Neck and mind: exploring emotion processing in cervical dystonia
A wide range of non-motor symptoms such as pain, mood disorders, insomnia, and executive dysfunction may occur in focal dystonia. Little is known, however, about emotional processing. We aim to assess emotion recognition and alexithymia in patients with cervical dystonia (CD) compared to healthy age...
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| Published in: | Frontiers in neuroscience Vol. 19; p. 1599951 |
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| Abstract | A wide range of non-motor symptoms such as pain, mood disorders, insomnia, and executive dysfunction may occur in focal dystonia. Little is known, however, about emotional processing. We aim to assess emotion recognition and alexithymia in patients with cervical dystonia (CD) compared to healthy age-, sex- and education-matched controls (HC).
Emotion processing was assessed with an eye-tracking paradigm using a validated dataset of facial expressions and the Toronto Alexithymia Scale (TAS-20). Dystonia severity and disability, cognition, and comorbid depression and anxiety were also assessed.
We recruited 35 CD patients and 17 matched HC. In the eye-tracking task, CD patients recognized emotions less accurately than HCs (77.0% vs. 84.4%;
= 0.001), primarily based on difficulties in identification of fear (
= 0.003) and surprise (
= 0.037). Moreover, patients had longer fixations within the mouth region (
= 0.027) and left eye (
= 0.037) than HC. CD patients also had significantly higher total TAS-20 scores (
= 0.002) and subscores (difficulty identifying and describing feelings; all
≤ 0.026). Five patients (14.3%) reached the threshold for alexithymia and 6 (17.1%) for possible alexithymia. No HC scored positive for alexithymia and only 2 (11.8%) did for possible alexithymia. TAS-20 score correlated inversely with emotion recognition task performance (
= -0.411;
= 0.014).
We found poorer performance in emotion recognition in CD patients compared to HC. Together with a different gaze pattern and higher scores for alexithymia our results highlight deficits in emotion processing in CD. |
|---|---|
| AbstractList | ObjectiveA wide range of non-motor symptoms such as pain, mood disorders, insomnia, and executive dysfunction may occur in focal dystonia. Little is known, however, about emotional processing. We aim to assess emotion recognition and alexithymia in patients with cervical dystonia (CD) compared to healthy age-, sex- and education-matched controls (HC).MethodsEmotion processing was assessed with an eye-tracking paradigm using a validated dataset of facial expressions and the Toronto Alexithymia Scale (TAS-20). Dystonia severity and disability, cognition, and comorbid depression and anxiety were also assessed.ResultsWe recruited 35 CD patients and 17 matched HC. In the eye-tracking task, CD patients recognized emotions less accurately than HCs (77.0% vs. 84.4%; p = 0.001), primarily based on difficulties in identification of fear (p = 0.003) and surprise (p = 0.037). Moreover, patients had longer fixations within the mouth region (p = 0.027) and left eye (p = 0.037) than HC. CD patients also had significantly higher total TAS-20 scores (p = 0.002) and subscores (difficulty identifying and describing feelings; all p ≤ 0.026). Five patients (14.3%) reached the threshold for alexithymia and 6 (17.1%) for possible alexithymia. No HC scored positive for alexithymia and only 2 (11.8%) did for possible alexithymia. TAS-20 score correlated inversely with emotion recognition task performance (r = −0.411; p = 0.014).InterpretationWe found poorer performance in emotion recognition in CD patients compared to HC. Together with a different gaze pattern and higher scores for alexithymia our results highlight deficits in emotion processing in CD. A wide range of non-motor symptoms such as pain, mood disorders, insomnia, and executive dysfunction may occur in focal dystonia. Little is known, however, about emotional processing. We aim to assess emotion recognition and alexithymia in patients with cervical dystonia (CD) compared to healthy age-, sex- and education-matched controls (HC).ObjectiveA wide range of non-motor symptoms such as pain, mood disorders, insomnia, and executive dysfunction may occur in focal dystonia. Little is known, however, about emotional processing. We aim to assess emotion recognition and alexithymia in patients with cervical dystonia (CD) compared to healthy age-, sex- and education-matched controls (HC).Emotion processing was assessed with an eye-tracking paradigm using a validated dataset of facial expressions and the Toronto Alexithymia Scale (TAS-20). Dystonia severity and disability, cognition, and comorbid depression and anxiety were also assessed.MethodsEmotion processing was assessed with an eye-tracking paradigm using a validated dataset of facial expressions and the Toronto Alexithymia Scale (TAS-20). Dystonia severity and disability, cognition, and comorbid depression and anxiety were also assessed.We recruited 35 CD patients and 17 matched HC. In the eye-tracking task, CD patients recognized emotions less accurately than HCs (77.0% vs. 84.4%; p = 0.001), primarily based on difficulties in identification of fear (p = 0.003) and surprise (p = 0.037). Moreover, patients had longer fixations within the mouth region (p = 0.027) and left eye (p = 0.037) than HC. CD patients also had significantly higher total TAS-20 scores (p = 0.002) and subscores (difficulty identifying and describing feelings; all p ≤ 0.026). Five patients (14.3%) reached the threshold for alexithymia and 6 (17.1%) for possible alexithymia. No HC scored positive for alexithymia and only 2 (11.8%) did for possible alexithymia. TAS-20 score correlated inversely with emotion recognition task performance (r = -0.411; p = 0.014).ResultsWe recruited 35 CD patients and 17 matched HC. In the eye-tracking task, CD patients recognized emotions less accurately than HCs (77.0% vs. 84.4%; p = 0.001), primarily based on difficulties in identification of fear (p = 0.003) and surprise (p = 0.037). Moreover, patients had longer fixations within the mouth region (p = 0.027) and left eye (p = 0.037) than HC. CD patients also had significantly higher total TAS-20 scores (p = 0.002) and subscores (difficulty identifying and describing feelings; all p ≤ 0.026). Five patients (14.3%) reached the threshold for alexithymia and 6 (17.1%) for possible alexithymia. No HC scored positive for alexithymia and only 2 (11.8%) did for possible alexithymia. TAS-20 score correlated inversely with emotion recognition task performance (r = -0.411; p = 0.014).We found poorer performance in emotion recognition in CD patients compared to HC. Together with a different gaze pattern and higher scores for alexithymia our results highlight deficits in emotion processing in CD.InterpretationWe found poorer performance in emotion recognition in CD patients compared to HC. Together with a different gaze pattern and higher scores for alexithymia our results highlight deficits in emotion processing in CD. A wide range of non-motor symptoms such as pain, mood disorders, insomnia, and executive dysfunction may occur in focal dystonia. Little is known, however, about emotional processing. We aim to assess emotion recognition and alexithymia in patients with cervical dystonia (CD) compared to healthy age-, sex- and education-matched controls (HC). Emotion processing was assessed with an eye-tracking paradigm using a validated dataset of facial expressions and the Toronto Alexithymia Scale (TAS-20). Dystonia severity and disability, cognition, and comorbid depression and anxiety were also assessed. We recruited 35 CD patients and 17 matched HC. In the eye-tracking task, CD patients recognized emotions less accurately than HCs (77.0% vs. 84.4%; = 0.001), primarily based on difficulties in identification of fear ( = 0.003) and surprise ( = 0.037). Moreover, patients had longer fixations within the mouth region ( = 0.027) and left eye ( = 0.037) than HC. CD patients also had significantly higher total TAS-20 scores ( = 0.002) and subscores (difficulty identifying and describing feelings; all ≤ 0.026). Five patients (14.3%) reached the threshold for alexithymia and 6 (17.1%) for possible alexithymia. No HC scored positive for alexithymia and only 2 (11.8%) did for possible alexithymia. TAS-20 score correlated inversely with emotion recognition task performance ( = -0.411; = 0.014). We found poorer performance in emotion recognition in CD patients compared to HC. Together with a different gaze pattern and higher scores for alexithymia our results highlight deficits in emotion processing in CD. |
| Author | Mahlknecht, Philipp Amprosi, Matthias Boesch, Sylvia Ellmerer, Philipp Djamshidian, Atbin Seppi, Klaus Hussl, Anna Indelicato, Elisabetta Peball, Marina Hotter, Anna Heim, Beatrice Carbone, Federico Nachbauer, Wolfgang Granata, Roberta |
| AuthorAffiliation | 2 Department of Neurology, District Hospital Kufstein , Kufstein , Austria 1 Department of Neurology, Medical University Innsbruck , Innsbruck , Austria |
| AuthorAffiliation_xml | – name: 1 Department of Neurology, Medical University Innsbruck , Innsbruck , Austria – name: 2 Department of Neurology, District Hospital Kufstein , Kufstein , Austria |
| Author_xml | – sequence: 1 givenname: Federico surname: Carbone fullname: Carbone, Federico – sequence: 2 givenname: Marina surname: Peball fullname: Peball, Marina – sequence: 3 givenname: Philipp surname: Ellmerer fullname: Ellmerer, Philipp – sequence: 4 givenname: Beatrice surname: Heim fullname: Heim, Beatrice – sequence: 5 givenname: Wolfgang surname: Nachbauer fullname: Nachbauer, Wolfgang – sequence: 6 givenname: Elisabetta surname: Indelicato fullname: Indelicato, Elisabetta – sequence: 7 givenname: Matthias surname: Amprosi fullname: Amprosi, Matthias – sequence: 8 givenname: Philipp surname: Mahlknecht fullname: Mahlknecht, Philipp – sequence: 9 givenname: Anna surname: Hussl fullname: Hussl, Anna – sequence: 10 givenname: Anna surname: Hotter fullname: Hotter, Anna – sequence: 11 givenname: Roberta surname: Granata fullname: Granata, Roberta – sequence: 12 givenname: Klaus surname: Seppi fullname: Seppi, Klaus – sequence: 13 givenname: Atbin surname: Djamshidian fullname: Djamshidian, Atbin – sequence: 14 givenname: Sylvia surname: Boesch fullname: Boesch, Sylvia |
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| Cites_doi | 10.1016/j.neuron.2021.06.001 10.1002/mds.29387 10.1016/j.prdoa.2020.100072 10.1016/0022-3956(75)90026-6 10.1016/j.parkreldis.2012.02.007 10.1016/j.prdoa.2023.100217 10.1016/0022-3999(94)90005-1 10.1002/mds.27229 10.1016/j.neubiorev.2021.09.036 10.1016/S0959-4388(00)00202-6 10.1007/s00702-017-1725-8 10.1213/ANE.0000000000002864 10.1016/j.prdoa.2020.100084 10.1002/mds.20659 10.1038/nrn2920 10.1016/j.jad.2024.02.071 10.1073/pnas.2009165117 10.1002/mdc3.13978 10.1136/jnnp.64.1.13 10.1016/j.psychres.2008.05.006 10.16910/jemr.13.6.1 10.1017/S1355617723011426 10.1176/appi.neuropsych.14070169 10.1007/s11065-022-09558-z 10.1111/ene.14508 10.1111/j.1600-0447.1983.tb09716.x 10.1016/S0140-6736(86)92070-2 10.1016/j.parkreldis.2016.06.004 |
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| Keywords | cervical dystonia neuropsychological test emotions facial recognition eye-tracking technology |
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| License | Copyright © 2025 Carbone, Peball, Ellmerer, Heim, Nachbauer, Indelicato, Amprosi, Mahlknecht, Hussl, Hotter, Granata, Seppi, Djamshidian and Boesch. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
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| Snippet | A wide range of non-motor symptoms such as pain, mood disorders, insomnia, and executive dysfunction may occur in focal dystonia. Little is known, however,... ObjectiveA wide range of non-motor symptoms such as pain, mood disorders, insomnia, and executive dysfunction may occur in focal dystonia. Little is known,... |
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| SubjectTerms | cervical dystonia emotions eye-tracking technology facial recognition neuropsychological test Neuroscience |
| Title | Neck and mind: exploring emotion processing in cervical dystonia |
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