The amygdala of patients with Parkinson’s disease is silent in response to fearful facial expressions
Section snippets
Subjects
Ten elderly healthy normal volunteers (range of age: 49–71 years; median: 63.5; all male) and nine patients with PD (range of age: 51–79 years; median: 72; seven males, two females) participated in the study. All patients were treated with medications that are appropriate for patients with PD. The severity of parkinsonian symptoms in all cases was equivalent to 2 or 3 on the Hoehn-Yahr scale (Hoehn and Yahr, 1967). As anxiety causes activation of the amygdala (Masaoka and Homma, 2000), the
Task performance
The normal subjects responded correctly to 98.5±1.24% of the stimuli, whereas the patients with PD responded to 98.9±0.65%. As is evident from the percentage of correct responses and RTs (Table 1), normal subjects and patients with PD performed the task equally well (Mann-Whitney U test, P>0.05). The mean STAI scores for anxiety were 40.2±5.9 in normal subjects and 42.3±11.2 in patients with PD. The mean scores for state anxiety were 40.9±8.6 in normal subjects and 37.6±8.4 in patients with PD.
Discussion
The most important observation in this study was that the ERPs elicited in response to fearful facial expressions were generated within the parietal somatosensory cortex in patients with PD, whereas the equivalent ECDs in normal subjects were located in the amygdala and visual temporal cortex. These findings support our hypothesis that dysfunction of the amygdala in patients with PD causes a change in the neural substrates that are normally used to recognize emotion.
Conclusions
This study revealed that normal subjects and patients with PD use different neural substrates to recognize emotion in facial expressions. The ECDs for component N1 of the ERPs evoked by fearful facial expressions were located in the parietal-associated cortex, in patients with PD. In normal subjects, the dipoles for the same stimulus were generated in the fusiform gyrus, amygdala, parahippocampal gyrus, and superior temporal gyrus, and then moved to the left orbitofrontal gyrus and middle
Acknowledgments
We are grateful to Dr. T. Nagamine (Human Brain Research Center, Kyoto University Graduate School of Medicine) for technical advice, and to Prof. Y. Okamoto (Chiba Institute of Technology), Dr. M. Inoue (Department of Neurology, Showa University School of Medicine), and Prof. Y. Iwamura (Kawasaki University of Medical Welfare) for useful criticism of an earlier version of this manuscript.
This study was supported in part by a Showa University Grant-in-Aid for Innovative Collaborative Research
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