Anodal Transcranial Direct Current Stimulation over the Cerebellum Enhances Sadness Recognition in Parkinson's Disease Patients: a Pilot Study

Fabiana Ruggiero, Michelangelo Dini, Francesca Cortese, Maurizio Vergari, Martina Nigro, Barbara Poletti, Alberto Priori, Roberta Ferrucci, Fabiana Ruggiero, Michelangelo Dini, Francesca Cortese, Maurizio Vergari, Martina Nigro, Barbara Poletti, Alberto Priori, Roberta Ferrucci

Abstract

Emotional processing impairments, resulting in a difficulty to decode emotions from faces especially for negative emotions, are characteristic non-motor features of Parkinson's disease (PD). There is limited evidence about the specific contribution of the cerebellum to the recognition of emotional contents in facial expressions even though patients with cerebellar dysfunction often lose this ability. In this study, we aimed to evaluate whether the recognition of facial expressions can be modulated by cerebellar transcranial direct current stimulation (tDCS) in PD patients. Nine PD patients were enrolled and received anodal and sham tDCS (2 mA, 20 min), for 5 consecutive days, in two separate cycles at intervals of at least 1 month. The facial emotion recognition task was administered at baseline (T0) and after cerebellar tDCS on day 5 (T1). Our preliminary study showed that anodal cerebellar tDCS significantly enhanced emotional recognition in response to sad facial expressions by about 16%, but left recognition of anger, happiness, and neutral facial expressions unchanged. Despite the small sample size, our preliminary results show that anodal tDCS applied for five consecutive days over the cerebellum modulates the way PD patients recognize specific facial expressions, thus suggesting that the cerebellum plays a crucial role in recognition of negative emotions and corroborating previous knowledge on the link between social cognition and the cerebellum.

Keywords: Cerebellum; Face emotion recognition; Parkinson’s disease; tDCS.

Conflict of interest statement

Alberto Priori, Roberta Ferrucci, and Maurizio Vergari are stakeholders in Newronika s.r.l., a spin-off company formed by the Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico and Università degli Studi di Milano, Italy.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Timeline of the experimental procedure (A) and task stimuli (B). SRT, simple reaction times; VAS, visual analogue scale
Fig. 2
Fig. 2
The effects of cerebellar tDCS and sham on FER-RTs % change for each emotion (sadness, anger, neutral, happiness) during the FER task. Anodal cerebellar tDCS decreased FER-RTs for sadness (p = 0.038). Data are displayed as median (bar height) with 95% CI (whiskers); dots represent individual FER-RTs % change between T1 and T0. Asterisks denote statistically significant differences between sham and anodal tDCS (* = p ≤ .05)

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