Understanding Impaired Expression and Facial Recognition with Parkinson's Disease
Living with Parkinson’s disease is a debilitating and daily battle; not only are people affected physically, but mental health strains can lead to severe anxiety, depression, mood swings, dizziness, restlessness, night terrors, and even amnesia. Not only is this a heartbreaking struggle for the affected patient, but also for loved ones who care for them as well. Although it is widely known that patients who suffer from Parkinson’s disease endure chronic tremors, increasing difficulty with movement, and overall nerve cell damage which impairs balance, less is known about the difficulties of impaired emotional recognition and expression.
A new study published in the journal Neuropsychiatric Disease and Treatment finds that as Parkinson’s disease progresses, people become less capable of communicating their needs and emotions to caretakers and family members. While movement is often tremendously affected, so are cognitive and emotional functions, such as recognizing someone’s facial expressions or properly exhibiting their own.
The regions of the brain involved in cognitive and emotional functioning, including the Basal Ganglia and the prefrontal cortex, become heavily affected by the disease as it progresses. Unfortunately, most of the expressions that become difficult to express for Parkinson’s patients are aversive feelings such as disgust and fear.
On the other hand, studies have also shown that happy and neutral feelings are more difficult for Parkinson’s patients to recognize in others. Facial Amimia, another term for the inability or difficulty to recognize facial expression, was researched by The PLOS Journal. This study found a greatly significant decrease in the recognition of joy on someone else’s face during a trial task. This impairment, paired with physical deterioration, can understandably take a great toll on individuals suffering from Parkinson’s disease who desperately wish to communicate properly with those around them.
Fortunately, although there is no clear solution yet, continuous studies have opened new clinical and rehabilitory options for suffering patients.
What causes impaired emotional recognition and expression?
Chinese researchers in particular have pioneered a study that explores some of the possible causes of these emotional and expressional deficits. A common surgical method for treating Parkinson’s disease called deep tissue stimulation has often been targeted as a potential cause of further cognitive impairment.
Using the Karolinska Directed Emotional Faces database 50 Faces Recognition test and the Montreal Affective Voices database 50 Voices Recognition test, Chinese researchers compared emotional facial expression recognition among individuals who underwent the surgery and those who did not.
Their results found that Parkinson’s patients who underwent the deep tissue stimulation had much lower scores in terms of emotional recognition and expression when compared to those who did not undergo the deep tissue stimulation. This study led researchers to believe that the areas that revolve around emotional expression and the nervous system may actually correspond with each other.
How to communicate with a loved one suffering from Parkinson’s disease
Unfortunately, as a side-effect of the illness, Parkinson’s patients become more and more compounded by speech complications as time passes. According to The Michael J. Fox Foundation, nearly 90% of people with Parkinson’s disease develop speech complications, so confusion and misunderstandings are very commonplace.
This also poses a great challenge with understanding what your loved ones are feeling, but luckily, there are a few methods available to help improve communication skills.
Techniques and helpful reminders
The greatest key in helping to relieve cognitive and emotional recognition, whether you are a loved one or a caretaker, is a great deal of patience and constant conversation. While it may be tough to consistently push the afflicted individual to speak louder or repeat themselves, practicing communication can help all parties connect better with each other and subsequently begin to recognize needs and reactions. Since facial expression and recognition becomes strenuous and often times infeasible for Parkinson’s patients, it is crucial to ask what they are feeling, if they are comfortable with what is happening to them or around them, and if they need something to change.
Constant eye contact can also play a big role in understanding your loved one better. While facial expressions may come naturally to non-Parkinson’s afflicted individuals, it may take some more time for patients to express themselves. Extended eye contact and attention will allow patients to have more time to formulate a reaction or emotion. Singing and any other vocal activity is also strongly recommended and should be encouraged among Parkinson’s patients. This could not only potentially help re-strengthen or maintain speech capabilities, but also uplift mood. Additionally, speech therapy can be a viable option for families and individuals who are able to afford or access it. Facial mimicry, or actively acting out a facial expression for an afflicted individual, has also proven to be quite beneficial with many emotional expressions. If the individual is comfortable with this, a caretaker or loved one can practice facial mimicry to help the individual gradually recognize and mirror back the emotion.
How can you help?
It is important to understand that sometimes, sitting in peaceful silence with your afflicted loved one also is natural and acceptable. Patience, eye contact, and casual conversation can go a long way, and most Parkinson’s patients will appreciate any extra effort put into face to face communication. The greatest task a caretaker or loved one can take on is constantly researching and informing themselves about new studies, techniques, and effective treatments for Parkinson’s disease.
While communicating with people who suffer from Parkinson’s disease can be a challenge, it is not impossible. Ultimately, it is important to note that Parkinson’s disease should not be only limited to impaired motor functioning. Impaired facial recognition and expression affects a large number of patients and should not be neglected. Emotional recognition in others is a powerful tool used to communicate, build relationships, and understand what it means to be human. While these impairments can be excruciating, constant practice and patience can help people with Parkinson’s disease regain a sense of normal communication abilities. While there is currently no cure to Parkinson’s disease and its unfortunate symptoms, a healthy and positive lifestyle filled with support can make the disease more manageable.
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0160329
