title: Neuroanatomical correlates of impaired decision-making and facial emotion recognition in early Parkinson's disease.
abstract: Decision-making and recognition of emotions are often impaired in patients with Parkinson's disease (PD). The orbitofrontal cortex (OFC) and the amygdala are critical structures subserving these functions. This study was designed to test whether there are any structural changes in these areas that might explain the impairment of decision-making and recognition of facial emotions in early PD. We used the Iowa Gambling Task (IGT) and the Ekman 60 faces test which are sensitive to the integrity of OFC and amygdala dysfunctions in 24 early PD patients and 24 controls. High-resolution structural magnetic resonance images (MRI) were also obtained. Group analysis using voxel-based morphometry (VBM) showed significant and corrected (P < 0.05 FEW-small volume correction) gray matter (GM) loss in the right amygdala and bilaterally in the OFC in PD patients. Volumetric analyses were also performed but did not yield significant differences between groups. Left lateral GM volume in OFC showed a slight correlation with the IGT, and bilateral OFC GM was strongly correlated with Ekman test performance in PD patients. We conclude that: (i) impairment in decision-making and recognition of facial emotions occurs at the early stages of PD, (ii) these neuropsychological deficits are accompanied by degeneration of OFC and amygdala, and (iii) bilateral OFC reductions are associated with impaired recognition of emotions, and GM volume loss in left lateral OFC is related to decision-making impairment in PD.
authors.affiliation: Centro de Investigation en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clinic de Barcelona, Barcelona, Spain.
authors.forename: Naroa
authors.initials: N
authors.lastname: Ibarretxe-Bilbao
authors.forename: Carme
authors.initials: C
authors.lastname: Junque
authors.forename: Eduardo
authors.initials: E
authors.lastname: Tolosa
authors.forename: Maria-Jose
authors.initials: MJ
authors.lastname: Marti
authors.forename: Francesc
authors.initials: F
authors.lastname: Valldeoriola
authors.forename: Nuria
authors.initials: N
authors.lastname: Bargallo
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Zarei
mesh_terms: D000679:Amygdala / Q000473:pathology / Q000503:physiopathology*; D000704:Analysis of Variance; D001931:Brain Mapping; D016009:Chi-Square Distribution; D003657:Decision Making; D004644:Emotions; D005149:Facial Expression; D005260:Female; D005625:Frontal Lobe / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009833:Olfactory Pathways / Q000473:pathology / Q000503:physiopathology; D009929:Organ Size; D010300:Parkinson Disease / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology; D018579:Patient Selection; D011597:Psychomotor Performance; D021641:Recognition, Psychology; D012938:Social Perception; D018709:Statistics, Nonparametric