The Effects of a Voice Treatment on Facial Emotional Expression in Parkinson's Disease: Expressivity, Experience, and Gender
Date of Degree
Joan C. Borod
Parkinson's disease, facial expressivity, facial emotions, LSVT
Individuals with Parkinson’s disease (PD) suffer from decreased ability to express emotion through facial expression, in what has been termed “masked facies” or hypomimia. Facial emotional expression is necessary for the accurate communication of needs, to obtain or maintain empathy from care-givers, and to be perceived by others in a way that matches the way that one feels. The current study provides a review of the deficits seen in Parkinson’s disease, an overview of the neurobehavioral disparity of spontaneous versus posed facial expression of emotion, and factors that influence the perception of emotion, such as gender and clinical variables. The relationship between the experience and expression of emotion is also discussed. Further, theorized neural mechanisms underlying a current treatment strategy for Parkinson’s disease (i.e., The Lee Silverman Voice Treatment – Loud [LSVT – LOUD®; Ramig et al., 2001]) is described. Finally, the neurobiological correlates between vocal production and facial expression were examined. The current study had three aims. The first one was to explore whether LSVT-LOUD® affects spontaneous facial emotional expression in PD compared to healthy control groups. Second, we examined whether the internal emotional experience of individuals with PD was related to their expression of facial emotion. The third aim was to explore whether there were gender differences in how men and women evaluated same- and opposite-gendered facial expressions of emotion.
Eighty-two individuals comprised the “the poser participants” (i.e., the participant groups of this study), which included PDs receiving the experimental treatment related to voice amplitude (LSVT-LOUD®; Ramig et al., 2001), PDs receiving a control therapy involving articulation (LSVT-ARTIC®; Ramig et al., 2015), PDs not receiving any therapeutic treatment (PD-untrx), and demographically-matched healthy controls (HCs). Using procedures from the New York Emotion Battery (Borod, Cicero, et al., 1998; Borod, Welkowitz, & Obler, 1992), all participants, while being videotaped, were asked to recall a previously experienced emotional event that was happy, sad, or angry, as well as a neutral non-emotional event. Participants’ self-reported experience of each emotion was also recorded. Twenty-fourundergraduate-student rater participants, naïve to the hypotheses of the study, viewed 15-second silent video clips of posers as they recalled the previously experienced emotional or non-emotional events. The “raters” evaluated each video on a 7-point Likert scale, from 1 (“very little”) to 7 (“extreme amount”), for facial emotional expressivity, in terms of emotional frequency, emotional intensity, and emotional variability, as well as social engagement and facial mobility (a non-emotional measure).
Our results indicated that the PDs in our sample demonstrated impaired facial expressivity relative to HCs. Contrary to our expectation, we did not find an effect of LSVT-LOUD® treatment on PDs’ spontaneous facial emotional expressions. Second, when exploring whether PDs and HCs experience monologue emotions similarly, we found no differences between the two participant groups. Finally, when viewing same- and opposite-gender facial expressions of emotion, male raters rated all posers as more facially expressive than did female raters. Female raters rated female posers as significantly more facially expressive than did male posers. The results of the current study further characterize the emotional deficits seen in PD and are discussed in terms of clinical implications.
Murray, Elizabeth M., "The Effects of a Voice Treatment on Facial Emotional Expression in Parkinson's Disease: Expressivity, Experience, and Gender" (2018). CUNY Academic Works.