title: Perception of Emotional Facial Expressions in Amyotrophic Lateral Sclerosis (ALS) at Behavioural and Brain Metabolic Level.
abstract: BACKGROUND
  Amyotrophic lateral sclerosis (ALS) primarily impairs motor abilities but also affects cognition and emotional processing. We hypothesise that subjective ratings of emotional stimuli depicting social interactions and facial expressions is changed in ALS. It was found that recognition of negative emotions and ability to mentalize other's intentions is reduced.
  
  
  METHODS
  Processing of emotions in faces was investigated. A behavioural test of Ekman faces expressing six basic emotions was presented to 30 ALS patients and 29 age-, gender and education matched healthy controls. Additionally, a subgroup of 15 ALS patients that were able to lie supine in the scanner and 14 matched healthy controls viewed the Ekman faces during functional magnetic resonance imaging (fMRI). Affective state and a number of daily social contacts were measured.
  
  
  RESULTS
  ALS patients recognized disgust and fear less accurately than healthy controls. In fMRI, reduced brain activity was seen in areas involved in processing of negative emotions replicating our previous results. During processing of sad faces, increased brain activity was seen in areas associated with social emotions in right inferior frontal gyrus and reduced activity in hippocampus bilaterally. No differences in brain activity were seen for any of the other emotional expressions. Inferior frontal gyrus activity for sad faces was associated with increased amount of social contacts of ALS patients.
  
  
  CONCLUSIONS
  ALS patients showed decreased brain and behavioural responses in processing of disgust and fear and an altered brain response pattern for sadness. The negative consequences of neurodegenerative processes in the course of ALS might be counteracted by positive emotional activity and positive social interactions.
authors.affiliation: Department of Neurology, University of Ulm, Ulm, Germany.
authors.forename: Helena E A
authors.initials: HE
authors.lastname: Aho-Özhan
authors.affiliation: Department of Neurology, University of Ulm, Ulm, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Keller
authors.affiliation: Department of Neurology, University of Ulm, Ulm, Germany.
authors.forename: Johanna
authors.initials: J
authors.lastname: Heimrath
authors.affiliation: Department of Neurology, University of Ulm, Ulm, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Uttner
authors.affiliation: Department of Neurology, University of Ulm, Ulm, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Kassubek
authors.affiliation: Institute of Medical Psychology and Behavioral Neurobiology, Eberhard-Karls-University of Tübingen, Tübingen, Germany.|The Wyss Center for Bio and Neuroengineering, Geneva, Switzerland.
authors.forename: Niels
authors.initials: N
authors.lastname: Birbaumer
authors.affiliation: Department of Neurology, University of Ulm, Ulm, Germany.
authors.forename: Albert C
authors.initials: AC
authors.lastname: Ludolph
authors.affiliation: Department of Neurology, University of Ulm, Ulm, Germany.|Institute of Medical Psychology and Behavioral Neurobiology, Eberhard-Karls-University of Tübingen, Tübingen, Germany.
authors.forename: Dorothée
authors.initials: D
authors.lastname: Lulé
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000503:physiopathology*; D001519:Behavior / Q000502:physiology*; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism*; D016022:Case-Control Studies; D004644:Emotions / Q000502:physiology*; D005149:Facial Expression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010775:Photic Stimulation; D012044:Regression Analysis