Neuropsychological impairments in emotion recognition compared to general cognition: profiles across six different neurological disorders

OBJECTIVE: Social cognition, particularly emotion recognition, can be impaired in neurological disorders involving brain damage and neurocognitive deficits. However, it remains unclear whether distinctive profiles of social versus general cognitive impairments exist across neurological patient groups: moderate-severe traumatic brain injury (mod-sevTBI), acute ischaemic stroke (AIS), aneurysmal subarachnoid haemorrhage (aSAH), frontal low-grade glioma (LGG), advanced Parkinson's disease (PD), and behavioural variant frontotemporal dementia (bvFTD). METHODS: Data were obtained from scientific studies and clinical records in four Dutch research centres. Neuropsychological testing included emotion recognition [Eckman 60-Faces test (EFT): total score and subscores], memory [Dutch Rey Auditory Verbal Learning Test (DRAVLT): encoding and retrieval], information processing speed, and cognitive control (Trail Making Test A and B). Scores were transformed into Z-scores using normative data and compared across groups. RESULTS: Included were 710 patients: 118 mod-sevTBI, 93 AIS, 121 aSAH, 100 LGG, 147 PD, 131 bvFTD. EFT-total was impaired in all groups (p < .001), with significant group differences (F(5,704) = 30.8, p < .001). Emotion recognition was the most severely affected domain in bvFTD, mod-sevTBI, AIS, and LGG. Only bvFTD and mod-sevTBI showed impairments in specific emotions, mainly sadness and fear. MANOVA showed overall group differences in general cognition (Wilks' Lambda = .69, p < .001). Memory encoding was impaired in all groups, but retrieval in none. Information processing speed and cognitive control were impaired only in bvFTD, mod-sevTBI, AIS, and PD. INTERPRETATION: Emotion recognition is significantly affected across six neurological patient groups, with distinct profiles relative to general cognition. These findings support tailored neuropsychological assessment in clinical practice.