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Semin Speech Lang 2018; 39(01): 087-100
DOI: 10.1055/s-0037-1608859
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Impaired Recognition of Emotional Faces after Stroke Involving Right Amygdala or Insula

Donna C. Tippett
1   Department of Neurology, Johns Hopkins University School of Medicine, Baltimore Maryland
2   Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore Maryland
3   Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore Maryland
,
Brittany R. Godin
4   Rehabilitation Services, University of Maryland Charles Regional Medical Center, La Plata, Maryland
,
Kumiko Oishi
5   Center for Imaging Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland
,
Kenichi Oishi
6   Department of Radiology, Johns Hopkins University School of Medicine, Baltimore Maryland
,
Cameron Davis
1   Department of Neurology, Johns Hopkins University School of Medicine, Baltimore Maryland
,
Yessenia Gomez
1   Department of Neurology, Johns Hopkins University School of Medicine, Baltimore Maryland
,
Lydia A. Trupe
1   Department of Neurology, Johns Hopkins University School of Medicine, Baltimore Maryland
,
Eun Hye Kim
1   Department of Neurology, Johns Hopkins University School of Medicine, Baltimore Maryland
,
Argye E. Hillis
1   Department of Neurology, Johns Hopkins University School of Medicine, Baltimore Maryland
3   Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore Maryland
7   Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, Maryland
› Author Affiliations
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Publication History

Publication Date:
22 January 2018 (online)

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Abstract

Despite its basic and translational importance, the neural circuitry supporting the perception of emotional faces remains incompletely understood. Functional imaging studies and chronic lesion studies indicate distinct roles of the amygdala and insula in recognition of fear and disgust in facial expressions, whereas intracranial encephalography studies, which are not encumbered by variations in human anatomy, indicate a somewhat different role of these structures. In this article, we leveraged lesion-mapping techniques in individuals with acute right hemisphere stroke to investigate lesions associated with impaired recognition of prototypic emotional faces before significant neural reorganization can occur during recovery from stroke. Right hemisphere stroke patients were significantly less accurate than controls on a test of emotional facial recognition for both positive and negative emotions. Patients with right amygdala or anterior insula lesions had significantly lower scores than other right hemisphere stroke patients on recognition of angry and happy faces. Lesion volume within several regions, including the right amygdala and anterior insula, each independently contributed to the error rate in recognition of individual emotions. Results provide additional support for a necessary role of the right amygdala and anterior insula within a network of regions underlying recognition of facial expressions, particularly those that have biological importance or motivational relevance and have implications for clinical practice.

Keywords

Emotion perception - facial recognition - stroke - magnetic resonance imaging - brain mapping