Laptop-based Testing of Emotion Discrimination in Amyotrophic Lateral Sclerosis

Background<br/>ALS shares neuropathological similarities with Frontotemporal Dementia (FTD) resulting in social<br/>cognitive dysfunction. Neuropathologically triggered cognitive deficits are not yet well explored in<br/>ALS research, and it has been argued that changes in subdomains of social cognition are part of the<br/>ALS neuropsychological profile independent of FTD symptoms.<br/>Objectives/Method<br/>A computer-based setup was used to investigate the potential positivity-bias in ALS patients<br/>without FTD, specifically regarding facial emotion perception. We also explored the metacognitive<br/>insight of patients’ performance to understand the neuropsychological profile of ALS and where<br/>dysfunction arises.<br/>Currently, 31 ALS patients and 9 healthy subjects have been included. Patients were on average 50<br/>months after diagnosis. An emotion discrimination task (EDT) was administered using a standard<br/>laptop. Participants were presented with a total of 60 images of faces morphed between angry and<br/>happy facial expressions. Participants were given a forced-choice “happy or angry” evaluating the<br/>emotion presented. Following each stimulus a confidence rating was obtained, on a scale from<br/>“pure guess” (value = 0) to “very sure” (value = 100). Emotion intensity (EI) represents degree of<br/>digital interlacement of facial expressions of angry (EI = 0) and happy (EI = 200). The EI level where<br/>a participant is equally likely to report happy or angry represents the EI Threshold (EIT) and one<br/>would expect healthy controls to have an EIT around 100.<br/>Results/Conclusion<br/>Preliminary data shows a tendency for a lower patient EIT (mean = 81.46, SD = 22.76) compared to<br/>control EIT (mean = 86.54, SD = 17.28, p = 0.465). Representing perception of slightly angry faces<br/>as neutral.<br/>Patients’ confidence ratings were significantly higher when perceiving happy faces (mean = 73.24,<br/>SD = 17.78) compared to when perceiving angry faces (mean = 60.84, SD = 26.69, p = 0.042)<br/>indicating higher confidence in perception of happy faces.<br/>These findings suggest a positivity-bias in ALS patients when interpreting ambiguous facial<br/>emotions. This points to the potential use of the brief laptop-based test for disturbances in<br/>emotional processing in ALS. Future work should compare the results to standardized tests of<br/>emotional perception to overall cognition.