Brain Advance Access originally published online on January 16, 2006
Brain 2006 129(3):707-717; doi:10.1093/brain/awl011
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Disgust-specific impairment of facial expression recognition in Parkinson's disease
1 Department of Cognitive and Behavioral Science, The University of Tokyo, Komaba, and 2 Department of Neurology, Showa University School of Medicine, Tokyo, Japan
Correspondence to: M. Kawamura, Department of Neurology, Showa University School of Medicine, Hatanodai 1-5-8, Shinagawa-ku, Tokyo 142-8666, Japan E-mail: kawa{at}med.showa-u.ac.jp
There is contradictory evidence regarding whether the impairments of the recognition of emotional facial expressions in Parkinson's disease are specific to certain emotions such as disgust and fear. Generally, neurological case reports on emotion-specific impairments have been suspected of being confounded with the factor of task difficulty. Using a refined assessment method in which the difficulty factors were controlled by means of mixed facial expressions and item response theory, we attempted to clarify whether Parkinson's disease disproportionately impaired the recognition of specific emotions. We studied 14 patients with Parkinson's disease and 39 healthy controls who were matched in terms of gender, age, years of education and intelligence quotient. Whereas the refined method revealed that the patients with Parkinson's disease displayed significantly lower scores in disgust recognition alone, conventional methods failed to detect this impairment. In addition, control measures including face recognition abilities did not statistically explain the impairment observed in the patients. The results indicate that Parkinson's disease can indeed selectively impair the recognition of facial expressions of disgust; this provides concrete evidence for emotion-specific impairments that sufficiently withstands criticisms regarding the difficulty artefacts. Furthermore, the results support the proposed role of the basal ganglia–insula system in disgust recognition. This study effectively demonstrates the benefits of refining neuropsychological assessment by taking advantage of the modern psychometric theory.
Key Words: Parkinson's disease; facial expression recognition; emotion-specific impairment; disgust; item response theory
Abbreviations: GRM = graded-response model; IRT = item response theory; SDS = Self-report Depression Scale
Received October 12, 2005. Revised December 7, 2005. Accepted December 19, 2005.
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