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PubMed1996

Quantitative assessment of the variation within grades of facial paralysis.

A completely objective, unambiguous outcome measure of facial function is now available. A new automated computer-assisted clinimetric system combines the crucial detection capabilities of the human observer and the unique capacity of the computer to quantify the image light reflectance difference observed during facial expression. The new system was applied to 27 patients with a variety of diseases affecting the facial nerve. All subjects could be individually and objectively ranked, and disease-specific profiles could be constructed. These tasks are not possible with the House-Brackmann scale, because of the wide variation within grades and the ambiguity between grades. With the automated objective, unambiguous outcome measure, it may be possible to define individual case progression, recovery, and outcome over the course of disease.

Cranial Nerve Neoplasms↗
PubMed1993

Taste and odor: reactivity in depressive disorders, a multidisciplinary approach.

Depressive patients often complain about dullness of taste of previously liked food items as well as of persistent bad taste. Taste and smell experience can be reflected by cognitive (psychophysical) indicators and also by reflectory (facial expressive) responses. In the present study 21 depressed, hospitalized patients and 16 control subjects were exposed to food-related gustatory and olfactory stimuli. Psychophysical and videotaped facial reactions were recorded from both groups. Analysis indicated that cognitive estimates of taste hedonics were similar for depressed and control groups; the former responded to sweet taste with a shorter-lasting facial reaction, involving markedly fewer facial features expressing enjoyment, than did controls. Aversive tastes, in contrast, triggered comparable facial expressive features of disgust in both groups. Facial reactions of depressed patients to acceptable and aversive olfactory stimuli were all significantly shorter and more muted than those of controls. Facial reflexes triggered by chemical cues are known to be controlled primarily by brainstem structures. Present findings suggest a possible influence of the profound anhedonia of severe depression on subcortical processes.

Adult↗
PubMed1993

GAP-43 mRNA expression in facial motoneurons during regeneration: in situ hybridization histochemistry study using an alkaline phosphatase-labelled probe.

By means of in situ hybridization histochemistry using an alkaline phosphatase-labelled probe, we found an increase of mRNA for the growth-associated protein GAP-43 in rat facial motoneurons following axotomy of the facial nerve. After nerve resection, the increased level of GAP-43 mRNA was maintained for at least 8 weeks, while it returned to almost undetectable levels by 8 weeks after nerve crush injury. Thus, expression of GAP-43 mRNA in motor neurons paralleled the process of axonal regeneration. However, the increase of GAP-43 mRNA after resection was more pronounced than after crushing, in this way being different from the pattern of low-affinity nerve growth factor receptor mRNA expression.

Alkaline Phosphatase↗
PubMed1999

[Computerized analysis of normal associated movements of facial mimic muscles].

There have been many reports on the synkinesis of mimic muscles following facial palsy, and many efforts have been made to evaluate the degree of synkinesis. Even in normal cases, associated movements of facial muscles can been seen. Empirically, mimic muscles move in association, e.g., when the lips are opened to grin, the lateral portion of the eyebrow moves, or when the mouth is moved as in whistling, tension around the root of the nose subconsciously builds up. Our purpose was to evaluate the movements of facial mimic muscles quantitatively, to analyze them in various facial expressions, and to obtain basic data to the objective evaluation of associated movement in normal subjects. Thirty-seven normal subjects (18 males and 19 females, aged 20 to 40 years) were included in the study. A total of 24 markers were stuck to each subject's face. The threshold image process which revealed only the markers, made it possible to trace and measure the markers on the face. The shifting positions of the markers showed that they moved in accordance with the facial movement from the stationary phase to the maximum stage of movement. These positions were measured and the traces plotted on the coordinate axis. The shifting of the markers were then numerically expressed as trajectory investigation. The facial movements examined in this study consisted of eye closing, forehead wrinkling, whistling, and grinning. We found that, quantitatively, certain groups of mimic muscles might work together to make one facial expression in all the above mentioned facial movements. In normal individuals, at least 15-20% of other mimic muscle collaboration is needed in addition to main muscles to create a facial expression. This result can serve as a reference for the evaluation of abnormal associated facial movement.

Adult↗
PubMed1994

Communication between the facial and auriculotemporal nerves.

The communication between the auriculotemporal and the facial nerves, i.e. the communicating auriculotemporal nerves (CATN), was studied in 55 facial sides from Thai cadavers. CATN only joined the temporofacial (upper) division of the facial nerve. CATN patterns were classified as follows: (1) the facial nerve was joined by 1 CATN (20.7%), (2) by 2 separate CATN branches (60.4%), (3) by 3 separate CATNs (15.1%); (4) several CATNs ran parallel to the zygomatic and buccal nerves to the muscles of facial expression (3.8%). The 4 types of CATN pattern showed further variations according to the site of union with the facial nerve. The superficial temporal artery was crossed by CATN branches anteriorly in 47.1%, posteriorly in 18.9%, and anteriorly and posteriorly in 34.0% of the cases. The facial nerve branches that were joined by CATNs were observed to supply the upper muscles of facial expression, i.e. frontalis, orbicularis oculi and zygomaticus major. Some offshoots from CATNs were seen to innervate orbicularis oculi. On the basis of our results we suggest that CATNs may convey proprioceptive impulses from orbicularis oculi.

Cranial Nerves↗
PubMed2005

Contribution of aging to the severity of different motor signs in Parkinson disease.

BACKGROUND: Evidence does not support the view that Parkinson disease (PD) represents an accelerated aging process; however, the additional contribution of aging to the severity of different motor signs in patients with PD is not known. This knowledge may have implications for clinical trials of neuroprotective agents in PD. OBJECTIVE: To investigate the contribution of aging to the severity of the different motor signs of idiopathic PD. SETTING: Center for Parkinson Disease and Other Movement Disorders of the Columbia University Medical Center and a neurology clinic that primarily served individuals from the Washington Heights-Inwood community in New York City. PATIENTS: Sample of patients with a wide range of disease duration and age. DESIGN: Cross-sectional clinic-based study. Patients with PD were evaluated using the Unified Parkinson Disease Rating Scale (UPDRS). The total UPDRS motor score was divided into 6 motor domains (tremor, rigidity, bradykinesia, facial expression, speech, and axial impairment) and 2 subscores that represented predominantly dopaminergic (subscore A: tremor, rigidity, bradykinesia, and facial expression) and nondopaminergic (subscore B: speech and axial impairment) deficiency. Analyses were performed using linear regression models with the UPDRS motor domains and subscores as the outcomes. The variation (adjusted R(2)) of the outcome variables explained by the inclusion of disease duration in the models, adjusting for sex, years of education, levodopa dosage, and use of other antiparkinsonian medications, was calculated. The additional variation explained by adding age at examination to the models was used to gauge the contribution of aging to each motor domain and subscore of the UPDRS. RESULTS: A total of 451 patients participated in the study. Mean age at examination was 62.0 years (SD, 12.6 years; median, 62.0 years; range, 18-93 years), and mean disease duration was 7.2 years (SD, 5.9 years; median, 5.6 years; range, 0.1-41.6 years). The additional variation of the outcome variable explained by including age in the models was higher for subscore B (14.3%; 95% confidence interval [CI], 9.9%-20.4%) than subscore A (4.7%; 95% CI, 2.0%-9.1%). Among the 6 motor domains, the additional variation of the outcome variable explained by including age in the models was highest for axial impairment (13.6%; 95% CI, 9.4%-19.6%). CONCLUSION: Axial (gait and postural) impairment in PD may result from the combined effect of the disease and the aging process on nondopaminergic subcortical structures.

Adolescent↗
PubMed1978

Facial reanimation in Möbius syndrome.

The psychosocial deformity associated with total lack of facial animation (as seen in Möbius syndrome) is an extremely crippling situation. This inability to show happiness, sadness, or anger by facial expression frequently results in severe introversion and a reclusive personality. Restoration of even a minimal degree of controlled facial movement is beneficial. Recent experience in the treatment of two patients with this syndrome using both dynamic and static procedures has been most rewarding. Operating simultaneously on both sides of the face poses some problems that are different from those in teh patient with unilateral paralysis. The operative details are described, with preoperative and postoperative evaluation.

Adolescent↗
PubMed1994

Hearing smiles and frowns in normal and whisper registers.

Two experiments measured listeners' abilities to detect facial expression in unfamiliar speech in normal and whisper registers. Acoustic differences between speech produced with neutral or marked facial expression were also assessed. Experiment 1 showed that in a forced-choice identification task, listeners could accurately select frowned speech as such, and neutral speech as happier sounding than frowned speech in the same speakers. Listeners were able to judge frowning in the same speakers' whispered speech. Relative to neutral speech, frowning lowers formant frequencies and increases syllable duration. In both registers, judgments of frowning and its relative happiness were significantly poorer for lip-rounded vowels, suggesting that listeners may recover lip protrusion in making judgments. Experiment 2 replicated the finding [V. Tartter, Percept. Psychophys. 27, 24-27 (1980)] that listeners can select speech produced with a smile as happier sounding than neutral speech in normal register, and extended the findings to whisper register. Relative to neutral, smiling increased second formant frequency. Results are discussed with respect to nonverbal auditory emotion prototypes and with respect to the direct realist theory of speech perception.

Emotions↗
PubMed1988

What can asymmetry and laterality in EMG tell us about the face and brain?

This paper will review the use of the electromyographic (EMG) technique for studying asymmetry and laterality in facial behavior. My discussion will include several issues: (1) a review of the neurology of facial expression with respect to asymmetry/laterality; (2) a compendium of models of cerebral hemispheric participation in emotion and in facial motor control that imply asymmetry-laterality in facial behavior; (3) a summary of facial asymmetry-laterality findings to date; and (4) uses and abuses of EMG techniques in inferring asymmetry-laterality in facial behavior. I conclude with (5) recommendations for future facial asymmetry-laterality research in general.

Behavior↗
PubMed2004

Axotomy abolishes NeuN expression in facial but not rubrospinal neurons.

The neuronal nuclei (NeuN) antibody, which binds to a poorly characterized antigen/antigens, is increasingly being used in several areas of study as a specific marker to identify neuronal populations. Despite the increasing reliance on NeuN as a panneuronal marker, changes of NeuN expression following axonal injury have not yet been examined. In the present study, NeuN immunoreactivity was analyzed in adult rodent facial motoneurons [peripheral nervous system (PNS) model] following nerve resection or crush and in rubrospinal neurons [central nervous system (CNS) model] after lesion of the dorsal lateral funiculus at the cervical level of the spinal cord. Peripheral nerve resection in the rat and mouse resulted in an almost complete loss of NeuN immunoreactivity in facial motoneurons by 3 days postinjury and remained absent at 28 days post-resection despite the survival of the neurons as evidenced by neuronal tracing. These results were confirmed with Western blot. In the peripheral nerve crush model of injury, there was an initial decline in NeuN immunoreactivity in facial motoneurons, but unlike the resection model, NeuN immunoreactivity began to return within 7 days postinjury and returned to the uninjured level of expression by 28 days. In contrast, axotomy in the CNS model resulted in little decline in NeuN immunoreactivity in the rubrospinal neurons, even after 28 days postaxotomy. These results indicate that NeuN expression in response to axonal injury is different in separate neuronal populations (PNS and CNS), and that care must be taken when addressing cell survival based on NeuN staining alone.

Animals↗
PubMed2000

Electrophysiological correlates of emotional and structural face processing in humans.

In order to study brain potentials related to decoding of facial expressions of emotions and those, related to basic perception of faces 16 right-handed subjects performed tasks on facial emotion recognition and perception of blurred faces and objects. Electroencephalograph (EEG) recordings during performance of the tasks revealed similar event-related potentials during the presentation of faces at 120 and 170 ms after stimulus onset in both of the tasks but significant differences in amplitudes between 180 and 300 ms. Whereas faces in the emotion recognition task produced high amplitudes in that latency range, potentials in response to faces in the blurred object condition were virtually absent. These data point to the assumption that decoding of facial expressions starts early in the brain and might be processed separately from basic stages of face perception.

Adult↗
PubMed2000

Facial-motion analysis with a video and computer system: a preliminary report.

HYPOTHESIS: To investigate the feasibility of a video and computer-assisted system for evaluating the temporal and spatial aspects of facial motion during selected facial expressions in a pilot group of six normal adults. Evaluation of the diverse medical and surgical treatments for facial paralysis and paresis cannot occur until objective, reliable, and sensitive measures of the spatial and temporal aspects of facial function at specific facial landmarks are developed. METHODS: Facial motion at predetermined facial locations was assessed using a commercially available computer-interactive motion analysis system, which is based on videography principles. The displacement, velocity, and acceleration data were averaged across all trials and subjects. Time plots also were obtained for the left versus right side. RESULTS: The greatest mean maximum displacement (resultant vector) occurred during the eyebrow lift expression, reaching 1.2 cm in magnitude. The mean maximum velocity (resultant vector), which ranged from 4.5 to 8.5 cm/s for the dynamic facial expressions, was greatest for the eyes closed tight expression. The mean maximum acceleration (resultant vector), which ranged from 193 to 465 cm/s/s, was greatest for the eyebrow lift expression. Symmetrical time plots were obtained. The system documented synkinesis by revealing substantial left upper eyelid motion during the nose-wrinkle expression in an illustrative case with slight left facial dysfunction. CONCLUSION: This approach to facial motion analysis is feasible for the simultaneous, multiregional, spatial-temporal assessment of facial expressions. Because motion at relatively remote regions could be quantified, this approach is potentially useful for the evaluation of synkinesis.

Adult↗
PubMed2004

Processing of a simple aversive conditioned stimulus in a divided visual field paradigm: an fMRI study.

A left visual hemifield advantage for the processing of negative facial expressions has been demonstrated in a variety of studies. We tested whether the same effect is found for a neutral facial expression that had acquired a negative meaning through pairing with an aversive event. Startle reflex amplitudes, skin-conductance responses (SCR), and two verbal measures of affect (negative valence and arousal) were significantly increased after pairing, but no stimulation side by pairing interaction was observed. Functional magnetic resonance imaging (fMRI) revealed a significant increase of BOLD (blood oxygen level dependent) activity in the medial prefrontal cortex (MPFC), and the right frontal opercular region (RFOP). MPFC activity was correlated with psychophysiological and verbal emotional responses across subjects and, like these responses, was independent of the stimulation side. In contrast, RFOP activity was significantly stronger during left than during right hemifield stimulation but did not correlate with psychophysiological or verbal measures of negative affect. These results suggest that emotional responses to an aversive conditioned expressively neutral face are similar in both visual hemifields. MPFC activity seems to be closely linked to the strength of these responses.

Adult↗
PubMed1992

Emotional experience and expression in schizophrenia and depression.

The emotional responses of schizophrenic, depressed, and normal subjects and whether differences in the emotional responding of these groups depended on how emotional responses were elicited or measured were examined. Twenty-three blunted and 20 nonblunted schizophrenics, 17 unipolar depressed subjects, and 20 normal subjects were exposed to a series of affect-eliciting stimuli. The stimuli varied in valence (positive vs. negative) and in level of cognitive demand. Subjects reported their subjective experiences, and their facial expressions were videotaped. Blunted schizophrenics were the least facially expressive, although their reported subjective experiences did not differ from those of the other groups. The nonblunted schizophrenics were more responsive than the depressed subjects to the positive stimuli, although the two groups did not differ in their clinical ratings of affective flatness.

Adult↗
PubMed2005

A new three-dimensional method of assessing facial volumetric changes after orthognathic treatment.

OBJECTIVE: To validate a new method of facial volumetric assessment that is dependent on the use of stereophotogrammetric models and a software-based Facial Analysis Tool. DESIGN: The method was validated in vitro with three-dimensional (3D) models of a lifelike plastic female dummy head and in vivo with a male-subject head. METHODS: Thirty facial silicone explants were added in the nasal and perioral regions of each head, and their volumes were obtained by three different algorithms. These were compared with the actual values obtained by a "water displacement" method. RESULTS: The least mean error was found with the "tetrahedron formation" method followed by the "projection" method and the "back-plane construction" method. The error with the tetrahedron formation method was 0.071 cm(3) (95% confidence interval [CI]: -0.074 to 0.2161 cm3) with the in vitro models and 0.314 cm3 (95% CI: -0.080 to 0.708 cm3) with the in vivo models. The increased volumetric assessment error observed in vivo was attributed to the registration procedure and possible changes in facial expression. CONCLUSIONS: These results encourage the use of this method in the 3D assessment of orthognathic surgical outcome, provided a standardized facial expression is used for image acquisition.

Algorithms↗
PubMed1999

[Correction of the secondary nasal deformities of the unilateral cleft lip and palate].

OBJECTIVE: To develop a new method to correct secondary nasanl deformities of cleft lip and palate. METHODS: Establishing the balance of maxilla on both sides, followed by varied procedures to correct anormaly of osseous-cartilagious framework of nose, and taking some of nasal-labial muscle to restore the continuity and balance of anterior facial expressive muscles. RESULTS: 78 cases were treated by this way and the result was satisfying. CONCLUSIONS: Imbalance of maxilla and anterior facial expressive muscle and anormaly of nasal framework should be repaired for correcting the nasal deformity of cleft lip and palate effectively.

Adolescent↗
PubMed1993

Face perception after brain injury. Selective impairments affecting identity and expression.

Current theoretical models of face perception postulate separate routes for processing information needed in the recognition of a familiar face, for matching photographs of unfamiliar faces and for the analysis of facial expressions. The present study investigated this claim in a group of ex-servicemen who had sustained unilateral brain injuries affecting posterior areas of the left or right cerebral hemisphere. Care was taken to confirm the nature of impairment by using two different tasks to assess each of the three theoretically defined abilities (leading to a total of six tasks). We adopted a stringent application of the double dissociation methodology to investigate the pattern of performance across tasks of individual ex-servicemen. A selective impairment was defined as a significantly impoverished performance on both tests of a specific ability, while all other tasks were performed within normal limits. In addition, we used both accuracy and response latency measures to substantiate evidence for spared or defective abilities. The results showed selective impairments of all three abilities on accuracy scores. Response latency data confirmed the finding of a selective deficit in the processing of facial expressions, but produced evidence suggesting that impairments affecting familiar face recognition and unfamiliar face matching were not completely independent from each other in this group of ex-servicemen.

Brain Injuries↗
PubMed1975

Piribedil (ET 495) in the treatment of Parkinson's disease combined with amantadine or levodopa.

The further therapeutic benefit of piribedil when combined with amantadine or Levodopa was studied by a double-blind, cross-over trial in 15 patients with Parkinson's disease. A significant improvement at the 5 per cent level for akinesia, gait, speech disorder and facial expression occurred when piribedil was added to Levodopa; and a more highly significant improvement at the 1 per cent level for akinesia, facial expression and finger dexterity occurred with piribedil and amantadine. No significant improvement occurred for special timed tests. Improvement was associated with side effects in both groups of patients. Side effects occurred with both placebo and active piribedil. Only nausea during piribedil and Levodopa treatment reached statistical significance when compared with the placebo. Piribedil did not give rise to any haematological or biochemical complications. Our findings suggest that piribedil is of further therapeutic benefit when added to amantadine or Levodopa. It was suggested that the improvement which occurred together with amantadine could be due to the combined action of both drugs on dopamine receptors.

Aged↗