Emotional and cognitive impairments in Parkinson's disease (PD) are prevalent, hamper interpersonal relations and reduce quality of life. It is however unclear to what extent these domains interplay in PD-related deficits and how they are influenced by dopaminergic availability. This study examined the effect of cognitive impairment and dopaminergic medication on neural and behavioral mechanisms of facial emotion recognition in PD patients. PD patients on and off dopaminergic medication and matched healthy controls underwent an emotional face matching task during functional MRI. In addition, a comprehensive neuropsychological evaluation of cognitive function was conducted. Increased BOLD response to emotional faces was found in the visual cortex of PD patients relative to controls irrespective of cognitive function and medication status. Administration of dopaminergic medication in PD patients resulted in restored behavioral accuracy for emotional faces relative to controls and decreased retrosplenial cortex BOLD response to emotion relative to off-medication state. Furthermore, cognitive impairment in PD patients was associated with reduced behavioral accuracy for non-emotional stimuli and predicted BOLD response to emotion in the anterior and posterior cingulate cortices, depending on medication status. Findings of aberrant visual and retrosplenial BOLD response to emotion are suggested to stem from altered attentional and/or emotion-driven modulation from subcortical and higher cortical regions. Our results indicate neural disruptions and behavioral deficits in emotion processing in PD patients that are dependent on dopaminergic availability and independent of cognitive function. Our findings highlight the importance of dopaminergic treatment not only for the motor symptoms but also the emotional disturbances in PD.

中文翻译：

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多巴胺和认知障碍对帕金森病面部情绪神经反应的影响

帕金森病 (PD) 中的情绪和认知障碍很普遍，会妨碍人际关系并降低生活质量。然而，尚不清楚这些结构域在 PD 相关缺陷中的相互作用程度以及它们如何受多巴胺能可用性的影响。本研究探讨了认知障碍和多巴胺能药物对 PD 患者面部情绪识别的神经和行为机制的影响。使用和停用多巴胺能药物治疗的 PD 患者和匹配的健康对照者在功能性 MRI 期间接受了情绪面部匹配任务。此外，还对认知功能进行了全面的神经心理学评估。无论认知功能和药物状态如何，在 PD 患者的视觉皮层中发现对情绪面孔的 BOLD 反应增加。在 PD 患者中使用多巴胺能药物导致情绪面孔相对于对照组的行为准确性恢复，并降低了相对于停药状态对情绪的脾后皮层 BOLD 反应。此外，根据药物状态，PD 患者的认知障碍与非情绪刺激的行为准确性降低有关，并预测前扣带回和后扣带皮层对情绪的 BOLD 反应。对情绪的异常视觉和脾后 BOLD 反应的发现被认为源于来自皮层下和较高皮层区域的注意力和/或情绪驱动调制的改变。我们的结果表明 PD 患者情绪处理中的神经中断和行为缺陷依赖于多巴胺能可用性且独立于认知功能。我们的研究结果强调了多巴胺能治疗不仅对 PD 的运动症状而且对情绪障碍的重要性。