title: Emotion processing in Parkinson's disease: a three-level study on recognition, representation, and regulation.
abstract: BACKGROUND
  Parkinson's disease (PD) is characterised by well-known motor symptoms, whereas the presence of cognitive non-motor symptoms, such as emotional disturbances, is still underestimated. One of the major problems in studying emotion deficits in PD is an atomising approach that does not take into account different levels of emotion elaboration. Our study addressed the question of whether people with PD exhibit difficulties in one or more specific dimensions of emotion processing, investigating three different levels of analyses, that is, recognition, representation, and regulation.
  
  
  METHODS
  Thirty-two consecutive medicated patients with PD and 25 healthy controls were enrolled in the study. Participants performed a three-level analysis assessment of emotional processing using quantitative standardised emotional tasks: the Ekman 60-Faces for emotion recognition, the full 36-item version of the Reading the Mind in the Eyes (RME) for emotion representation, and the 20-item Toronto Alexithymia Scale (TAS-20) for emotion regulation.
  
  
  RESULTS
  Regarding emotion recognition, patients obtained significantly worse scores than controls in the total score of Ekman 60-Faces but not in any other basic emotions. For emotion representation, patients obtained significantly worse scores than controls in the RME experimental score but no in the RME gender control task. Finally, on emotion regulation, PD and controls did not perform differently at TAS-20 and no specific differences were found on TAS-20 subscales. The PD impairments on emotion recognition and representation do not correlate with dopamine therapy, disease severity, or with the duration of illness. These results are independent from other cognitive processes, such as global cognitive status and executive function, or from psychiatric status, such as depression, anxiety or apathy.
  
  
  CONCLUSIONS
  These results may contribute to better understanding of the emotional problems that are often seen in patients with PD and the measures used to test these problems, in particular on the use of different versions of the RME task.
authors.affiliation: Department of Philosophy and Educational Sciences, University of Turin, Turin, Italy; Center for Cognitive Science, University of Turin, Turin, Italy; Neuroscience Institute of Turin, Turin, Italy.
authors.forename: Ivan
authors.initials: I
authors.lastname: Enrici
authors.affiliation: Center for Cognitive Science, University of Turin, Turin, Italy; Neuroscience Institute of Turin, Turin, Italy; Department of Psychology, University of Turin, Turin, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Adenzato
authors.affiliation: Center for Cognitive Science, University of Turin, Turin, Italy; Department of Psychology, University of Turin, Turin, Italy.
authors.forename: Rita B
authors.initials: RB
authors.lastname: Ardito
authors.affiliation: Department of Psychology, University of Turin, Turin, Italy.
authors.forename: Antonia
authors.initials: A
authors.lastname: Mitkova
authors.affiliation: eCampus University, Novedrate, Como, Italy; Azienda Sanitaria Locale Torino 3, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Cavallo
authors.affiliation: Department of Neuroscience, University of Turin, Turin, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zibetti
authors.affiliation: Neuroscience Institute of Turin, Turin, Italy; Department of Neuroscience, University of Turin, Turin, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Lopiano
authors.affiliation: Department of Psychology, University of Turin, Turin, Italy.
authors.forename: Lorys
authors.initials: L
authors.lastname: Castelli
mesh_terms: D000342:Affective Symptoms / Q000523:psychology*; D000368:Aged; D001007:Anxiety; D016022:Case-Control Studies; D003863:Depression; D004644:Emotions / Q000502:physiology*; D056344:Executive Function / Q000502:physiology; D005145:Face; D005149:Facial Expression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000523:psychology*; D010364:Pattern Recognition, Visual / Q000502:physiology; D021641:Recognition, Psychology / Q000502:physiology*