Objective: To examine facial emotion recognition (FER) as crucial component of social cognition and its relationship with social-behavioral problems in de novo drug-naïve Parkinson’s disease (PD) patients.

Background: Decline in cognitive functions such as attention, executive function and memory, is widely recognized as an important part of non-motor symptoms in PD, which may be present already at the early stages of PD. Although research shows that FER impairment in advanced PD is a robust finding, and may also affect quality of life of patients and caregivers, it is still often neglected in clinical practice. To date, it is not clear whether FER is already affected at the time of PD diagnosis, and if so, how it relates to behavioral functioning in daily life.

Method: 144 de novo, drug-naïve PD patients (71% male, median age 66.5 years, range [36-85]) and 144 healthy controls (HC) matched on sex, age and educational level took part in the study. FER was assessed by the Ekman 60 faces test (FEEST), with higher scores indicating better performance. Behavioral problems in PD patients were assessed using the Dysexecutive Questionnaire (DEX-self and DEX-proxy), with higher scores indicating more social behavioral problems. A DEX difference score (DEX-self minus DEX-proxy) was calculated as an indication of self-awareness. PD and HC were compared on total FEEST scores and the subscores of the separate emotions (anger, disgust, fear, happiness, sadness, surprise), using Mann-Whitney U. Spearman’s rho was used to assess correlations between total FEEST score and DEX scores. The false discovery rate was used to correct for multiple testing.

Results: PD patients presented with significantly lower scores on the total FEEST (p = .001), with lower recognition of the emotions disgust (p = .001) and sadness (p = .017), compared to HC. Correlational analyses yielded significant, though moderate, negative correlations between DEX-proxy and total FEEST score (r_s = -.29), and the subscore anger (r_s = -.27). No significant correlations were found between the DEX difference or DEX-self score and FEEST scores.

Conclusion: Drug-naïve de novo PD patients already show a significant impairment of  FER, compared to HC. This is linked to increased social-behavioral problems, as reported by proxies. These findings should lead to standard assessment of social cognition in early PD, being part of the spectrum of cognitive pathology in early PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/facial-emotion-recognition-and-social-behavioral-problems-in-de-novo-parkinsons-disease-patients/