IMPAIRED FACIAL EMOTION RECOGNITION AND PRESERVED REACTIVITY TO FACIAL EXPRESSIONS IN PEOPLE WITH SEVERE DEMENTIA
IMPAIRED FACIAL EMOTION RECOGNITION AND PRESERVED REACTIVITY TO FACIAL EXPRESSIONS IN PEOPLE WITH SEVERE DEMENTIA
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DOI：
10.1016/j.archger.2009.09.023
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发表时间：
2009-01-01
影响因子：
4
通讯作者：
Colombo, M.
中科院分区：
文献类型：
--
作者：
Guaita, A.;Malnati, M.;Colombo, M.
额颞叶痴呆患者的面部表情解码能力可能在早期受损，而阿尔茨海默病患者的面部表情解码能力相对较好。然而，有关痴呆严重程度与面部情绪识别能力关系的数据存在矛盾和不足，主要针对疾病的中重度阶段。本研究扩展到现有的文献：（1）评估的人在中度和重度阶段的痴呆症，与没有认知障碍的人相比;（2）评估不仅识别，而且反应的面部表情的情绪。对79例老年痴呆症患者和64例健康老年人的面部表情理解能力进行了评估。这项测试包括向他们展示14张照片，分别来自男性和女性的7种情绪，代表快乐，悲伤，恐惧，厌恶，无聊，愤怒和惊讶。患者被要求观察面部，并通过命名或描述来识别情绪。然后，对面部表情的自发反应进行录像，并由两名独立的观察者进行分类，这些观察者表现出良好的评分者间信度。在这些患者中，53%的痴呆症患者在14种情绪中识别出多达5种情绪，而在健康对照组中，这一平均识别数上升到8.4，MMSE评分为16的患者达到了这个值。最明显的情绪是快乐，无论是对病人还是对控制组。一般来说，积极情绪比消极情绪更容易被识别，这证实了文学数据。在对面孔情绪刺激的反应上，对照组与痴呆组在任何一种面孔情绪上均无显著差异。这些数据表明，痴呆症患者在疾病的严重阶段也可以识别面部情绪并对其做出反应，这表明非语言情感沟通的有用性，并支持对护理人员，亲属和专业人员进行更多情感教育的必要性。
The ability of decoding the emotional facial expressions may be early damaged in frontotemporal dementia, but relatively well preserved in the Alzheimer's disease (AD). Nevertheless, the data about the relationship of the dementia severity with the ability of recognizing the face emotions are conflicting and insufficient, mainly for the moderate-severe stage of the disease. The present study extends to the existing literature by: (1) assessing people in the moderate and severe stage of dementia, compared with people without cognitive impairment; (2) assessing not only recognition but also reactivity to the facial expression of emotion. The capability of understanding the facial emotions has been evaluated in 79 patients with dementia compared to 64 healthy elderly people. The test consisted in showing them 14 photographic representations of 7 emotions both from male and from female faces, representing happiness, sadness, fear, disgust, boredom, anger and surprise. Patients were asked to observe the face and to recognize the emotion either with a denomination or a description. Then the spontaneous reactivity to the face expressions was videotaped and classified as a congruous or incongruous reaction by two independent observers who showed a good inter-rater reliability. Of the patients, 53% with dementia recognized up to 5 emotions out of 14, while in the healthy controls this number of mean recognition raised to 8.4, a value reached by the patients who scored 16 at MMSE. The most identified emotion is happiness both for the patients and for the controls. In general, positive emotions are better recognized than the negative ones, confirming the literary data. About the reactions to face emotion stimuli, there is no significant difference for any of the face emotion between the control group and the people with dementia. These data show that patients with dementia can recognize and react to facial emotions also in the severe stage of the disease, suggesting the usefulness of a non-verbal, emotional communication and supporting the need for more emotional education for care givers, both relatives and professionals.