Emotional dysfunctions in neurodegenerative diseases

Abstract

Neurodegenerative diseases are characterized primarily by motor signs but are also accompanied by emotional disturbances. Because of the limited knowledge about these dysfunctions, this Review provides an overview of emotional competencies in Huntington's disease (HD), Parkinson's disease (PD), and multiple sclerosis (MS), with a focus on emotion recognition, emotion regulation, and depression. Most studies indicate facial emotion recognition deficits in HD and PD, whereas data for MS are inconsistent. On a neural level, dysfunctions of amygdala and striatum, among others, have been linked to these impairments. These dysfunctions also tap brain regions that are part of the emotion regulation network, suggesting problems in this competency, too. Research points to dysfunctional emotion regulation in MS, whereas findings for PD and HD are missing. The high prevalence of depression in all three disorders emphasizes the need for effective therapies. Research on emotional disturbances might improve treatment, thereby increasing patients' and caregivers' well-being.

The Insula: An Underestimated Brain Area in Clinical Neuroscience, Psychiatry, and Neurology

“…For example, structural and functional deficits in the insula have been implicated in anxiety disorders [43, 44], in schizophrenia for disturbed affective processing [45], in psychopathy for abnormal social emotion processing such as empathetic pain processing [46], and in anorexia nervosa for distorted subjective feelings of one’s body [47]. Insula pathology has also been implicated in neurological disorders, including Huntington’s disease and multiple sclerosis for impaired processing of facial emotions [48], and Alzheimer’s disease for the loss of sense of self [49]. …”

Altered Kinematics of Facial Emotion Expression and Emotion Recognition Deficits Are Unrelated in Parkinson’s Disease

“…Indeed, the cingulate cortex and amygdala are also known to be involved in the neurodegenerative process of PD (5–8). Therefore, a proportion of patients suffer from altered emotional processing (9, 10). …”

The Insula: An Underestimated Brain Area in Clinical Neuroscience, Psychiatry, and Neurology

“…For example, structural and functional deficits in the insula have been implicated in anxiety disorders [43,44], in schizophrenia for disturbed affective processing [45], in psychopathy for abnormal social emotion processing such as empathetic pain processing [46], and in anorexia nervosa for distorted subjective feelings of one's body [47]. Insula pathology has also been implicated in neurological disorders, including Huntington's disease and multiple sclerosis for impaired processing of facial emotions [48], and Alzheimer's disease for the loss of sense of self [49].…”