Relapsing–remitting and secondary‐progressive multiple sclerosis patients differ in decoding others' emotions by their eyes

Abstract

Background and purpose Difficulties in emotion processing and social cognition identified in multiple sclerosis (MS) patients have a potential impact on their adaptation to the social environment. We aimed to explore the neural correlates of emotion recognition in MS and possible differences between relapsing–remitting MS (RRMS) and secondary progressive MS (SPMS) patients by the Reading the Mind in the Eyes test (RMEt). Methods A total of 43 MS patients (27 RRMS, 16 SPMS) and 25 matched healthy controls (HC) underwent clinical assessments, RMEt, and a high‐resolution T1‐weighted 3‐T magnetic resonance imaging (MRI) scan. The number of correct answers on the RMEt was compared between groups. T1‐weighted volumes were processed according to an optimized voxel‐based morphometry (VBM) protocol to obtain gray matter (GM) maps. Voxelwise analyses were run to assess potential associations between RMEt performance and regional GM volumes. Results Taken altogether, MS patients reported significantly lower performance on the RMEt compared to HC. When dividing the patients into those with RRMS and those with SPMS, only the latter group was found to perform significantly worse than HC on the RMEt. VBM analysis revealed significant association between RMEt scores and GM volumes in several cortical (temporoparieto‐occipital cortex) and subcortical (hippocampus, parahippocampus, and basal ganglia) brain regions, and in the cerebellum in SPMS patients only. Conclusions Results suggest that, in addition to other clinical differences between RRMS and SPMS, the ability to recognize others' emotional states may be affected in SPMS more significantly than RRMS patients. This is supported by both behavioral and MRI data.

Emotional Recognition and Its Relation to Cognition, Mood and Fatigue in Relapsing–Remitting and Secondary Progressive Multiple Sclerosis

“…In addition, the differences found for cognitive scores and for cognitive impairment index reflect the higher disability of SP-pMS as it has been widely reported in the literature [ 53 , 63 ]. Furthermore, as found in a previous study, patients in the two courses also had significantly different RMEt scores, with RR-pMS performing better than SP-pMS [ 49 ].…”

“…Within even basic conversations, this has required the ability to understand others’ mental states only by observing the eye regions, making the maintenance of appropriate social relationships for pMS even harder. In fact, as previously demonstrated, these patients have difficulties in ER explored by the RMEt to a different degree for the two main courses of the pathology [ 49 ].…”

“…Interestingly, in a previous study, we found that ER difficulties often affect MS patients with consequences on quality of life, psychosocial adaptation due to problems in understanding pragmatic language statements (such as irony), employment and interpersonal domains (such as personal relationships). ER difficulties were found to relate to a different GM atrophy pattern in secondary progressive (SP-pMS) and RR-pMS [ 49 ]. Furthermore, SP-pMS performed significantly worse than matched healthy controls in the emotional recognition task, while RR-pMS did not.…”

Cognitive impairment in multiple sclerosis: “classic” knowledge and recent acquisitions

“…Usually, no differences in impairment levels were observed between MS phenotypes. In contrast, Argento et al 83 demonstrated the presence of specific patterns of impairment of SC skills by phenotype: both RRMS and SPMS performed poorly on the Reading the Mind in the Eyes test compared with HCs, but only SPMS patients reached a statistically significant difference. 83 Individuals with MS are not only less accurate in recognizing basic emotions than healthy individuals, but they have longer reaction times.…”

“…In contrast, Argento et al 83 demonstrated the presence of specific patterns of impairment of SC skills by phenotype: both RRMS and SPMS performed poorly on the Reading the Mind in the Eyes test compared with HCs, but only SPMS patients reached a statistically significant difference. 83 Individuals with MS are not only less accurate in recognizing basic emotions than healthy individuals, but they have longer reaction times. 84 Regarding empathy, while some studies have highlighted subtle difficulties in pMS, 84 recent research found no difference in empathy between pMS and the healthy population.…”