Emotion recognition of morphed facial expressions in presymptomatic and symptomatic frontotemporal dementia, and Alzheimer’s dementia
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Background: The emotion recognition task (ERT) was developed to overcome shortcomings of static emotion recognition paradigms, by identifying more subtle deficits in emotion recognition across different intensity levels. In this study, we used the ERT to investigate emotion recognition deficits across the frontotemporal (FTD) and Alzheimer’s Dementia (AD) spectrum. Methods: With the ERT, we assessed the recognition of facial emotional expressions (anger-disgust-fear-happiness-sadness-surprise) across four intensities (40–60–80–100%) in patients with behavioural variant FTD (bvFTD; n = 32), and AD (n = 32), presymptomatic FTD mutation carriers (n = 47) and controls (n = 49). We examined group differences using multilevel linear regression with age, sex and education level as covariates, and performed post hoc analyses on presymptomatic (MAPT, GRN and C9orf72) mutation carriers. Classification abilities were investigated by means of logistic regression. Results: Lowest ERT total scores were found in patients with bvFTD and AD, whereas equal highest performance was found in presymptomatic mutation carriers and controls. For all emotions, significantly lower subscores were found in patients with bvFTD than in presymptomatic mutation carriers and in controls (highest p value = 0.025). Patients with bvFTD performed lower than patients with AD on anger (p = 0.005) and a trend towards significance was found for a lower performance on happiness (p = 0.065). Task performance increased with higher emotional intensity, and classification was better at the lowest than at the highest intensity. C9orf72 mutation carriers performed worse on recognizing anger at the lowest intensity than GRN mutation carriers (p = 0.047) and controls (p = 0.038). The ERT differentiated between patients with bvFTD and controls, and between patients with AD and controls (both p < 0.001). Discussion: Our results demonstrate emotion recognition deficits in both bvFTD and AD, and suggest the presence of subtle emotion recognition changes in presymptomatic C9orf72-FTD. This highlights the importance of incorporating emotion recognition paradigms into standard neuropsychological assessment for early differential diagnosis, and as clinical endpoints in upcoming therapeutic trials.
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The addition of different intensities of emotions in the Emotion Recognition Task increased diagnostic sensitivity, even in presymptomatic C9ORF72 carriers.
“The addition of different intensities of emotions in the Emotion Recognition Task [ERT; (Kessels et al., 2007)] showed to increase diagnostic sensitivity, even in presymptomatic C9ORF72 carriers (Jiskoot et al., 2021), but longitudinal research is needed.”
From The pursuit for markers of disease progression in behavioral variant frontotemporal dementia: a scoping review to optimize outcome measures for clinical trials (2024) · cites this paper as Jiskoot et al., 2021
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Self-citation
- Authors
- Jiskoot, L. C., Poos, J. M., Vollebergh, M. E., Franzen, S., van Hemmen, J., Papma, J. M., van Swieten, J. C., Kessels, R. P. C., & van den Berg, E.
- Affiliations
- Erasmus MC (NL)
- Leiden University Medical Center (NL)
- Radboud University Nijmegen (NL)
- Corresponding author
- Jiskoot, Lize C.
- Venue
- Journal of Neurology
- Published
- 2020-07-29
- Volume
- 268
- Issue
- 1
- Pages
- 102-113
- ISSN
- 0012-1037 (ISSN-L)
- 0340-5354
- 1432-1459
- PMC
- PMC7815624
- OpenAlex
- W3045950748
- Cited by
- 42
- References
- 57
- Citations by year
- 2026: 13 · 2025: 8 · 2024: 5 · 2023: 3 · 2022: 6 · 2021: 6 · 2020: 1
- FWCI
- 2.92
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Neurology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, cc-by)
- RePub (Erasmus University Rotterdam) (submittedVersion, cc-by)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, cc-by)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Funders
- Stichting Dioraphte (09-02-00)
- Association for Frontotemporal Degeneration (2009)
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (HCMI 056-13-018)
- ZonMw Memorabel (733050103 & 733050813)
- Bluefield (-)
- JPND PreFrontAls (733051042)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Face Recognition and Perception
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Keywords
- emotion recognition, facial expressions, behavioral variant frontotemporal dementia, Alzheimer's disease, emotional intensity, neuropsychological assessment, clinical trial endpoints
- MeSH terms
- Alzheimer Disease, Emotions, Facial Expression, Humans, Recognition, Psychology, Frontotemporal Dementia
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