Impaired Recognition of Emotional Faces after Stroke Involving Right Amygdala or Insula.
Donna C Tippett, Brittany R Godin, Kumiko Oishi and 6 others
PMID 29359308WHAT IT FOUND
Acute right hemisphere stroke, especially right amygdala or anterior insula damage, was associated with poorer recognition of happy and angry faces.
The stroke group was less accurate than controls. No damage was tied specifically to fear recognition.
Key findings
01Acute right hemisphere stroke patients identified happy and surprise faces less accurately than controls (82.9% vs. 92.9% correct), aversive faces less accurately (58.9% vs. 77.5% correct), and neutral faces less accurately (82.1% vs. 98.4% correct).
02Patients with right amygdala lesions scored lower than other right hemisphere stroke patients on happy faces (82.1% vs. 98.6% correct) and angry faces (48.2% vs. 73.6% correct), and more were impaired on both (4/7 vs. 2/18).
03Patients with right anterior insula lesions scored lower on happy faces (87.5% vs. 98.6% correct) and angry faces (47.7% vs. 73.6% correct), and more were impaired on angry faces (6/11 vs. 2/18); impaired disgust recognition was associated with anterior insula or inferior fronto-occipital fasciculus lesions.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only right hemisphere stroke patients were studied, so it does not show what happens after left hemisphere stroke. The lesion-specific comparisons involved small groups, including 7 patients with right amygdala lesions and 11 with right anterior insula lesions in the main comparisons. Patients were tested acutely, which helps avoid recovery effects but may also reflect temporary disruption of connected brain areas, so the findings may not persist in the same way in chronic stroke. The study did not test any therapy, so it cannot show that facial expression recognition training improves communication. Fear recognition was low across right hemisphere stroke patients, so the study could not separate a specific fear deficit from general right hemisphere stroke difficulty. The supplied text does not report blinding or dropout.
Declared interests
The supplied text does not report author conflicts of interest; the article metadata lists NIH extramural research support.
The easy way to misread this
Do not conclude that right amygdala or anterior insula damage causes a specific fear-recognition deficit. The study did not find a lesion-fear association, and fear recognition was low across right hemisphere stroke patients.