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PubMed1999

Emotional impairment after right orbitofrontal lesion in a patient without cognitive deficits.

The present study describes a patient, M.L., with right orbitofrontal lesion, who showed no impairment on main neuropsychological tests, including those measuring frontal functions. Nevertheless, he had deeply affected emotional responses. In line with Damasio's work, the patient had lower skin conductance during the projection of a standardized set of emotional slides. Furthermore, he showed altered facial expressions to unpleasant emotions, displaying low corrugator supercilii electromyographical activity associated with reduced recall of unpleasant stimuli. During a task focusing on imagery of emotional situations, M.L.'s heart rate and skin conductance responses were affected during both pleasant and unpleasant conditions. Facial expressions to unpleasant imagery scripts were also impaired. Thus, the orbitofrontal cortex proved to play a critical role in retrieval of psychophysiological emotional patterns, particularly to unpleasant material. These results provide the first evidence that orbitofrontal lesions are associated with emotional impairment at several psychophysiological levels.

Accidents, Traffic↗
PubMed1999

Quantifying driver stress: developing a system for collecting and processing bio-metric signals in natural situations.

A system for quantifying the physiological features of emotional stress is being developed for use during a driving task. Two prototypes, using sensors that measure the driver's skin conductance, respiration, muscle activity, and heart activity are presented. The first system allows sampling rates of 200 Hz on two fast channels and 20 Hz on six additional channels. It uses a wearable computer to do real-time processing on the signals and has an attached digital camera which was used to capture images of the driver's facial expression once every minute. The second system uses a car-based computer that allows a sampling rate of 1984 samples per second on eight channels. This system uses multiple video cameras to continuously capture the driver's facial expression and road conditions. The data is then synchronized with the physiological signals using a video quad-splitter. The methods for extracting physiological features in the driving environment are discussed, including measurement of the skin conductance orienting response, muscle activity, pulse, and respiration patterns. Preliminary studies show how using multiple modalities of sensors can help discriminate reactions to driving events and how individual's response to similar driving conditions can vary from day to day.

Automobile Driving↗
PubMed2003

Visual scanpaths and facial affect recognition in delusion-prone individuals: Increased sensitivity to threat?

INTRODUCTION: Using visual scanpaths as a measure of directed attention, we investigated whether delusion-prone individuals would exhibit reduced visual appraisal, and impaired recognition accuracy, for threat-related facial expressions. METHODS: 47 psychiatrically healthy individuals completed the Peters et al. Delusions Inventory (PDI) as an index of delusion-proneness; experimental groups of high and low PDI scorers were formed on the basis of a median split. Visual scanpaths were recorded while participants viewed photographs of faces displaying anger, fear, happy, sad, and neutral expressions under a free-viewing condition. Affect recognition accuracy was assessed using a forced-choice response format. RESULTS: The high PDI group displayed generally "extended" scanpaths, characterised by increased distances between fixations, for angry, fearful, and happy faces, but exhibited a distinctive pattern of reduced foveal attention (fewer fixations) for facial expressions of anger and fear. Impaired affect recognition accuracy in the high PDI group was most pronounced for fearful faces. Reduced recognition accuracy for fearful faces was associated with longer distances between fixations in the entire group. CONCLUSIONS: Delusion-prone individuals displayed a bias of directing attention away from threat-related faces, and a trend toward reduced recognition accuracy for fearful faces, suggesting that these individuals may be particularly sensitive to facial threat.

Journal Article↗
PubMed1993

[The development of visual co-action in infancy].

The purpose was to examine (1) whether infants are capable of imitation or not and (2) to assess their ability for information processing, specifically for visual perception. Twenty-one infants were presented four kinds of facial expressions (tongue protrusion, opened mouth, mouth protrusion and eye blink) at the ages of six, ten, and fourteen weeks. Infants' responses were videotaped and analyzed. Their behavior indicated that six-week-olds could not differentiate between the four stimuli. They could not imitate the facial expressions, because their perception did not differentiate the stimuli sufficiently yet. Responses by ten- and fourteen-week-olds indicated that their perceptual processes had developed sufficiently to differentiate stimuli, and make some matching behaviors with the processed information. Some matching responses, open mouth and mouth protrusion, were less frequent at fourteen weeks than at ten weeks. However, the overall matching responses were greater among fourteen than ten week olds. Apparently with the development of perceptual processes, matching responses also emerge.

Child Behavior↗
PubMed2004

[Non verbal communication abilities in severe traumatic brain injury].

OBJECTIVE: Discursive abilities of severe brain injured patient are always impaired: loss of flexibility, lack of cohesion and coherence, often more elliptic. We know few about nonverbal competencies during discourse. The objective is to verify nonverbal abilities of these patients by pragmatic analysis. METHODS: Four men were examined more than 7 years after severe traumatic brain injury. Nonverbal Prutting and Kirchner Pragmatic Protocol (1987) were done allowing to a qualitative and quantitative measurement of paralinguistic behaviour: prosody and quality of speech, facial expression, posture, gaze, gesture. Two conditions were recorded: dual (descriptive discourse) and group (conversational discourse). Associated impairments such as cognitive and dysexecutive functioning were also investigated. RESULTS/DISCUSSION: Impoverishment (loss of ability) or impaired inadequacity was observed in all patients. Paralinguistic competences of conversational discourse was worse than descriptive one. Facial expression, gaze functioning, referential gesture were more often impaired. Maladjustment could be interpretated in reference with dysexecutive syndrome. CONCLUSION: In spite of the lack of information about the range of normal pragmatic behaviour, it seems that brain injured patients have shown poor nonverbal abilities during discourse. Rehabilitation training of communication skills would integrate this fact in order to improve interactivity and social relationship.

Adult↗
PubMed2000

[The modiolus. Comparative anatomy, embryological and physiological review, surgical importance].

Monkeys, imitators of man's gesture never shared smile with him and their facial expressions only result in grimaces. Study of animal anatomy may explain why subtle expressions of the lips are a more man's special gift than laughter. These fine movements are related to a subcutaneous muscular structure termed modiolus, which is the meeting point of muscles involved in the motion of mouth and comparative anatomy shows this structure to be better defined in Man than in other primates. Embryologically, muscles that form the modiolus derive from a cellular concentration in the region of the second branchial arch. It is then logical to see these muscles converge to the corner of the mouth to form the modiolus, as they emerge from a common area. Functioning of the modiolus is complex, as its position may change many times in a minute to allow the orbicularis oris muscle to take any position and do any movement as if it was inserted on bone. With its complex physiology, the modiolus is of critical importance in the subtle expressions of the lips and must be preserved or reconstructed when performing repair of full-thickness tissue defects of lips.

Animals↗
PubMed2004

Understanding 'not': neuropsychological dissociations between hand and head markers of negation in BSL.

Simple negation in natural languages represents a complex interrelationship of syntax, prosody, semantics and pragmatics, and may be realised in various ways: lexically, morphologically and prosodically. In almost all spoken languages, the first two of these are the primary realisations of syntactic negation. In contrast, in many signed languages negation can occur without lexical or morphological marking. Thus, in British Sign Language (BSL), negation is obligatorily expressed using face-head actions alone (facial negation) with the option of articulating a manual form alongside the required face-head actions (lexical negation). What are the processes underlying facial negation? Here, we explore this question neuropsychologically. If facial negation reflects lexico-syntactic processing in BSL, it may be relatively spared in people with unilateral right hemisphere (RH) lesions, as has been suggested for other 'grammatical facial actions' [Language and Speech 42 (1999) 307; Emmorey, K. (2002). Language, cognition and the brain: Insights from sign language research. Mahwah, NJ: Erlbaum (Lawrence)]. Three BSL users with RH lesions were specifically impaired in perceiving facial compared with manual (lexical and morphological) negation. This dissociation was absent in three users of BSL with left hemisphere lesions and different degrees of language disorder, who also showed relative sparing of negation comprehension. We conclude that, in contrast to some analyses [Applied Psycholinguistics 18 (1997) 411; Emmorey, K. (2002). Language, cognition and the brain: Insights from sign language research. Mahwah, NJ: Erlbaum (Lawrence); Archives of Neurology 36 (1979) 837], non-manual negation in sign may not be a direct surface realisation of syntax [Language and Speech 42 (1999) 143; Language and Speech 42 (1999) 127]. Difficulties with facial negation in the RH-lesion group were associated with specific impairments in processing facial images, including facial expressions. However, they did not reflect generalised 'face-blindness', since the reading of (English) speech patterns from faces was spared in this group. We propose that some aspects of the linguistic analysis of sign language are achieved by prosodic analysis systems (analysis of face and head gestures), which are lateralised to the minor hemisphere.

Aged↗
PubMed1984

The response of the apparent receptive speech disorder of Parkinson's disease to speech therapy.

Eleven patients with Parkinson's disease were tested for prosodic abnormality, on three tests of speech production (of angry, questioning, and neutral statement forms), and four tests of appreciation of the prosodic features of speech and facial expression. The tests were repeated after a control period of two weeks without speech therapy and were not substantially different. After two weeks of intensive domiciliary prosodic therapy, the prosodic abnormality score was improved, as were three of the four tests of recognition of the prosodic features of speech and facial expression, and two of the three tests of production (of angry and questioning forms). The apparent receptive disorder of speech in Parkinson's disease can thus respond to therapy. Possible mechanisms of improvement are briefly discussed.

Aged↗
PubMed1985

Agitation-increased electromyogram activity in the corrugator muscle region: a possible explanation of the "Omega sign"?

The corrugator muscle region of the forehead has special significance in producing facial expressions associated with depression. Darwin observed in 1872 that contractions in the corrugator region produce peculiarly formed wrinkles on the forehead, referred to as "Omega Melancholium." In the present study, results from 61 right-handed, drug-free women with major depressive disorder showed a significant positive correlation between facial corrugator EMG values and psychomotor agitation. Results were not due to differences in severity of depression. These data offer preliminary evidence that agitation is reflected in corrugator muscle activity and may explain the "Omega sign" of melancholia.

Adult↗
PubMed1994

Etiology and management of facial palsy.

Palsy of the facial nerve can result in severe debilitation. The physical disfigurement has a disastrous effect on self-image. Asymmetry of facial expression, drooling, and difficulty with speech may occur. Additionally, impaired closure of the eye can result in exposure of the cornea with not only discomfort, but also loss of vision. If the nerve injury is proximal, loss of salivation, lacrimation, and changes in taste can occur. Clearly, an understanding of facial palsy and a framework for management are needed by the clinician who encounters this condition. The recent literature is surveyed for various causes of seventh nerve palsy and for therapeutic modalities available to the physician.

Facial Expression↗
PubMed2002

Automatic mimicry reactions as related to differences in emotional empathy.

The hypotheses of this investigation were derived by conceiving of automatic mimicking as a component of emotional empathy. Differences between subjects high and low in emotional empathy were investigated. The parameters compared were facial mimicry reactions, as represented by electromyographic (EMG) activity when subjects were exposed to pictures of angry or happy faces, and the degree of correspondence between subjects' facial EMG reactions and their self-reported feelings. The comparisons were made at different stimulus exposure times in order to elicit reactions at different levels of information processing. The high-empathy subjects were found to have a higher degree of mimicking behavior than the low-empathy subjects, a difference that emerged at short exposure times (17-40 ms) that represented automatic reactions. The low-empathy subjects tended already at short exposure times (17-40 ms) to show inverse zygomaticus muscle reactions, namely "smiling" when exposed to an angry face. The high-empathy group was characterized by a significantly higher correspondence between facial expressions and self-reported feelings. No differences were found between the high- and low-empathy subjects in their verbally reported feelings when presented a happy or an angry face. Thus, the differences between the groups in emotional empathy appeared to be related to differences in automatic somatic reactions to facial stimuli rather than to differences in their conscious interpretation of the emotional situation.

Adult↗
PubMedDate not supplied

Functional reconstruction after facial paralysis: a survey.

The attempt to achieve symmetrical harmonious facial expression represents a complex surgical challenge, necessitating an individualized approach. Clinical investigations and laboratory experiments have demonstrated how to better reconstruct a "smile." In long-standing deformities, ipsilateral or crossfacial nerve grafting followed by functional muscle transfer in a 2-stage procedure seems to give the most acceptable results; however, hypoglossal-facial anastomosis and dynamic muscle techniques such as temporal muscle transposition and others can result in adequate functional reconstruction. The development of these techniques with special emphasis on those made during the last 10 years is discussed and compared with our own experiences.

Facial Expression↗
PubMed1994

[Möbius syndrome with crossed total hemiatrophy--a case report].

The patient was a 26-year-old male who was noted to have asymmetry on the face, upper limbs, and trunk, and who showed no pursuit eye movements and no changes in the facial expression from birth. The patient developed transient global amnesia and was hospitalized. Neurological examination established atrophy of the right face, and left trunk involving the upper limb, and bilateral oculomotor and abducens nerve palsy. In auditory brainstem response, waves III to V were bilaterally obscured, and the blink reflex disclosed disturbances of peripheral facial nerve and the brainstem, suggesting developmental abnormalities of the facial motor nucleus. Contralateral R1 was also recorded in the blink reflex, and crossed trigeminofacial pathway was suspected. Möbius syndrome is associated with various muscle and skeletal abnormalities, but the coexistence of crossed total hemiatrophy has not been reported. We think that our case might be the first case of Möbius syndrome with total hemiatrophy.

Abnormalities, Multiple↗
PubMed1994

Smile psychology.

Facial expression, including smiling, is an important means of universal communication and an understudied area in dentistry. Currently there is limited availability of data on smile psychology in either general or cosmetic dental literature. However, the number of cosmetic dentistry patients is increasing and many require and desire physical changes that restore or enhance facial expressions, appearances, and smiles. Cosmetic dentistry patients, particularly those presenting with dental anxiety or phobia, require a more detailed physical and psychologic assessment due to their habitual avoidance of dental care and subsequent oral health deterioration. Increasing knowledge and data facilitate the development of new intervention and treatments for anxious and phobic dental patients. These new developments strengthen the dentist-patient partnership to foster optimal dental results.

Dental Anxiety↗
PubMed1996

[Moebius syndrome: therapeutic proposals from 2 cases].

Moebius syndrome is a congenital bilateral palsy of the sixth and seventh cranial nerves. It results a total absence of facial expression and a severe strabismus. Social life is greatly disturbed. Other anomalies may be associated, especially other cranial palsies and Poland syndrome. The etiology of this syndrome isn't clearly established. Stem necrosis secondary to a vascular deficiency is often admitted. We report two observations. We emphasize the importance of a complete maxillo-facial treatment including maxillo-mandibular anomaly. Both patient underwent orthognathic surgery. The first one for class II and the second for class III anomaly. One patient underwent a facial reanimation by temporal muscle transfer. Orthognathic surgery must be realized prior to facial reanimation. A correction of the strabismus is possible. Moebius syndrome is a rare (200 observations) but very severe malformation. Maxillofacial surgery is able to improve the morphological and relational aspect of Moebius syndrome.

Adolescent↗
PubMed1999

P-ASA block injection: a new palatal technique to anesthetize maxillary anterior teeth.

UNLABELLED: This technique article presents a new local anesthetic injection that is reported to produce anesthesia of the six maxillary anterior teeth, the anterior third of the palate, and the facial gingiva from a single-site injection. The injection is referred to as the palatal approach anterior superior alveolar (P-ASA) nerve block. The 0.9 to 1.4 mL dosage recommendation for this block injection is significantly less than for a traditional supraperiosteal approach. The primary advantage of this injection is that it allows the dentist to anesthetize the teeth and gingiva without collateral anesthesia to the lips, face, or muscles of facial expression. Therefore, the smile line is not distorted during the operative phase of an appointment, and the patient is more comfortable postoperatively. CLINICAL SIGNIFICANCE: The P-ASA is a new block injection technique that provides anesthesia of the maxillary anterior teeth from a single injection without numbness of the face, lips, and muscles of facial expression. This injection technique prevents distortion of the smile line and enhances restorative procedures that use the lip line as an esthetic reference element.

Anesthesia, Dental↗
PubMed2005

Emotional communication in primates: implications for neurobiology.

The social brain hypothesis proposes that large neocortex size in Homonoids evolved to cope with the increasing demands of complex group living and greater numbers of interindividual relationships. Group living requires that individuals communicate effectively about environmental and internal events. Recent data have highlighted the complexity of chimpanzee communication, including graded facial expressions and referential vocalizations. Among Hominoids, elaborate facial communication is accompanied by specializations in brain areas controlling facial movement. Finally, the evolution of empathy, or emotional awareness, might have a neural basis in specialized cells in the neocortex, that is, spindle cells that have been associated with self-conscious emotions, and mirror neurons that have recently been shown to activate in response to communicative facial gestures.

Animals↗
PubMed1997

Effectiveness of oral sucrose and simulated rocking on pain response in preterm neonates.

Feeding and carrying have been interventions used by caregivers throughout history in relieving distress in infants. Recent studies on the food substance sucrose have elucidated the comforting effect of the taste component of feeding while studies of rocking have examined the comforting effect of the vestibular component of carrying. The purpose of this study was to determine the effectiveness of sucrose and simulated rocking alone and in combination on diminishing pain response in preterm neonates undergoing routine heelstick procedure in the neonatal intensive care unit (NICU). Preterm infants (n = 85) between 25-34 weeks post-conceptual age (PCA) and 2-10 days postnatal age (PNA) were randomly assigned to one of four conditions for routine heelstick procedure. The conditions were (1) sucrose alone: 0.05 ml of 24% sucrose was placed on the anterior surface of the tongue just prior to the lancing of the heel; (2) simulated rocking alone: 15 min prior to and during the heelstick procedure, the infant was swaddled and put on an oscillating mattress; (3) combination of sucrose and simulated rocking; and (4) placebo: 0.05 ml sterile water administered just prior to heelstick. Physiological (heart rate) and behavioural (facial actions) responses from baseline across 90 s following heelstick were scored second-to-second. Facial actions were analysed with repeated measures MANCOVA and heart rate with repeated measures ANCOVA. Behavioural state and gestational age were covariates. The groups that received sucrose alone or in combination with simulated rocking showed less facial actions indicative of pain than the rocking alone or control group. The addition of rocking to the sucrose condition tended to further blunt the facial expression of pain, but this enhancement did not reach a significant level. Heart rate was not decreased by any intervention compared to the control condition. Although the simulated rocking did promote quiet sleep, which has been reported in earlier studies to blunt pain response, there was no difference between simulated rocking and control groups in either facial expressions indicative of pain or heart rate. The implication of these results is that sucrose, but not simulated rocking may be a means of diminishing pain from minor procedures in preterm infants. Further research is needed on the use of sucrose for more than one procedure as well as examining the contact component of natural rocking, as opposed to simulated rocking.

Administration, Oral↗