Facial Emotion Recognition in Parkinson's Disease: The Role of Executive and Affective Domains

Objective: The ability to recognize emotions from facial expression (FER) may be impaired in Parkinson's disease (PD). We aimed to explore FER in PD patients by using a dynamic presentation of emotions across different intensities and to examine the extent to which executive and affective alterations contributed to FER deficits. Method: Fifteen PD patients and 15 healthy controls were assessed on the emotion recognition task (ERT). We also explored how clinical and executive factors could have contributed to ERT accuracy. Results: PD patients showed poorer performance on the ERT, specifically on angry expressions, but they benefited from increased intensity as much as controls did. Differences were also found for apathy, depression, and executive tests, especially in the inhibition domain. Importantly, differences between groups on the ERT disappeared when controlling for inhibition and the affective symptoms. A significant effect of inhibition dysfunction was also observed on the ERT performance. Conclusions: Our findings demonstrate the presence of emotion recognition deficits of morphed facial expressions in patients with PD. Moreover, they suggest that inhibition dysfunctions may act as an important factor negatively influencing FER. The present study highlights the complex nature of emotion processing and its relation with emotional-affective and cognitive aspects to provide a better understanding of FER deficits in PD.