Disorders of Emotional Communication in Patient with Cerebellar Dysfunction

描述(由申请人提供)：小脑与认知和情绪功能有关，越来越多的证据表明，小脑后部的损伤可导致额叶执行、视觉空间和表达能力障碍，包括节律障碍，以及包括钝化情感或去抑制和不适当行为的情感变化(Stoodley&Schmahmann，2010；Schmahmann&Sherman，1998)。根据我们临床的初步临床观察和测试，情绪交流障碍也可能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，对于保持积极和支持性的关系至关重要。情感交流的缺失可能会对受影响的人的关系和生活质量产生毁灭性的影响(Blonder等人，2012年)。虽然情感和韵律缺陷已被报道与小脑后部功能障碍有关，但目前尚无系统研究小脑功能障碍个体的情感交流。众所周知，小脑与大脑皮质，尤其是额叶有很强的联系，中风或神经退行性疾病造成的皮质损伤会导致情感交流的障碍(Tucker，Watson&Helman，1977；Helman，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在情感交流方面产生类似的缺陷。本研究的目的是系统地调查和描述一系列小脑疾病患者在情感交流方面的缺陷。方法。参与者将是40名被诊断为小脑后部变性或因非出血性脑梗塞而受损的人，以及40名年龄匹配的神经学健康对照。评估将包括一系列神经心理功能测试以及情感交流测试。情绪面部和韵律表达的理解将使用佛罗里达影响电池(Bowers等人，1998)进行评估。情感交流的成果将通过在佛罗里达情感表达电池上的表现来评估。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。我们还将使用既定的评分标准(Bradley&Lang，1999；Lang，Bradley，&Cuthbert，2008)以及命题情感语言的理解和产生来评估对情绪唤起的图片和单词的反应性。结果。预期的结果将是识别和描述情绪交流缺陷(言语和非言语)的产生和理解方面的缺陷，以及识别和描述小脑疾病患者对情绪唤起刺激的反应的变化。目前对小脑-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对这些衰弱障碍的创新治疗方法。

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.