Disorders of Emotional Communication in Patient with Cerebellar Dysfunction

背景小脑与认知和情感功能有关， 有证据表明，小脑后部的损伤可导致额叶执行，视觉空间， 表达缺陷，包括韵律障碍，以及情感变化，包括情感迟钝或抑制解除， 不当行为（Stoodley & Schmahmann，2010; Schmahmann &谢尔曼，1998）。基于 在我们的诊所进行的初步临床观察和测试中，情感交流障碍可能 也与小脑功能障碍有关（Heilman等人，. 2012年）。情感交流包括 面部和韵律表情的产生和理解，是保持积极和 相互支持的关系情感交流的缺陷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已经被 据报道，与小脑后部疾病有关，目前尚无系统的研究 调查患有小脑功能障碍的人的情感交流。它是已知的 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 （Tucker，沃森& Heilman，1977; Heilman，Leon，& Rosenbek，2004; Ross & Mesulam，1979）。障碍 小脑疾病对小脑-大脑网络完整性的影响可能会在 情感交流本研究的目的是系统地调查和描述缺陷， 一系列小脑疾病患者的情感交流。法参与者将为40人 被诊断患有小脑后变性或非出血性梗死损伤的个体， 和40名年龄匹配的神经系统健康对照。评估将包括一系列测试， 神经心理学功能以及情感交流测试。面部表情理解 并且韵律表达将使用佛罗里达情感成套测验（Bowers等人，1998年）。生产 情感交流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 使用已建立评级标准的材料评估对情感唤起图片和文字的反应 （布拉德利& Lang，1999; Lang，布拉德利，& Cuthbert，2008）以及对 命题的情感语言。结果。预期的结果将是确定和描述以下方面的不足： 产生和理解情感沟通缺陷（语言和非语言），并确定和 描述了小脑疾病患者对情绪诱发刺激的反应性改变。之甚少 目前已知小脑-大脑连接在情感交流障碍中的作用， 更深入的了解可能会导致对这些使人衰弱的疾病的治疗的创新方法。

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.