Disorders of Emotional Communication in Patient with Cerebellar Dysfunction

描述（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，小脑后部的损伤会导致额叶执行、视觉空间和表达缺陷，包括韵律异常，以及情感变化，包括情感迟钝或抑制和不当行为（Stoodley & Schmahmann，2010; Schmahmann &谢尔曼，1998）。基于在我们的诊所中进行的初步临床观察和测试，情感交流障碍也可能与小脑功能障碍相关（Heilman等人，2012年）。情感交流包括面部表情和韵律表情的产生和理解，对维持积极和支持性的关系至关重要。情感沟通的缺陷可能对人际关系和受影响者的生活质量产生破坏性影响（Blonder等人，2012年）。虽然已经报道了情感和韵律的缺陷与小脑后部疾病有关，但目前还没有系统研究小脑功能障碍患者的情感交流。众所周知，小脑与大脑皮层，特别是额叶有着密切的联系，中风或神经退行性疾病造成的皮层损伤会导致情感交流障碍（Tucker，沃森& Heilman，1977; Heilman，Leon，& Rosenbek，2004; Ross & Mesulam，1979）。小脑疾病对小脑-大脑网络完整性的损害可能会产生类似的情感沟通缺陷。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感沟通缺陷。法参与者将是40名被诊断患有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。将使用佛罗里达情感成套测验（Bowers等人，1998年）。情感交流的产生将通过在佛罗里达情感表达成套测验中的表现来评估。面部表情和韵律将被记录下来，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（布拉德利& Lang，1999; Lang，布拉德利，& Cuthbert，2008）以及命题情感语言的理解和产生来评估对情感唤起图片和文字的反应。结果。预期的结果将是识别和描述情感沟通缺陷（语言和非语言）的产生和理解缺陷，并识别和描述小脑疾病患者对情感唤起刺激的反应性改变。目前对小脑-大脑连接在情感沟通障碍中的作用知之甚少，更深入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.