Disorders of Emotional Communication in Patient with Cerebellar Dysfunction

描述（由申请人提供）：小脑与认知和情感功能有关，越来越多的证据表明，小脑后部的损伤可导致额执行、视觉空间和表达缺陷，包括言语障碍，以及情感变化，包括情感钝化或去抑制和不当行为（Stoodley & Schmahmann, 2010; Schmahmann & Sherman, 1998）。根据初步的临床观察和在我们诊所进行的测试，情绪沟通障碍也可能与小脑功能障碍有关(Heilman, et al,；2012)。情感交流包括面部和韵律表达的产生和理解，对维持积极和支持的关系至关重要。情感沟通的缺陷会对人际关系和生活质量造成毁灭性的影响（Blonder等人，2012）。虽然有报道称情感和韵律缺陷与小脑后部障碍有关，但目前还没有研究系统地调查小脑功能障碍患者的情绪沟通。众所周知，小脑与大脑皮层，特别是额叶有很强的联系，中风或神经退行性疾病引起的皮层损伤可导致情绪交流障碍（Tucker, Watson & Heilman, 1977; Heilman, Leon, & Rosenbek, 2004; Ross & Mesulam, 1979）。小脑疾病导致的小脑-大脑网络完整性受损可能会导致情绪沟通方面的类似缺陷。本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绪沟通缺陷。方法。参与者将是40名诊断为小脑后变性或非出血性梗死损伤的个体，以及40名年龄匹配的神经健康对照。评估将包括一系列神经心理功能测试以及情感交流测试。对情绪面部和韵律表情的理解将使用佛罗里达情感电池进行评估（鲍尔斯等人，1998年）。情感交流的产生将通过佛罗里达情感表达电池的表现来评估。面部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规范的材料（Bradley & Lang, 1999; Lang, Bradley, & Cuthbert, 2008）评估对情感唤起图片和文字的反应，以及对命题情感语言的理解和产生。结果。预期的结果将是识别和描述产生和理解情感交流缺陷（言语和非言语）的缺陷，并识别和描述小脑疾病患者对情感唤起刺激的反应性变化。目前，人们对小脑-大脑连接在情绪沟通障碍中的作用知之甚少，更多的了解可能会导致治疗这些使人衰弱的疾病的创新方法。

DESCRIPTION (provided by applicant): 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.