Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan 31:18:305-314.
doi: 10.1016/j.nicl.2018.01.034. eCollection 2018.

Impact of gender and genetics on emotion processing in Parkinson's disease - A multimodal study

Julia Heller  1 , Shahram Mirzazade  1 , Sandro Romanzetti  1 , Ute Habel  2 , Birgit Derntl  3 , Nils M Freitag  4 , Jörg B Schulz  1 , Imis Dogan  1 , Kathrin Reetz  5
Affiliations

Impact of gender and genetics on emotion processing in Parkinson's disease - A multimodal study

Julia Heller et al. Neuroimage Clin. .

Abstract
in English, German

•Understanding of the phenotypic heterogeneity of Parkinson's disease is needed.•Gender and genetics determine manifestation and progression of Parkinson's disease.•Altered emotion processing in Parkinson's disease is specific to male patients.•This is influenced by endocrinal and genetic factors in both genders.•This finding may impact the diagnosis and treatment of emerging clinical features.

Background: Parkinson's disease (PD) has been suggested to affect males and females differently. Neuropsychiatric symptoms are common and disabling in PD. However, previous studies focusing on emotion recognition in PD have neglected the confounder of gender and lack evidence on the underlying endocrinal and genetic mechanisms. Moreover, while there are many imaging studies on emotion processing in PD, gender-related analyses of neural data are scarce. We therefore aimed at exploring the interplay of the named factors on emotion recognition and processing in PD.

Methods: 51 non-demented PD patients (26 male) and 44 age- and gender-matched healthy controls (HC; 25 male) were examined clinically and neuropsychologically including an emotion recognition task (Ekman 60faces test). A subsample of 25 patients and 31 HC underwent task-based functional magnetic resonance imaging (fMRI) comprised of videos of emotional facial expressions. To examine the impact of hormones and genetics on emotion processing, blood samples were taken for endocrinal (testosterone, estradiol, progesterone) and genetic testing (5-HTTLPR, Val158Met COMT polymorphisms).

Results: No group or gender differences emerged regarding cognitive abilities. Male but not female PD patients exhibited confined impairments in recognizing the emotion anger accompanied by diminished neural response to facial expressions (e.g. in the putamen and insula). Endocrinologically, fear recognition was positively correlated with estrogen levels in female patients, while on the genetic level we found an effect of Val158Met COMT genotype on the recognition of fear in PD patients.

Conclusions: Our study provides evidence that impaired emotion processing in PD specifically affects male patients, and that hormones and genetics contribute to emotion recognition performance. Further research on the underlying neural, endocrinological and genetic mechanisms of specific symptoms in PD is of clinical relevance, as it can improve our understanding of the phenomenology and pathobiology of the disease and may allow a more personalized medicine.

Keywords: BAI, Beck anxiety inventory; BDI-II, Beck depression inventory version II; BFRT, Benton facial recognition test; BOLD, blood‑oxygen-level dependent; COMT, catechol-O-methyltransferase; EPI, echo planar imaging; Emotion; Functional magnetic resonance imaging (fMRI); GM, gray matter; Gender; Genetics; H&Y, Hoehn and Yahr rating scale; HC, healthy controls; LEDD, levodopa equivalence daily dose; MCI, mild cognitive impairment; MMSE, Mini-Mental State Examination; MRI, magnetic resonance imaging; MoCA, Montreal Cognitive Assessment; NMS, non-motor symptoms; PD, Parkinson's disease; Parkinson's disease (PD); UPDRS, Unified Parkinson's disease rating scale; VBM, voxel-based morphometry; fMRI, functional magnetic resonance imaging.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Significant group differences in emotion recognition according to the Ekman 60 faces test. Note: PD = Parkinson's disease; HC = healthy controls; data represent means (95% confidence interval shown as error bars); ANCOVA with the factors group (PD versus HC) and gender (male versus female) revealed a significant main effect of gender for the recognition of disgust (male < female; F1,90 = 8.37, p = 0.030, Bonferroni-corrected) and a significant interaction between group and gender on the recognition of anger (F1,90 = 7.76, p = 0.042, Bonferroni-corrected) with male PD < female PD (t49 = 2.62, p = 0.012) and male PD < male HC (t49 = 2.41, p = 0.020).
Fig. 2
Fig. 2
Significant group differences in neural response during emotion processing. Note: PD = Parkinson's disease; HC = healthy controls; L:R = left:right; coordinates in MNI space; colour bars represent T-values; A) Significant differences between male PD patients and male HC in neural response during emotion processing; results are cluster-level FWE-corrected at p ≤ 0.05 (uncorrected at the voxel level with p ≤ 0.001) across the whole brain. B) Parameter estimates showing group differences in selected regions of interest (ROI); results are FWE-corrected at p ≤ 0.05 within ROI (MNI coordinates in brackets); data represent means (95% confidence interval shown as error bars).
Fig. 3
Fig. 3
Association of fear recognition with Val158Met COMT in PD. Note: Val158Met COMT = functional Val158Met polymorphism of the catechol-O-methyltransferase gene; PD = Parkinson's disease; data represent means (95% confidence interval shown as error bars); ANCOVA with the factors gender and Val158Met COMT expression (low functioning methionine versus high functioning valine gene variants) showed a significant main effect of Val158Met COMT on fear recognition in PD patients (F1,45 = 7.70, p = 0.048, Bonferroni-corrected: Val/Val < Met/Met & Val/Met).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Adolphs R. Neural systems for recognizing emotion. Curr. Opin. Neurobiol. 2002;12:169–177. - PubMed
    1. Adolphs R., Schul R., Tranel D. Intact recognition of facial emotion in Parkinson's disease. Neuropsychology. 1998;12:253–258. - PubMed
    1. Alexander G.E., DeLong M.R., Strick P.L. Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annu. Rev. Neurosci. 1986;9:357–381. - PubMed
    1. Ariatti A., Benuzzi F., Nichelli P. Recognition of emotions from visual and prosodic cues in Parkinson's disease. Neurol. Sci. 2008;29:219–227. - PubMed
    1. Ashburner J., Friston K.J. Voxel-based morphometry—the methods. NeuroImage. 2000;11:805–821. - PubMed

Publication types

MeSH terms