Beyond disgust: impaired recognition of negative emotions prior to diagnosis in Huntington's disease
1Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA, 2Departments of Psychiatry and Biostatistics, University of Iowa, Iowa City, IA, USA, 3Department of Radiology, University of Washington, Seattle, WA, USA, 4Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA, 5Struthers Parkinson's Center, Hennepin County Medical Center, Golden Valley, MN, USA, 6Clinical Trials Coordination Center, University of Rochester, Rochester, NY, USA, 7Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada, 8Departments of Neurology and Community and Preventive Medicine, University of Rochester, Rochester, NY, USA, 9Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada, 10Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USA, 11Department of Neurology, University of Rochester, Rochester, NY, USA, 12Department of Psychiatry, University of Iowa, Iowa City, IA, USA and 13Departments of Psychiatry, Neurology, Psychology and Neurosciences, University of Iowa, Iowa City, IA, USA
Correspondence to: Julie C. Stout, PhD, School of Psychology, Psychiatry and Psychological Medicine, Building 17, Clayton Campus, Monash University, Victoria 3800, Australia E-mail: julie.stout{at}med.monash.edu.au
Previous studies of emotion recognition suggest that detection of disgust relies on processing within the basal ganglia and insula. Research involving individuals with symptomatic and pre-diagnostic Huntington's disease (HD), a disease with known basal ganglia atrophy, has generally indicated a relative impairment in recognizing disgust. However, some data have suggested that recognition of other emotions (particularly fear and anger) may also be affected in HD, and a recent study found fear recognition deficits in the absence of other emotion-recognition impairments, including disgust. To further examine emotion recognition in HD, we administered a computerized facial emotion recognition task to 475 individuals with the HD CAG expansion and 57 individuals without. Logistic regression was used to examine associations of emotion recognition performance with estimated proximity to clinical diagnosis (based on CAG repeat length and current age) and striatal volumes. Recognition of anger, disgust, fear, sadness and surprise (but not happiness) was associated with estimated years to clinical diagnosis; performance was unrelated to striatal volumes. Compared to a CAG-normal control group, the CAG-expanded group demonstrated significantly less accurate recognition of all negative emotions (anger, disgust, fear, sadness). Additionally, participants with more pronounced motor signs of HD were significantly less accurate at recognizing negative emotions than were individuals with fewer motor signs. Findings indicate that recognition of all negative emotions declines early in the disease process, and poorer performance is associated with closer proximity to clinical diagnosis. In contrast to previous results, we found no evidence of relative impairments in recognizing disgust or fear, and no evidence to support a link between the striatum and disgust recognition.
Key Words: presymptomatic Huntington's disease; emotion recognition; striatum; disgust; Predict-HD
Abbreviations: HD, Huntington's disease
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Received September 21, 2006. Revised April 4, 2007. Accepted April 16, 2007.
Present address: 14Department of Psychology, Dalhousie University, Halifax, NS, Canada
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