Disorders of Emotional Communication in Patient with Cerebellar Dysfunction

背景资料。小脑与认知和情感功能有关，而且有越来越多的 小脑后部受损可导致额叶-执行、视觉空间和 表达缺陷，包括韵律障碍，以及情感变化，包括钝化情感或去抑制和 不当行为(Stoodley&Schmahmann，2010；Schmahmann&Sherman，1998)。基于 在我们诊所进行的初步临床观察和测试，情绪沟通障碍可能 也与小脑功能障碍有关(海尔曼等人)。2012年)。情感交流包括 面部和韵律表情的产生和理解，对保持积极和 支持性的关系。情感交流的缺陷可能会对人际关系产生毁灭性的影响 以及受影响者的生活质量(Blonder等人，2012年)。尽管情感和韵律方面的缺陷一直是 关于与小脑后部疾病有关的报道，目前还没有系统的研究。 调查小脑功能障碍患者的情绪交流。据了解， 小脑与大脑皮层有很强的联系，特别是额叶，而大脑皮层 中风或神经退行性疾病造成的损伤会导致情感交流障碍 (塔克，沃森和海尔曼，1977；海尔曼，利昂和罗森贝克，2004；罗斯和梅苏拉姆，1979)。减值 小脑疾病的小脑-大脑网络的完整性可能会在 情感交流。这项研究的目的是系统地调查和描述 一系列小脑疾病患者的情感交流。方法。参赛者为40岁 被诊断为小脑后部变性或因非出血性脑梗塞而受损的个人， 以及40名年龄匹配的神经学健康对照。评估将包括一系列测试 神经心理功能以及情感交流的测试。对表情情绪化的理解 韵律表达将使用佛罗里达影响电池(Bowers等人，1998)进行评估。生产 情感交流将通过在佛罗里达情感表达电池上的表现进行评估。 面部表情和韵律表情将被记录下来，并由训练有素的评委独立评分。我们还将 使用具有既定评级标准的材料评估对情绪唤起的图片和单词的反应 (Bradley&Lang，1999；Lang，Bradley，&Cuthbert，2008)以及对 命题情感语言。结果。预期结果将是确定和描述 产生和理解情感交流缺陷(语言和非语言)，并识别和 描述小脑疾病患者对情绪刺激反应的变化。小才是 目前已知小脑-大脑连接在情绪沟通障碍中的作用 更多的了解可能会带来治疗这些衰弱疾病的创新方法。

Background. The cerebellum has been linked to cognitive and emotional functions and there is increasing evidence that damage to posterior portions of the cerebellum can result in frontal-executive, visuospatial, and expressive deficits, including dysprosodia, and affective changes including blunting of affect or disinhibited and inappropriate behavior (Stoodley & Schmahmann, 2010; Schmahmann & Sherman, 1998). Based on preliminary clinical observations and tests performed in our clinic, disorders of emotional communication may also be associated with cerebellar dysfunction (Heilman, et al,. 2012). Emotional communication includes the production and comprehension of facial and prosodic expressions and is critical to maintaining positive and supportive relationships. Deficits in emotional communication can have devastating effects on relationships and on quality of life for those affected (Blonder et al., 2012). Although deficits in affect and prosody have been reported in association with posterior cerebellar disorders, there are currently no studies systematically investigating emotional communication in individuals with cerebellar dysfunction. It is known that the cerebellum has strong connections with the cerebral cortex, especially the frontal lobes, and that cortical damage from stroke or neurodegenerative disease can result in disorders of emotional communication (Tucker, Watson & Heilman, 1977; Heilman, Leon, & Rosenbek, 2004; Ross & Mesulam, 1979). Impairments in the integrity of cerebellar-cerebral networks from cerebellar disease may produce similar deficits in emotional communication. The purpose of this study is to systematically investigate and describe deficits in emotional communication in a series of patients with cerebellar disease. Method. Participants will be 40 individuals diagnosed with posterior cerebellar degeneration or damage from a non-hemorrhagic infarction, and 40 age-matched neurologically healthy controls. Assessment will include a battery of tests of neuropsychological function as well as tests of emotional communication. Comprehension of emotional facial and prosodic expressions will be assessed using the Florida Affect Battery (Bowers et al., 1998). Production of emotional communication will be evaluated by performance on the Florida Emotional Expressive Battery. Facial and prosodic expressions will be recorded and independently rated by trained judges. We will also assess reactivity to emotionally evocative pictures and words using materials with established rating norms (Bradley & Lang, 1999; Lang, Bradley, & Cuthbert, 2008) as well as comprehension and production of propositional emotional language. Outcomes. The expected outcomes will be to identify and describe deficits in production and comprehension of emotional communicative deficits (verbal and nonverbal) and to identify and describe alterations in reactivity to emotionally evocative stimuli in individuals with cerebellar disease. Little is currently known about the role of cerebellar-cerebral connections in emotional communication disorders and greater understanding may result in innovative approaches to treatment for these debilitating disorders.