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

Abstract

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.

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

“…A study by Williams et al (2003) highlighted atypical visual scanning during FER in individuals with schizophrenia, similar to what was seen here in individuals with NDD (Polet et al, 2017, 2021, 2022). Williams et al (2003) also found that individuals with schizophrenia with atypical neuroleptic treatment allocated as much attention to salient features of the face (eyes, nose, and mouth) as controls, whereas typical neuroleptic treatment led to fewer observations of these features.…”

“…The principal cause of FER ability impairment in PD is dysfunction of the amygdala, orbitofrontal cortex, superior frontal gyrus, and posterior cingulate gyrus (Baggio et al, 2012; Heller et al, 2018; Ibarretxe-Bilbao et al, 2009; Péron et al, 2012; Robert et al, 2014; Wabnegger et al, 2015), as well as an increase in somatosensory cortex activity (Wabnegger et al, 2015). As observed in AD, FER ability impairment is also linked to a slight modification of the visual scanning strategy (Polet et al, 2017, 2022).…”

Social cognition deficits and biometric signatures in the behavioural variant of Alzheimer’s disease

“…Fifth, although all bvAD cases met our recently proposed research criteria for ‘possible bvAD’, 3 it is important to note that establishing consensus on the clinical criteria for this phenotype remains an active research area. Sixth, while the previous two studies 38 , 52 on eye tracking in bvFTD assessed the number of fixations, the present work assessed dwell time as the eye-tracking metric, potentially hampering comparisons between studies. Dwell time represents the time that gaze coordinates were directed towards a specific area of interest, 32 while fixation counts represent the amount of fixations made within the area of interest and as such do not contain a measure of time.…”

“…the eyes and mouth, 33 , 34 more detailed work should focus on other facial areas as well, such as the nose, as differences in this region of interest have been observed in bvFTD compared to SCD. 52 For the present study, we aimed to include a selective number of outcomes to minimize potential type one errors. Seventh, although differences in general cognitive functioning may hamper adequate comparison between bvAD and bvFTD on social cognition measures, this bias is deemed minimal, as the former showed better social cognition levels compared to the latter and the analyses of biometric responses showed similar patterns in these groups.…”

An Intelligent Mental Health Identification Method for College Students: A Mixed-Method Study

“…Moreover, the concealment of students and the incomplete coverage of questionnaire questions may cause serious misdiagnosis and missed diagnosis. As mental health is related to emotions, explaining mental health problems by observing facial emotions is a hot topic of extensive research by scholars [ 39 , 40 , 41 ], for example, C. Priyesh [ 42 ] performed facial emotion recognition in patients with schizophrenia and bipolar disorder with low recognition accuracy and reaction time. The experimental results illustrate the correlation between mental illness and facial emotions.…”