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The perception of emotional facial expressions in stroke patients with and without depression

  • Barbara Montagne (a1), Gudrun M. S. Nys (a2), Martine J. E van Zandvoort (a3) (a4), L. Jaap Kappelle (a3), Edward H. F de Haan (a3) (a4) and Roy P. C. Kessels (a5) (a6) (a7)...



Emotion perception may be impaired after stroke. No study on emotion perception after stroke has taken the influence of post-stroke depressive symptoms into account, although depressive symptoms themselves may hamper emotion perception.


To compare the perception of emotional facial expressions in stroke patients with and without depressive symptoms.


Twenty-two stroke patients participated whose depressive symptoms were classified using the Montgomery-Åsberg Depression Rating Scale (cutoff = 10) and who were compared with healthy controls. Emotion recognition was measured using morphed images of facial expressions.


Patients with depressive symptoms performed worse than controls on all emotions; patients without depressive symptoms performed at control level. Patients with depressive symptoms were less sensitive to the emotions anger, happiness and sadness compared with patients without depressive symptoms.


Post-stroke depressive symptoms impair emotion perception. This extends findings in bipolar disorder indicating that emotion perception deficits are strongly related to the level of depression.


Corresponding author

Dr Roy P. C. Kessels, NICI/Biological Psychology & Neuropsychology, PO Box 9104, 6500 HE Nijmegen, The Netherlands. Tel: +3124 3612541; Fax: +3124 3616066; E-mail:


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1.Carota, A, Staub, F, Bogousslavsky, J. Emotions, behaviours and mood changes in stroke. Curr Opin Neurol 2002;15:5769.
2.Nys, GMS, van Zandvoort, MJE, van Der Worp, HB, de Haan, EHF, de Kort, PLM, Kappelle, LJ. Early depressive symptoms after stroke: neuropsychological correlates and lesion characteristics. J Neurol Sci 2005;228:2733.
3.Chemerinsky, E, Robinson, RG, Kosier, JT. Improved recovery in activities of daily living associated with remission of poststroke depression. Stroke 2001;32:113117.
4.Leppänen, JM. Emotional information processing in mood disorders: a review of behavioral and neuroimaging findings. Curr Opin Psychiatry 2006;19:3449.
5.Kucharska-Pietura, K. Disordered emotional processing in schizophrenia and one-sided brain damage. Prog Brain Res 2006;156:467479.
6.Montgomery, SA, ÅSberg, M. A new depression scale designed to be sensitive to change. Br J Psychiatry 1979;134:382389.
7.Zimmerman, M, Chelminski, I, Posternak, M. A review of studies of the Montgomery-Asberg Depression Rating Scale in controls: implications for the definition of remission in treatment studies of depression. Int Clin Psychopharmacol 2004;19:17.
8.Benton, AL, Sivan, AB, Des Hamsher, K, Varney, NR, Spreen, O. Contributions to neuropsychological assessment: a clinical manual, 2nd ed. New York: Oxford University Press, 1994.
9.Montagne, B, Kessels, RPC, de Haan, EHF, Perrett, DI. The Emotion Recognition Task: a paradigm to measure the perception of facial emotional expressions at different intensities. Percept Mot Skills 2007;104:589598.
10.Karparova, SP, Kersting, A, Suslow, T. Disengagement of attention from facial emotion in unipolar depression. Psychiatry Clin Neurosci 2005;59:723729.
11.Gray, J, Venn, H, Montagne, Bet al. Bipolar patients show mood-congruent biases in sensitivity to facial expressions of emotion when exhibiting depressed symptoms, but not when exhibiting manic symptoms. Cognit Neuropsychiatry 2006;11:505520.
12.Venn, HR, Gray, JM, Montagne, Bet al. Perception of facial expressions of emotion in bipolar disorder. Bipolar Disord 2004;6:286293.
13.Green, MJ, Malhi, GS. Neural mechanisms of the cognitive control of emotions. Acta Neuropsychiatrica 2006;18:144153.
14.Braun, M, Traue, HC, Frisch, S, Deighton, RM, Kessler, H. Emotion recognition in stroke patients with left and right hemispheric lesion: results with a new instrument: the FEEL Test. Brain Cogn 2005;58:193201.
15.Silberman, CD, Laks, J, Capitao, CF, Rodrigues, CS, Moreira, I, Engelhardt, E. Recognizing depression in patients with Parkinson’s disease: accuracy and specificity of two depression rating scale. Arq Neuropsiquiatr 2006;64:407411.
16.Rasquin, SM, Verhey, FR, Lousberg, R, Winkens, I, Lodder, J. Vascular cognitive disorders: memory, mental speed and cognitive flexibility after stroke. J Neurol Sci 2002;203-204:115119.
17.Haldane, M, Frangou, S. Functional neuroimaging studies in mood disorders. Acta Neuropsychiatrica 2006;18:8899.
18.Berntsen, EM, Rasmussen, I-A, Samuelsen, Pet al. Putting the brain in Jeopardy: a novel comprehensive and expressive language task? Acta Neuropsychiatrica 2006;18:115119.



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