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Perception of Emotions on Happy/Sad Chimeric Faces in Alzheimer Disease: Relationship With Cognitive Functions

Luzzi, Simona MD*; Piccirilli, Massimo MD; Provinciali, Leandro MD*

Alzheimer Disease & Associated Disorders: April-June 2007 - Volume 21 - Issue 2 - p 130-135
doi: 10.1097/WAD.0b013e318064f445
Original Articles

Aims To investigate the ability to recognize facial emotions in patients with Alzheimer disease (AD). Happiness and sadness, fundamental emotions that are easily recognized across cultures, were evaluated. Results were further analyzed in relation to demographic, clinical, and neuropsychologic characteristics.

Methods A test exploring recognition of facial emotions using chimeric faces based on Jaynes' happy and sad faces was administered to 71 patients with probable AD.

Results The ability to identify positive and negative facial emotions was largely preserved in AD subjects. Impaired recognition of facial emotions was found in 27%. Poor test performance was associated with low scores on constructional praxis and nonverbal memory tasks.

Conclusions Decoding of emotional facial expressions seems to be differently affected in relation to patients' neuropsychologic profile, as poor test performance closely correlated with nonverbal cognitive impairment. This emotion-discrimination disorder likely characterizes the behavior of a subset of AD patients with predominant right-hemisphere dysfunction. A preserved ability to process the emotional features of faces may have an important role in the management of demented patients, and suggests the use of nonverbal communication as an integrative/alternative system. The simple test used in our study may be a useful clinical tool to explore emotional behavior in demented subjects.

*Unit of Neurology, Department of Neuroscience, University of Ancona

Unit of Cognitive Rehabilitation, University of Perugia, Italy

Reprints: Simona Luzzi, MD, Clinica Neurologica, Dipartimento di Neuroscienze, Università Politecnica delle Marche, Via Conca, Torrette di Ancona, Ancona 60020, Italy (e-mail:

Received for publication August 24, 2006; accepted March 20, 2007

© 2007 Lippincott Williams & Wilkins, Inc.