Emotion Perception Seen to Be Impaired in Friedreich’s Ataxia Patients, Study Finds

Patients with Friedreich’s ataxia have impaired emotion recognition that may be secondary to neuropsychological impairment, according to a study published in the journal The Cerebellum.

Expressing and reading emotions are essential social skills necessary for developing relationships, as well as for showing your own feelings. To a great extent, emotions are produced and perceived based on the immediate recognition of facial expression patterns.

“Developmental psychology showed how the quality of nonverbal communications between infants and their caregivers can influence, among others, the development of emotion understanding, attachment relationships, and emotion regulation,” the researchers wrote.

Studies have shown that the frontotemporal lobe and dopaminergic systems of the brain are responsible for both facial processing and facial expression recognition. Diseases that affect these brain regions, such as Alzheimer’s and Parkinson’s, may lead to impaired emotional competence and negative processing of emotions.

The cerebellum, a brain region affected in patients with Friedreich’s ataxia, has been perceived as a main controller of body movement. But some studies have suggested that it may also be involved in the regulation of human behavior, and in computing facial expressions.

In the study, “Emotion Recognition and Psychological Comorbidity in Friedreich’s Ataxia,” a research team from the University Federico II in Naples, Italy, evaluated the ability of patients with Friedreich’s ataxia to recognize emotions using visual and nonverbal auditory hints.

The study included 20 patients previously diagnosed with Friedreich’s ataxia and 20 healthy volunteers. They underwent an extensive psychological, emotional, and neuropsychological evaluation.

Friedreich’s ataxia patients showed an overall deficit in correctly identifying emotions compared to the healthy individuals, and they required 42 percent more time to respond to an emotion.

They were found to have more difficulties in identifying sadness, interest, amusement, and pleasure.

“Usual Friedreich’s ataxia onset is during adolescence, [a] crucial life period in which the person undergoes biological, psychological, and social changes,” the researchers wrote. “It is possible that pathogenetic changes deriving from Friedreich’s ataxia leave kids unable to integrate social emotions and develop normal emotion recognition abilities.”

An evaluation of global cognitive function revealed that Friedreich’s ataxia patients had a lower score than the control group, which may in part explain the difficulties reported in emotion identification. Cognitive functions are involved in the complex computation process required for emotion recognition.

Overall, patients showed a lower state of anxiety than their healthy counterparts, and no major depressive disorder was detected in either group.

The team reported that three patients had personality disorders: antisocial; avoidant; and obsessive-compulsive disorder (OCD). Additional studies are necessary to understand if the personality disorders were a pre-existing condition or were due to Friedreich’s ataxia.

The researchers believe that Friedreich’s ataxia patients have “impaired emotion recognition that may be secondary to neuropsychological impairment.”

“The impact of the disease on psychological measures is minimal, except for the onset of personality disorders, and should not be considered as part of the clinical picture of Friedreich’s ataxia,” they said.

“These findings should be taken into account when approaching patients both in clinical routine practice, as well as psychological counseling and support,” researchers added.