Polet Kévin, Hesse Solange, Morisot Adeline, Kullmann Benoît, Louchart de la Chapelle Sandrine, Pesce Alain, Iakimova Galina
Clinical Research Unit-Memory Clinic Princess Grace Hospital, Monaco.
Public Health Department, Nice Côte d'Azur University, University Hospital Center of Nice, Nice, France.
Cogn Behav Neurol. 2022 Mar 3;35(1):14-31. doi: 10.1097/WNN.0000000000000288.
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.
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.
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.
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.
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.
面部情绪识别（FER）在行为变异型额颞叶痴呆（bvFTD）患者中主要且严重受损，在阿尔茨海默病（AD）或帕金森病（PD）患者中通常轻度受损。这种损伤与不适当的社交行为有关。
确定FER损伤是否与使用不适当的眼神注视策略来解码面部情绪有关，从而导致对他人意图的误解进而引发行为障碍。
我们使用“解读眼神中的心思”（RME）测试和艾克曼面部表情测试，对9名bvFTD患者、23名AD患者、20名PD患者以及22名健康对照者（HC）进行了FER评估。使用眼动追踪设备记录眼动情况（注视次数和持续时间）。使用神经精神科问卷评估行为。
AD组和PD组的FER轻度受损，bvFTD组严重受损。FER损伤伴随着注视次数增加以及更倾向于注视他人面部下部。FER损伤和注视次数增加与行为障碍呈正相关。
我们的研究表明，bvFTD患者以及AD或PD患者的FER损伤、观察情绪面孔时眼神注视策略的改变与行为障碍之间存在关联。这些结果表明，眼神注视策略康复计划可能对这些疾病患者的情绪识别和行为障碍产生有益影响。
