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We studied the effect of crying and facial expression on TcB readings at the forehead in 38 high-risk full-term newborn infants. Our study showed that crying and facial expression were significant factors affecting the TcB readings at the forehead. We recommend that TcB readings at the forehead should be obtained in a quiet condition.
Pediatric facial nerve palsy (FNP) can result from a variety of etiologies including Lyme disease, varicella, primary gingivostomatitis, herpes zoster oticus (Ramsay Hunt syndrome), coxsackievirus, trauma, otitis media, HIV, diseases causing tumors or demyelinations, compressions, and possibly Epstein Barr virus. Lyme disease has been implicated as the cause of over 50% of the FNPs in children. The paralysis of the facial nerve disturbs motor function to the muscles of facial expression and results in a flaccid appearance of the face (unilateral or bilateral). This case report derails undiagnosed Lyme disease presenting as a facial palsy in a 6 year, 5 month-old white female. The palsy was recognized and consultation with the child's physician prompted definitive diagnosis and treatment. A review of the literature and the implications of facial nerve palsy are discussed.
The confidence we have in our assessment of an interaction partner's emotional state can have important consequences for the quality of the interaction. Two studies assessed the hypothesis that immigrants are more confident in their judgment of others' emotional facial expressions if the expresser is a member of their cultural ingroup rather than a member of the host community or another cultural group. In addition, the effects of the perceived familiarity with the type of expression, the length of residence in the host country, the quality of cross-cultural contact, the level of acculturation, and the intensity of the facial expressions were assessed. Overall, the results revealed an ingroup advantage effect for confidence ratings as well as support for the notion that individuals are more confident when judging expressions that they consider as more frequently displayed in everyday life. Furthermore, individuals were more confident when judging happiness expressions as well as more intense expressions in general.
Recent research has found a discrepancy between schizophrenic patients' outward expression of emotion and their reported emotional experience. In this study, which attempts to replicate and extend the findings of previous studies, participants with and without schizophrenia viewed emotional film clips while their facial expressions were videotaped and skin conductance was recorded. Participants also reported their subjective experience of emotion following each film. Those with schizophrenia were less facially expressive than controls during the emotional films and reported experiencing as much positive and negative emotion, replicating previous findings. Additionally, schizophrenic patients exhibited greater skin conductance reactivity to all films than controls. These findings suggest a disjunction among emotional response domains for schizophrenic patients; alternative explanations for the findings are considered as well as suggestions for future research.
We have shown in a series of studies that the human salivary response habituates to repeated presentation of gustatory cues. Parallel animal research has shown that mouthing and food acceptance also habituate. Facial expressions represent a complex response pattern in animals and humans that may provide an objective measurement of motivation to eat. The current study assessed whether facial muscles (orbicularis oris region, risorius region, and zygomaticus region) that regulate mouthing habituate to repeated presentations of a small amount (3 kcal) of a pleasant tasting food stimulus. Participants were randomly assigned to groups that received ten presentations of the same or changing taste stimuli. Following these trials all subjects were presented a novel dishabituating stimulus followed by the habituating stimulus. Integrated facial electromyography EMG responses over each region were measured for a 50 second period following the taste stimulus. Results showed differential habituation rates across the two groups, with participants in the repeated taste group showing decreases in contrast to the changing taste group who did not decrease. The participants in the repeated taste group showed dishabituation of these responses. These results systematically replicate basic animal research, and extend the number of responses related to eating in humans that habituate to repeated food presentations.
Reconstruction of multiple branches of the facial nerve by sural nerve graft using end-to-side nerve suture was performed successfully on a patient with advanced parotid tumor. In this technique, one end of the grafted nerve is sutured with the stump of the facial nerve trunk in an end-to-end manner. Epineural windows are made on the nerve graft, and the distal stumps of the facial nerve branches (temporal, zygomatic, and buccal branches) are sutured with the graft in an end-to-side manner. Functional recovery of all branches and satisfactory facial expression were obtained within 2 years postoperatively. Axonal regeneration through the graft was confirmed by electrodiagnosis. Regeneration through the anastomosis at the stump of the facial nerve trunk using this technique is more efficient than conventional cable grafting, and the length of the nerve required is minimal. This technique may be a useful option for facial nerve reconstruction managing multiple branches.
The classic rhytidectomy leaves the upper third of the face without improvement. Yet the eye-eyebrow region is the most influential in determining facial expressions. There is only a narrow range of positions of the eyebrows in which they are perceived as attractive. The influence of the coronal browlift on facial mimics is discussed as it seems to be a way to predictably reposition the eyebrows and improve crow's feet and forehead, and glabellar wrinkles at the same time. The results of 56 patients surveyed 1-3 years postoperatively are presented.
The urofacial (Ochoa) syndrome (UFS) is a very rare autosomal recessive disorder characterized by abnormal facial expression and urinary abnormalities. Patients with this syndrome have urinary tract infection, hydronephrosis, hydroureter and voiding dysfunctions resulting from neurogenic bladder, together with a peculiar inverted facial expression, mainly when smiling or crying. This syndrome has been so far observed in Colombia, USA, France and Spain. We report the first case of Ochoa syndrome in the central European population.
According to the modern affect theory, the human being is equipped from birth with a number of affect programmes which can be activated both by internal and external signals and by the memory. According to theory, facial expressions constitute an important component of the affect programme. Research findings suggest the human being to be biologically programmed both to send and receive communications via facial expressions. Emotional communication seems to occur at an unconscious level, and to precede conscious information processing. There is scientific evidence that the emotional components of information processing are faster and occur in phylogenetically older brain structures. The right hemisphere appears to be more closely related than the left hemisphere to the autonomic nervous system, and thus more intimately linked with the physiological and automatic components of the emotions. Modern psychodynamic theory, in which emotion and unconscious processes are seen as human driving forces, derives scientific support from emotion research based both upon experimental psychology and neuroscience.
The present study was designed to evaluate whether aversively conditioned responses to facial stimuli are detectable in all three components of the emotional response system, i.e. the expressive/behavioral, the physiological/autonomic and the cognitive/experienced component of emotion. Two groups of subjects were conditioned to angry or happy facial expression stimuli using a 100 dB noise as UCS in a differential aversive conditioning paradigm. The three components of the emotional response system were measured as: Facial-EMG reactions (corrugator and zygomatic muscle regions); autonomic activity (skin conductance, SCR; SCR half recovery time, T/2; heart rate, HR); and ratings of experienced emotion. It was found that responses in all components of the emotional response system were detectable in the angry group as greater EMG and autonomic resistance to extinction and greater self-reported fear. More specifically the angry group showed a resistant conditioning effect for the facial-EMG corrugator muscle that was accompanied by resistant conditioning for SCR frequency, slower SCR recovery, resistant conditioning in HR and a higher self-reported fear than the happy group. Thus, aversive conditioning to angry facial stimuli induce a uniform negative emotional response pattern as indicated by all three components of the emotional response system. These data suggest that a negative 'affect program' triggers responses in the different emotional components. The results suggest that human subjects are biologically prepared to react with a negative emotion to angry facial stimuli.
The present study was undertaken to evaluate the results of a group of patients following treatment for cerebellopontine angle lesions who developed postoperative facial palsy and underwent facial nerve repair in order to reanimate the muscles of facial expression. A retrospective study was performed on 23 patients treated between 1988 and 1997 at the 2nd and 4th ENT chairs of University "La Sapienza" of Rome for facial palsy following cerebellopontine angle surgery. Tumors included acoustic neuromas (n = 3). Seventeen patients underwent hypoglossal-facial anastomoses [10 with end-to-end anastomoses, 4 with May's interposition "jump-nerve" grafts and 3 with partial (30%) use of the hypoglossal nerve plus a facial cross-over]. The remaining patients were operated on using a cable graft with the sural nerve (n = 2) and the great auricular nerve (n = 4). Postoperative facial function was determined by the House-Brackmann 6-scale classification The hypoglossal-facial anastomoses resulted in long-term grade III or IV findings. Cable grafts improved facial function from grade VI to grade III. None of the patients operated on with the modfied VII-XII anastomosis developed swallowing disturbances. The ten patients having traditional hypoglossal-facial anastomoses showed different degrees of tongue disability and retention of residue in the oral cavity. Surgical recovery of postoperative facial palsy can be obtained with various techniques according to the availability of the proximal facial nerve stump at the brain stem. Since a traditional hypoglossal-facial anastomosis procedure can be a source of a separate disability for the patient, techniques are preferred that leave the hypoglossal nerve mostly intact and uncompromised.
We investigated the hypothesis that people's facial activity influences their affective responses. Two studies were designed to both eliminate methodological problems of earlier experiments and clarify theoretical ambiguities. This was achieved by having subjects hold a pen in their mouth in ways that either inhibited or facilitated the muscles typically associated with smiling without requiring subjects to pose in a smiling face. Study 1's results demonstrated the effectiveness of the procedure. Subjects reported more intense humor responses when cartoons were presented under facilitating conditions than under inhibiting conditions that precluded labeling of the facial expression in emotion categories. Study 2 served to further validate the methodology and to answer additional theoretical questions. The results replicated Study 1's findings and also showed that facial feedback operates on the affective but not on the cognitive component of the humor response. Finally, the results suggested that both inhibitory and facilitatory mechanisms may have contributed to the observed affective responses.
BACKGROUND: Schizophrenia patients show reduced neural activity, relative to controls, in the amygdala and its projection to the medial prefrontal cortex (MPFC) in response to fear perception. In this study we tested the hypothesis that schizophrenia is characterized by abnormal functional connectivity in the amygdala network underlying fear perception. METHODS: Functional MRI images were acquired from 14 schizophrenia patients and 14 matched healthy control subjects during an emotion perception task, in which fearful and neutral facial expression stimuli were presented pseudorandomly under nonconscious (using masking) and conscious conditions. Both subtraction and functional connectivity analyses were undertaken using a region of interest approach. RESULTS: In response to fearful facial expressions, schizophrenia patients displayed reduced amygdala activity, compared to controls, in both the conscious and nonconscious conditions. The amygdala displayed a reversal of the normal pattern of connectivity with the brainstem, visual cortex, and also with the dorsal and ventral divisions of the MPFC in the schizophrenia patients. CONCLUSIONS: The presence of functional disconnections in amygdala pathways suggests that schizophrenia patients have a failure in coordinating their automatic orienting to salient signals and the associated prefrontal monitoring of these signals.
In a prospective trial in 139 infants ASA classification I-II 13 observational items were scaled during the first postoperative hour (13 assessments). The items were drawn from the literature and chosen for economic purpose. Factor analyses (Principal component, Kaiser Criterion, Scree-test) were used for the elimination of useless items and for the identification of suitable ones. The discriminative properties of single items and different subsets of items to detect an analgetic demand were tested in discriminant analyses and variance analyses with repeated measurements. Due to insufficient variance four items had to be eliminated: "nasolabial folding", "colour of the face", "sweating of the head", and "muscle tone". The factor analysis if the remaining 9 items resulted in a one factorial solution. Neither the corrected item-scale-correlations nor the inter-item-correlations showed advantageous properties of single items compared with the others. For economic reasons two 5-item scales were chosen for further evaluation in regard to sensitivity, specify and validity. The items "crying", "facial expression", "positioning of the legs", "positioning of the trunc" and "motoric restlessness" built the Children's and Infants Postoperative Pain Scale (CHIPPS) whereas an Infants Postoperative Pain Scale (IPPS) contained the items "crying", "facial expression", "positioning of the arms", "positioning of the trunc" and "motoric restlessness". The latter five items had shown the highest factor loadings. The two systems had a high intern consistency with alpha > 0.90 (p < 0.01) with at least 73% explained variance. Inter-item-correlations and corrected item-scale-correlations showed no differences between the two scales. The discriminant analyses resulted in almost identic data for specify, sensitivity and predictive values of the IPPS compared with the CHIPPS. There was a significant interaction between repeated measurements and the supply of Piritramide and Ketamine, but not of Midazolam. Concurrent and constructive validation were positive for both systems, using administration of Piritramide as a criterion. For clinical purpose the CHIPPS should be preferred, because it has been proven to be valid in children up to 4 years of age and because controlled data on its sensitivity, specify, reliability and validity could already be presented.
As a tribute to Freud's genius, he was able to recognize not only the importance of implicit unconscious learning but also the way it currently impacts on the patient in psychoanalytic therapy. He prevented the patient from viewing the analyst's facial expressions by placing the patient on the couch. In addition, the analyst was instructed not to say too much, to be neutral, nonjudgmental, and calmly reflective. Thus the patient's response to the facial expressions and voice tone of the analyst, even when subliminally perceived, were minimized. This may be even more significant in women, who seem to be more sensitive to nonverbal cues of emotional states. Ferenczi further elaborated on the importance of establishing a connective empathic relationship, using a kindly, soothing voice tone and being emotionally available. Sandler and Sandler (1994) also emphasized the importance of tolerance and acceptance when making interpretations. These clinical instructions diminish external threats to survival and thereby minimize the activation of the amygdala. These procedures in psychoanalytic treatment seem similar to a subliminal MIO message and to the subliminal exposure of a happy face, as mentioned above in the fMRI study by Whalen et al. (1998). The empathic responses of the therapist need to create a condition of safety. In turn, this decreases the patient's vigilance and defensiveness and allows for the emergence of unconscious material that can be worked through verbally and rectified by explicit memory. Another fascinating finding is that Freud (1914) became aware, in his paper on the repetition compulsion, that repressed traumatic and conflictual relationships are acted out behaviorally outside of conscious awareness. He then considered that the focus of analysis should be on analyzing the transference relationship, where this enactment was manifested. Brockman (1998) notes that modern empirical findings confirm Freud's clinical hypotheses regarding the repetition compulsion. Repressed traumatic emotional memories are encoded in the amygdala, and they are unconsciously enacted through behavior, especially in the transference. In summary, childhood and other traumatic memories become encoded in the amygdala and are later enacted and expressed behaviorally, especially in the transference relationship. Working through of the emotional trauma makes these implicit memories explicit and exposes them to adult judgment. When the therapist creates a condition of safety, old memories are reexperienced and detoxified. The memories are experienced as nonthreatening now, thus calming the amygdala and diminishing its activity. Biologically, new neural pathways from the cortex to the amygdala can be established, since the cortex is plastic. This process is slow and may account for the need to repeatedly work through in analysis old conflicted relationships that had threatened security and survival. As imaging techniques improve, we may soon be able to evaluate therapy outcomes scientifically by measuring these actual brain changes. We are on the threshold of establishing a scientific psychoanalysis, as empirical research is providing us with data that integrate the mind and the brain. Subliminal stimulation and brain imaging techniques provide us with important tools for developing an empirical base for psychoanalytic theory and treatment. These techniques were not available to Freud at the turn of the last century, and as we center the new millennium Freud's dream of psychoanalysis having a firm scientific foundation is becoming a reality.
Amygdala interconnections with the cingulate motor cortices were investigated in the rhesus monkey. Using multiple tracing approaches, we found a robust projection from the lateral basal nucleus of the amygdala to Layers II, IIIa, and V of the rostral cingulate motor cortex (M3). A smaller source of amygdala input arose from the accessory basal, cortical, and lateral nuclei, which targeted only the rostral region of M3. We also found a light projection from the lateral basal nucleus to the same layers of the caudal cingulate motor cortex (M4). Experiments examining this projection to cingulate somatotopy using combined neural tracing strategies and stereology to estimate the total number of terminal-like immunoreactive particles demonstrated that the amygdala projection terminates heavily in the face representation of M3 and moderately in its arm representation. Fewer terminal profiles were found in the leg representation of M3 and the face, arm, and leg representations of M4. Anterograde tracers placed directly into M3 and M4 revealed the amygdala connection to be reciprocal and documented corticofugal projections to the facial nucleus, surrounding pontine reticular formation, and spinal cord. Clinically, such pathways would be in a position to contribute to mediating movements in the face, neck, and upper extremity accompanying medial temporal lobe seizures that have historically characterized this syndrome. Alterations within or disruption of the amygdalo-cingulate projection to the rostral part of M3 may also have an adverse effect on facial expression in patients presenting with neurological or neuropsychiatric abnormalities of medial temporal lobe involvement. Finally, the prominent amygdala projection to the face region of M3 may significantly influence the outcome of higher-order facial expressions associated with social communication and emotional constructs such as fear, anger, happiness, and sadness.
The authors extended a previous examination of the effects of nonverbal behavior on perceptions of a male employee's power bases (H. Aguinis, M. M. Simonsen, & C. A. Pierce, 1998) by examining the effects of nonverbal behavior on perceptions of a female employee's power bases. U.S. undergraduates read vignettes describing a female employee engaging in 3 types of nonverbal behavior (i.e., eye contact, facial expression, body posture) and rated their perceptions of the woman's power bases (i.e., reward, coercive, legitimate, referent, expert, credibility). As predicted, (a) direct eye contact increased perceptions of coercive power, and (b) a relaxed facial expression decreased perceptions of all 6 power bases. Also as predicted, the present results differed markedly from those of Aguinis et al. (1998) regarding a male employee. The authors discuss implications for theory, future research, and the advancement of female employees.
This article studies the changes produced with age in the different facial tissues, analyzes how these tissues can be affected by surgical manipulation, and sets out certain principles that should be kept in mind during facial rejuvenation surgery. Surgeons are alerted to the possibility of causing iatrogenia, in the sense of interfering with normal facial expression and accelerating the normal aging process. We present two techniques that use these principles.