that schizophrenia patients and healthy controls may utilize different neural networks when processing facial emotional information.     

Reactions of patients with focal cerebral lesions to success or failure

Multiple measures were used to investigate emotional reactions to card sorting in patients with focal cerebral lesions and in matched non-brain-injured controls. Spontaneous facial expressions of patients with anterior lesions were impoverished, relative to the posterior group, on a quantitative index of facial movement. This deficit did not appear to be attributable to group differences on lesion variables, or degree of cognitive deficit. There were also indications that a "non-emotional" facial-motor deficit was not the primary cause. The marked anterior deficit for facial movement was not, however, associated with equally pronounced deficits on qualitative, self-report and heart rate indices of emotional response. Right hemisphere patients differed from left hemisphere patients on only one qualitative measure of emotional reaction, but this may have been due to the stronger negative reactions of dysphasic patients. Left unilateral neglect was not associated with reduced emotional response.     

Right hemisphere specialization for the identification of emotional words and sentences: evidence from stroke patients.

This study examines the contribution of the lexical/verbal channel to emotional processing in 16 right brain-damaged (RBD), 16 left brain-damaged (LBD) and 16 normal control (NC) right-handed adults. Emotional lexical perception tasks were developed; analogous nonemotional tasks were created to control for cognitive and linguistic factors. The three subject groups were matched for gender, age and education. The brain-damaged groups were similar with respect to cerebrovascular etiology, months post-onset, sensory-motor status and lesion location. Parallel emotional and nonemotional tasks included word identification, sentence identification and word discrimination. For both word tasks, RBDs were significantly more impaired than LBDs and NCs in the emotional condition. For all three tasks, RBDs showed a significantly greater performance discrepancy between emotional and nonemotional conditions than did LBDs or NCs. Results were not affected by the valence (i.e. positive/negative) of the stimuli. These findings suggest a dominant role for the right hemisphere in the perception of lexically-based emotional stimuli.     

Differential age-related decline in conflict-driven task-set shielding from emotional versus non-emotional distracters

While normal aging is associated with a marked decline in cognitive abilities, such as memory and executive functions, recent evidence suggests that control processes involved in regulating responses to emotional stimuli may remain well-preserved in the elderly. However, neither the precise nature of these preserved control processes, nor their domain-specificity with respect to comparable non-emotional control processes, are currently well-established. Here, we tested the hypothesis of domain-specific preservation of emotional control in the elderly by employing two closely matched behavioral tasks that assessed the ability to shield the processing of task-relevant stimulus information from competition by task-irrelevant distracter stimuli that could be either non-emotional or emotional in nature. The efficacy of non-emotional versus emotional task-set shielding, gauged via the ‘conflict adaptation effect’, was compared between cohorts of healthy young adults, healthy elderly adults, and individuals diagnosed with probable Alzheimer's disease (PRAD), age-matched to the elderly subjects. It was found that, compared to the young adult cohort, the healthy elderly displayed deficits in task-set shielding in the non-emotional but not in the emotional task, whereas PRAD subjects displayed impaired performance in both tasks. These results provide new evidence that healthy aging is associated with a domain-specific preservation of emotional control functions, specifically, the shielding of a current task-set from interference by emotional distracter stimuli. This selective preservation of function supports the notion of partly dissociable affective control mechanisms, and may either reflect different time-courses of degeneration in the neuroanatomical circuits mediating task-set maintenance in the face of non-emotional versus emotional distracters, or a motivational shift towards affective processing in the elderly.     

A psychophysical study of visual extinction: ipsilesional distractor interference with contralesional orientation thresholds in visual hemineglect patients

Visual extinction was investigated in left (n=15) and right (n=25) brain-damaged patients with or without visual neglect, and in normal control subjects (n=14), using a psychophysical paradigm. Orientation discrimination thresholds were determined for both left and right hemifield gratings presented either in isolation or simultaneously with a contralateral distractor grating. To minimize the influence of possible sensory-perceptual deficits, the luminances of both target and distractor gratings were chosen to be 20 times the luminances necessary to discriminate between horizontal and vertical grating orientations. The location of the target grating was always cued, making the distractor grating task irrelevant. Even after equalizing the visibility of left and right hemifield stimuli, neglect patients still displayed an increased interference effect from an ipsilesional distractor (and no interference from a contralesional distractor). Left or right brain-damaged controls did not show this asymmetric interference of irrelevant distractors, even the patients who demonstrated extinction on standard extinction testing. This suggests that visual extinction is a critical component of the visual neglect syndrome and that it involves an attentional deficit.     

Attentional load and visual neglect.

Ten subjects suffering from left unilateral neglect carried out a letter cancellation task under normal conditions, while counting forward, and when generating random numbers, respectively. The index of neglect increased with each of these conditions, though only the normal-random difference was statistically significant. In a second study, four left unilateral neglect subjects and four right brain-damaged controls carried out a simple reaction time task, with stimuli appearing randomly to the left and right, with and without the simultaneous performance of a secondary task (counting backward in threes from 100). The discrepancy between left versus right latencies increased significantly in the secondary task condition for two patients in the neglect group but not for the other two. None of the control group showed this effect. Theoretical implications of these findings for understanding neglect are discussed.     

Deficit in negative emotional information processing in schizophrenia: Does it occur in all patients?

The nature of the impairment in the processing of emotional information in schizophrenia is still being debated. Some authors reported that schizophrenia patients would show deficits in the treatment processing of negative emotional information without a negative bias, as observed in controls, when in a combined emotional situation including positive/negative information. Eighteen subjects with paranoid schizophrenia in remission with a low level of negative symptoms and 18 control subjects were exposed to 108 pairs of pictures (International Affective Picture System) depicting different emotions (N = negative, P = positive, n = neutral) from six different combinations: N/N, P/P, n/n, P/N, P/n, and N/n. The subjects responded by clicking on a right or left button in response to a negative or positive feeling toward the stimuli (forced choice task). They were also asked to classify each of the individual pictures as positive, negative, or neutral (emotion-recognition task). In this well-defined group of paranoid schizophrenia patients in remission, we observed the persistence of a negative bias when an ambiguous situation is displayed (P/N) with the absence of an impairment in negative emotional information recognition and the presence of a positive bias in the recognition of neutral stimuli, reflecting a tendency to keep arousal-provoking perceptual cues from entering into subjective awareness.     

Relationship between mood state and information processing of negative versus positive emotional stimuli in brain-damaged patients

The present study investigates the relationship between affective mood state as assessed by self- and hetero-rating scales and information processing of negative versus positive emotional stimuli in unilateral brain-damaged patients. Results show a high positive correlation between depressive mood scores and rating of self-awareness. Left brain-damaged (LBD) patients do not differ significantly from right brain-damaged (RBD) patients on both rating scales. RBD patients mismatch negative emotional stimuli in the nonverbal matching task. Results are discussed with reference to interaction between expression of emotion and cognition. The selective neglect of negative information is interpreted as a more basic emotional impairment.     

Inhibitory processes and spatial bias after right hemisphere damage

Patients with lesions in the right hemisphere often show signs of unilateral neglect for the left side of space. Even in the absence of these signs, however, when exploring a visual scene these patients show an initial orientation of their attention towards the right side (Gainotti, D'Erme, & Bartolomeo, 1991). Some patients might be able to compensate for this spatial bias by actively inhibiting the rightward orientation after its occurrence; as a result, they would be capable of extending their exploration to the left part of space. However, due to conflicting demands on the same resource pool, a rightward bias in these patients is expected to reappear or be enhanced when inhibitory mechanisms are used to avoid producing prepotent but inappropriate responses. Eighteen normal controls and 40 right brain-damaged (RBD) patients (17 showing signs of left neglect, 23 without neglect) performed two reaction time tasks requiring manual motor responses to lateralised visual stimuli. In one task, trials in which a motor response was to be withheld (catch trials) were also presented. Regardless of whether they had neglect, patients responded more slowly to left-sided than to right-sided events in both tasks. The presence of catch trials further increased this rightward bias in patients without signs of neglect, but not in neglect patients, consistent with the hypothesis that RBD patients may use inhibitory processes to compensate for spatial bias.     

Emotional facial expressions capture attention

OBJECTIVE: To determine whether the emotional significance of stimuli can influence spatial attention. BACKGROUND: Motivational and emotional factors may affect attention toward stimuli. However, this has never been examined in brain-damaged patients who present with unilateral inattention due to left spatial neglect. METHODS: The authors studied three patients with chronic left neglect and visual extinction after right parietal stroke. Shapes or faces with neutral, happy, or angry expressions were briefly presented in the right, left, or both visual fields. On unilateral trials, the patients detected all stimuli equally on both sides. On bilateral trials, they extinguished faces in the contralesional field much less often than shapes, and faces with happy or angry facial expressions much less than faces with a neutral expression. CONCLUSION: Facial features and emotional expressions can be analyzed despite lying on the unattended side, and may influence the spatial distribution of attention. These findings support the view that attention is controlled by neural mechanisms involving not only frontoparietal areas but also limbic components in cingulate cortex and amygdala, which may interact with ventral visual areas in the temporal lobe to detect affective value and prioritize attention to salient stimuli.     

抑郁症患者汉语情绪词阈下的Stroop效应事件相关电位

背景：抑郁症患者负性认知偏差与情绪信息加工的关系是一个重要的研究课题。情绪Stroop测验常用于评估情绪加工特点,而情绪词阈下Stroop刺激模式也常用于精神病学临床研究。 目的：本研究采用阈下汉语情绪词Stroop刺激范式来探讨抑郁症患者异常情绪信息加工的事件相关电位(ERP)效应。 设计,时间和地点：随机对照设计,时间为2007年8月至2008年3月,地点在中南大学湘雅二医院。 研究对象：首发抑郁症患者26例,符合DSM-IV抑郁症诊断标准,无脑部疾病、躯体疾病,未进行电休克治疗和抗抑郁药物治疗。健康对照组24例。两组在年龄、性别和教育水平方面无差异,均为右利手。 方法：采用阈下汉语情绪词Stroop刺激范式,要求被试对呈现200ms的红色或蓝色方块进行反应,而汉语情绪词阈下启动刺激为20ms。主要分析行为学和ERP数据。 主要测试指标：反应时和ERP成分的潜伏期和波幅。参照ERP平均波幅图以及其它研究,主要分析N270 (220~300ms)成分和N400 (380~450ms)成分的潜伏期和波幅。 结果：行为数据显示两组正确率之间无显著性差异,抑郁症组反应时比正常对照组延长,尤其是负性词与中性词(p<0.01)。重复测量方差分析表明,N270成分的波幅有词性和电极的主效应(p<0.01)以及词性和电极的交互效应(p<0.05);两组波幅大小顺序均为正性词>负性词>中性词。组别、词性差异波地形图显示差异主要分布在额区和左侧顶颞区。N400成分的波幅有词性和电极的主效应(p<0.01),潜伏期显示电极的主效应(p<0.01)以及电极和组别的交互效应(p<0.01);两组波幅大小顺序均为正性词>负性词>中性词,而且两组之间的三种情绪词波幅之间有显著性差异(p<0.01)。组别、词性差异波地形图显示差异主要分布在左右额区、中央区和左侧顶颞区。 结论：抑郁症患者执行阈下汉语情绪词Stroop刺激作业时表现了异常的情绪信息加工特征,以及对汉语情绪词三种词性进行语义激活时与正常组相比表现为不同的ERP时程效应。研究结果支持我们提出的正负性情绪平行神经模型。     

A transfer appropriate processing approach to investigating implicit memory for emotional words in the cerebral hemispheres

Forty undergraduate students participated in two experiments designed to investigate the impact of perceptual and conceptual encoding manipulations on implicit memory for emotional words in each cerebral hemisphere. Adopting a transfer appropriate processing approach, the encoding manipulations were designed to promote processing of the surface features of stimuli in Experiment 1, and their semantic meaning in Experiment 2. In both experiments, participants completed the designated encoding task, followed by a lexical decision task where primed and unprimed words were presented to the left (LVF) and right visual fields (RVF). In Experiment 1, implicit memory was observed for RVF presentations of words primed according to their perceptual features. Word valence did not impact on visual field of presentation for primed or unprimed words. In Experiment 2, participation in the conceptual encoding task differentially impacted on processing and implicit memory for emotional words presented in the LVF, where priming the conceptual meaning of words facilitated the processing of positive, relative to negative and non-emotional words. In addition, implicit memory for conceptually primed negative words was reflected in inhibition of primed relative to unprimed negatively valenced words presented in the LVF. In contrast, for RVF presentations, there was evidence of implicit memory for conceptually primed non-emotional words, but not for emotional words. The results are generally consistent with the right hemisphere model of emotion, which posits greater right hemisphere involvement in both the processing and implicit memory of emotional stimuli. The results also support Nagae and Moscovitch's suggestion [Nagae, S., & Moscovitch, M. (2002). Cerebral hemispheric differences in memory of emotional and non-emotional words in normal individuals. Neuropsychologia, 40, 1601-1607] that level of processing be incorporated into studies examining the veracity of the right hemisphere and valence models of emotional processing. The study demonstrated the usefulness of adopting a transfer appropriate processing approach to investigating memory for word valence in each hemisphere.     

Prism adaptation does not change the rightward spatial preference bias found with ambiguous stimuli in unilateral neglect

Previous research has shown that prism adaptation (prism adaptation) can ameliorate several symptoms of spatial neglect after right-hemisphere damage. But the mechanisms behind this remain unclear. Recently we reported that prisms may increase leftward awareness for neglect in a task using chimeric visual objects, despite apparently not affecting awareness in a task using chimeric emotional faces (Sarri et al., 2006). Here we explored potential reasons for this apparent discrepancy in outcome, by testing further whether the lack of a prism effect on the chimeric face task task could be explained by: i) the specific category of stimuli used (faces as opposed to objects); ii) the affective nature of the stimuli; and/or iii) the particular task implemented, with the chimeric face task requiring forced-choice judgements of lateral ‘preference’ between pairs of identical, but left/right mirror-reversed chimeric face tasks (as opposed to identification for the chimeric object task). We replicated our previous pattern of no impact of prisms on the emotional chimeric face task here in a new series of patients, while also similarly finding no beneficial impact on another lateral ‘preference’ measure that used non-face non-emotional stimuli, namely greyscale gradients. By contrast, we found the usual beneficial impact of prism adaptation (prism adaptation) on some conventional measures of neglect, and improvements for at least some patients in a different face task, requiring explicit discrimination of the chimeric or non-chimeric nature of face stimuli. The new findings indicate that prism therapy does not alter spatial biases in neglect as revealed by ‘lateral preference tasks’ that have no right or wrong answer (requiring forced-choice judgements on left/right mirror-reversed stimuli), regardless of whether these employ face or non-face stimuli. But our data also show that prism therapy can beneficially modulate some aspects of visual awareness in spatial neglect not only for objects, but also for face stimuli, in some cases.     

The role of the cerebral hemispheres in specific versus abstract priming

The present study examined specific and abstract priming for pictures in unilateral brain-damaged patients using a picture fragment identification task. Participants were 10 posterior right hemisphere (RH) damaged patients, 11 posterior left hemisphere (LH) damaged patients, and 30 healthy normal controls. Results reveal that RH patients perform specific priming tasks significantly worse than healthy participants (p < .005). There was a trend (p < .1) towards worse abstract priming in LH patients when compared to healthy participants. These results are additional evidence that specific priming depends on normal functioning of the posterior right cerebral hemisphere, while abstract priming depends on normal functioning of the posterior left cerebral hemisphere, and extend this finding from verbal to non-verbal stimuli.     

Differential processing of word and color in unilateral spatial neglect

The aim of the present study was to investigate mechanisms underlying processing of contralesional visual stimuli in brain-damaged patients with unilateral spatial neglect (USN). Nine right-hemisphere-damaged stroke patients with left-sided neglect and nine controls performed a reaction-time task involving manual response to a central color patch (target stimulus) flanked to the left or right by a Stroop stimulus they had to ignore. While the word dimension of the flanker affected patients' responses considerably and equally when presented to either side, the color dimension of the flanker had no effect when presented to the left, but had a large effect when presented to the right. Four of the patients performed a control task requiring same/different judgments between either of the two flanker dimensions (color and word) and the central target. Their performance indicated that they were able to process color information from the contralesional field, despite their results in the first experiment. These findings demonstrate a dissociation between how the patients processed different dimensions of the same stimuli and imply that the extent of processing in the contralesional hemifield depends both on task requirements and on the exact features of the stimuli. The implications of these results on normal attentional mechanisms is also discussed.     

Role of cerebral hemispheres and regions in processing hemifacial expression of emotion: evidence from brain-damage.

Patients with focal brain-damage, right or left hemisphere-damage (RHD/LHD) and anterior or posterior region-damage (ARD/PRD), and normal controls (NC) were asked to match the photographs of (left-right) hemifacial expressions of emotions, positive (happy-surprise), negative-aroused (fear-anger), negative-nonaroused (sad-disgust). Findings indicated that (a) NC subjects were significantly superior to brain-damaged patients; the difference between RHD and LHD patients was nonsignificant, and (b) ARD patients were significantly inferior to PRD patients who, in turn, were significantly inferior to NC subjects, in the perceptual matching task with hemifacial affective stimuli.     

Frontal lobe lesions and electrodermal activity: effects of significance.

Several studies have shown that cortical damage, especially to the right hemisphere and to frontal lobes, may attenuate skin conductance responses selectively to psychologically significant stimuli. We tested this hypothesis in 32 patients with frontal lesions, verified by computer assisted tomography and magnetic resonance imaging, and 45 healthy controls. Patients and controls were given a protocol which included a rest period, a series of innocuous tones, and a reaction time task. Patients were given a second protocol in which they viewed slides with positive and negative emotional content and neutral slides. Results showed attenuated electrodermal activity (EDA) during task instructions and smaller skin conductance responses to reaction-time stimuli in patients compared to controls but few differences under passive conditions or in orienting responses to simple tones. Patients with lateral prefrontal and paraventricular lesions were especially low in EDA in the reaction time task, and those with right and bilateral lesions in the cingulate gyrus and/or frontal operculum had attenuated EDA in both protocols. We conclude that the effects of certain frontal lesions are on the psychological response to significance which is indexed by EDA rather than directly on EDA per se.     

Perception of chimeric faces in schizophrenia and right hemispheric dysfunction

The aim of this study was the assessment of cerebral specialisation in perception of emotional chimeric drawings in 50 non-chronic schizophrenics (S), 50 chronic schizophrenics (CS), 30 right brain-damaged inpatients (P), and 50 normal controls. All were marked right handers. The assessment was performed after a four-week treatment. Structure and intensity of schizophrenia symptomatology were scored on the PANSS scale. Happy-sad chimeric face drawings (David 1989) were viewed twice in free vision. A perceiver bias towards left hemiface of chimeric drawings (LHF bias) and sad bias were scored in all subjects. Subjects rated their mood at the time of testing on a visual analogue scale. The schizophrenics and right brain-damaged inpatients showed significantly weaker LHF bias compared with healthy subjects, which may suggest right cerebral hemisphere dysfunction in perception of emotional chimeric drawings. Moreover, chronic schizophrenic patients revealed significantly weaker LHF bias and sad bias compared to non-chronic subjects. There was no correlation of left perceptual bias with clinical ratings: PANSS scale, MMSE, number of hospitalisations, neuroleptic dose, and current mood, which suggests stable properties of the perceptual deficit.