Emotion Recognition Correlates With Social-Neuropsychiatric Dysfunction in Huntington’s Disease

Kempnich, Clare; Andrews, Sophie C.; Fisher, Fiona; Wong, Dana; Georgiou‐Karistianis, Nellie; Stout, Julie C.

doi:10.1017/s1355617717001308

Cited by 24 publications

(25 citation statements)

References 55 publications

(56 reference statements)

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“…The current study demonstrated a specific impairment in the recognition of happy expressions in apathetic compared with non-apathetic participants. This is partially in line with the broader emotion recognition impairments found previously in apathetic participants with HD and other neurological disorders (Buunk et al, 2017; Kempnich et al, 2017; Martínez-Corral et al, 2010; Njomboro et al, 2014; Robert et al, 2014). While shared reliance on fronto-striatal pathways may broadly explain associations between emotion recognition and apathy found across a number of patient groups, further work is needed to determine what relationships exist between recognition of specific emotions, distinct subtypes of apathy and underlying neuropathology.…”

Section: Discussionsupporting

confidence: 90%

“…Further, this impairment was found despite no difference in general cognitive functioning between the two groups. One previous study found that overall emotion recognition score on the TASIT was related to FrsBe apathy scores in a smaller sample of participants with HD (Kempnich et al, 2017). Kempnich and colleagues, however, did not explore relationships with specific emotions and thus may have overlooked the possibility of particular emotions driving the effect.…”

Section: Discussionmentioning

confidence: 97%

“…The relationship between apathy and emotion perception has only once been assessed in an HD sample. The study found that performance on the Emotion Evaluation Test of The Awareness of Social Inference Test (TASIT-EET) was associated with informant ratings of apathy on the Frontal System Behavior Scale (FrsBe) above general disease progression (Kempnich et al, 2017). The current study aimed to replicate these results in a larger, multinational sample of participants with HD.…”

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confidence: 99%

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Apathy Associated With Impaired Recognition of Happy Facial Expressions in Huntington’s Disease

Osborne-Crowley

Andrews

Labuschagne

et al. 2019

J Int Neuropsychol Soc

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Objective Previous research has demonstrated an association between emotion recognition and apathy in a number of neurological conditions involving fronto-striatal pathology, including Parkinson’s disease and brain injury. In line with these findings, we aimed to determine whether apathetic participants with early Huntington’s disease (HD) were more impaired on an emotion recognition task compared to non-apathetic participants and healthy controls. Method We included 43 participants from the TRACK-HD study who reported apathy on the Problem Behaviours Assessment – short version (PBA-S), 67 participants who reported no apathy and 107 controls matched for age, sex and level of education. During their baseline TRACK-HD visit, participants completed a battery of cognitive and psychological tests including an emotion recognition task, the Hospital Depression and Anxiety Scale (HADS) and were assessed on the PBA-S. Results Compared to the non-apathetic group and the control group, the apathetic group were impaired on the recognition of happy facial expressions, after controlling for depression symptomology on the HADS and general disease progression (UHDRS total motor score). This was despite no difference between the apathetic and non-apathetic group on overall cognitive functioning assessed by a cognitive composite score. Conclusions Impairment of the recognition of happy expressions may be part of the clinical picture of apathy in HD. While shared reliance on fronto-striatal pathways may broadly explain associations between emotion recognition and apathy found across a number of patient groups, further work is needed to determine what relationships exist between recognition of specific emotions, distinct subtypes of apathy and underlying neuropathology.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 99%

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Apathy Associated With Impaired Recognition of Happy Facial Expressions in Huntington’s Disease

Osborne-Crowley

Andrews

Labuschagne

et al. 2019

J Int Neuropsychol Soc

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“…Consistent with past literature, 32 our results highlight the detrimental impact of Emotional apathy on functional independence. This finding fits with the disrupted fronto‐limbic pathology of HD leading to impaired emotional regulation and a clinical phenotype characterized by flattened affect, impaired emotion recognition and reduced social engagement 58–60 . These deficits in social cognition worsen as the disease progresses, contributing to a loss of functional independence.…”

Section: Discussionsupporting

confidence: 78%

Multidimensional Apathy: The Utility of the Dimensional Apathy Scale in Huntington's Disease

Atkins

Andrews

Chong

et al. 2021

Movement Disord Clin Pract

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Background Apathy is a disorder of motivation common to Huntington's disease (HD). Recent conceptual frameworks suggest that apathy is not unitary but consists of discrete subtypes (“dimensions”). Which of the proposed dimensions are preferentially affected in HD, and how these dimensions evolve with disease progression is unknown. Objectives The Dimensional Apathy Scale (DAS) separates apathy into Executive, Initiation and Emotional subscales. Using the DAS, we aimed to: 1) Determine the apathy subtypes prevalent in HD; 2) Compare the DAS against a unitary measure of apathy (Apathy Evaluation Scale, AES); 3) Assess the reliability of self‐ and observer‐ratings; and 4) Determine the relationship between the DAS, and disease burden, total functional capacity (TFC) and the AES. Method Fifty pre‐manifest, 51 manifest‐HD, 87 controls, and 50 HD‐observers completed the DAS, AES, and TFC. Results Manifest‐HD participants had the highest levels of apathy across all dimensions (30.4% on Executive subscale, 34.8% on Initiation subscale, and 15.2% on Emotional subscale), relative to pre‐manifest and control participants. Self‐ and observer‐ratings on the DAS did not differ. Hierarchical regressions across the entire gene‐expanded sample showed that scores on the Initiation subscale correlated with AES scores; higher Executive subscale scores were related to higher disease burden; and Emotional subscale scores with lower total functional capacity. Conclusions In this first study of the DAS in HD, manifest‐HD participants were more apathetic than pre‐manifest and control participants across all apathy subtypes. The DAS may be a useful tool for measuring different aspects of apathy in people with HD.

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“…Reduced recognition of facial expression of emotions has also been detected in premanifest HD [7][8][9][10]. Reduced emotional recognition has recently been found to be associated with apathy, which is the psychiatric symptom that most clearly increases with disease progression [11,12]. Sleep problems and an altered circadian rhythm occur in many individuals with HD [13][14][15][16][17][18].…”

Section: Non-motor Features Of Huntington's Diseasementioning

confidence: 99%

The Role of Hypothalamic Pathology for Non-Motor Features of Huntington’s Disease

Cheong

Gabery

Petersén

2019

JHD

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Huntington's disease (HD) is a fatal genetic neurodegenerative disorder. It has mainly been considered a movement disorder with cognitive symptoms and these features have been associated with pathology of the striatum and cerebral cortex. Importantly, individuals with the mutant huntingtin gene suffer from a spectrum of non-motor features often decades before the motor disorder manifests. These symptoms and signs include a range of psychiatric symptoms, sleep problems and metabolic changes with weight loss particularly in later stages. A higher body mass index at diagnosis is associated with slower disease progression. The common psychiatric symptom of apathy progresses with the disease. The fact that non-motor features are present early in the disease and that they show an association to disease progression suggest that unravelling the underlying neurobiological mechanisms may uncover novel targets for early disease intervention and better symptomatic treatment. The hypothalamus and the limbic system are important brain regions that regulate emotion, social cognition, sleep and metabolism. A number of studies using neuroimaging, postmortem human tissue and genetic manipulation in animal models of the disease has collectively shown that the hypothalamus and the limbic system are affected in HD. These findings include the loss of neuropeptide-expressing neurons such as orexin (hypocretin), oxytocin, vasopressin, somatostatin and VIP, and increased levels of SIRT1 in distinct nuclei of the hypothalamus. This review provides a summary of the results obtained so far and highlights the potential importance of these changes for the understanding of non-motor features in HD.

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Emotion Recognition Correlates With Social-Neuropsychiatric Dysfunction in Huntington’s Disease

Cited by 24 publications

References 55 publications

Apathy Associated With Impaired Recognition of Happy Facial Expressions in Huntington’s Disease

Apathy Associated With Impaired Recognition of Happy Facial Expressions in Huntington’s Disease

Multidimensional Apathy: The Utility of the Dimensional Apathy Scale in Huntington's Disease

The Role of Hypothalamic Pathology for Non-Motor Features of Huntington’s Disease

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