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In this paper, we introduce a new neonatal facial expression database for pain analysis. This database, called facial expression of neonatal pain (FENP), contains 11000 neonatal facial expression images associated with 106 Chinese neonates from two children's hospitals, i.e., the Children's Hospital Affiliated to Nanjing Medical University and Second Affiliated Hospital Affiliated to Nanjing Medical University in China. The facial expression images cover four categories of facial expressions, i.e., severe pain expression, mild pain expression, crying expression and calmness expression, where each category contains 2750 neonatal facial expression images. Based on this database, we also investigate the pain facial expression recognition problem using several state-of-the-art facial expression features and expression recognition methods, such as Gabor+SVM, LBP+SVM, HOG+SVM, LBP+HOG+SVM, and several Convolutional Neural Network (CNN) methods (including AlexNet, VGGNet, GoogLeNet, ResNet and DenseNet). The experimental results indicate that the proposed neonatal pain facial expression database would be very suitable for the study of both neonatal pain and facial expression recognition. Moreover, the FENP database would be publicly available after signing a license agreement (the users can contact Jingjie Yan (yanjingjie@njupt.edu.cn) or Guanming Lu (lugm@njupt.edu.cn)).

Determining the psychophysiological state of people has been a significant issue in many fields, such as the adaptation of disabled people to social life. Recently, various physiological signals have been used in emotion recognition studies since the desired success is limited in studies conducted with traditional methods such as posture and facial expressions. In this study, a GoogLeNet-based deep learning method that can automatically detect human emotions using Electroencephalogram (EEG) signals is proposed. EEG signals were converted to EEG images (scalogram) with Continuous Wavelet Transform (CWT), which is more sensitive to Time Frequency (TF) changes in EEG signals. Then, feature extraction was performed from EEG images with a pre-trained GoogLeNet. Finally, the deep features obtained were applied to popular machine learning methods such as k-Nearest Neighbor (k-NN), Support Vector Machine (SVM), and Extreme Learning Machine (ELM) classifiers for emotion classification. The proposed method was tested using the GAMEEMO dataset. This study regards two emotions, namely ‘Positive’ and ‘Negative’ for classification. The comprehensive experimental results show that the proposed method achieved 98.78%, 98.53%, and 98.41% emotion detection accuracy in SVM, k-NN, and ELM classifiers, respectively. The proposed method shows improved performance of about 21.85% than of the existing state-of-the-art methods using the same dataset.

Surprised facial expressions, which are ambiguous in valence, are interpreted more positively by older adults than by younger adults. To evaluate the processes that contribute to this age difference, we varied the spatial frequency of the surprised-face stimuli. Replicating prior results, we found that older adults rated the unfiltered surprised faces more positively than did younger adults. However, valence ratings were affected by spatial frequency. When the surprised faces were presented in a low-spatial-frequency band, it biased the participants to rate them negatively. Even though this occurred for both the younger and older adults, the older adults’ ratings of the low-spatial-frequency faces were still more positive than that of the younger adults. This suggests that there is an age-related reduction in the default negativity of interpretations. Evidence for additional processes comes from analyses of the high-spatial-frequency faces. Although older adults, as a whole, rated the high-spatial frequency faces to be more positive than the younger adults, this effect was eliminated for the subset of older adults with poor high-spatial-frequency perception abilities. We suggest that this is because these older adults needed to use top-down cognitive resources to compensate for the decrease in bottom-up input, and this cognitive load interfered with their ability to increase the positivity of their ratings for the difficult-to-perceive faces. Thus, older adults’ more positive interpretations of surprised faces can be attributed to age-related reduction in default negativity and also to older adults’ use of cognitively-effortful top-down regulatory processes that serve to increase positivity.

A large body of research on emotion communication has demonstrated that facial muscle movements (i.e., facial expressions) influence social perceptions made from faces. However, new research suggests that head position can also affect the way that faces are perceived, by systematically changing the appearance of the face. More specifically, according to the action-unit imposter account, tilting one's head downward causes the eyebrows to appear lower and take on a V shape-the same appearance cues associated with a particular facial muscle movement (corrugator activity, or Action Unit 4 [AU4]). Drawing on this account, four studies (two of which were preregistered) tested whether a downward head tilt intensifies perceptions of facial expressions of emotion that include V-shaped eyebrows from AU4 but weaken perceptions of expressions that do not. Supporting this hypothesis, findings showed that (a) when the head is tilted downward, anger expressions-which include V-shaped eyebrows from AU4-are perceived as more intense, whereas expressions of happiness, disgust, fear, and surprise-which do not include V-shaped eyebrows from AU4-are perceived as less intense; (b) visually apparent changes to the eyebrows caused by the action-unit imposter effect account for the effect of a downward head tilt on perceptions of anger; and (c) this head movement is spontaneously used by individuals seeking to encode facial expressions of anger. Together, findings suggest that head movements play an important role in communicating emotion expressions from the face, especially anger. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Objective Difficulties identifying emotional facial expressions are commonly observed in alcohol use disorder (AUD). Critically, this work utilizes single-race stimulus sets, although study samples are not similarly constrained. This is particularly concerning given evidence among community samples showing the impact of racial incongruity, giving rise to interpretative caveats. Method Community controls (n = 55, 12 Black) and individuals with AUD (n = 46, 9 Black) completed a two-choice emotion judgment task. A similar nonaffective sex judgment task was employed as a covariate. Repeated measures mixed-model analyses were conducted with race, AUD status (AUD vs. control), and their interaction as fixed effects. Accuracy and reaction time (RT) were primary dependent measures. A post hoc analysis was conducted on efficiency (accuracy/RT). Results In addition to lower accuracy by individuals with AUD (p = .02), Black participants were less accurate than White participants (p = .0001) overall. Significant interactions between race and AUD were also detected for accuracy (p = .002), RT (p = .05), and efficiency (p = .01), wherein Black participants with AUD identified emotional expressions most poorly. This latter finding suggests that AUD-associated differences may be biased under racial incongruity. Conclusion Taken together, these preliminary findings do not reflect a deficit among Black respondents. Instead, our results reflect the need for greater attention to stimulus diversity and sensitivity to respondent demographics in emotion-processing examinations. Given the purported role of emotion processing in alcohol-related problems and the increase in racial minority representation in the U.S., elucidating these differences remains critical. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Computational systems that process multiple affective states may benefit from explicitly considering the interaction between the states to enhance their recognition performance. This work proposes the combination of a multi-label classifier, Circular Classifier Chain (CCC), with a multimodal classifier, Fusion using a Semi-Naive Bayesian classifier (FSNBC), to include explicitly the dependencies between multiple affective states during the automatic recognition process. This combination of classifiers is applied to a virtual rehabilitation context of post-stroke patients. We collected data from post-stroke patients, which include finger pressure, hand movements, and facial expressions during ten longitudinal sessions. Videos of the sessions were labelled by clinicians to recognize four states: tiredness, anxiety, pain, and engagement. Each state was modelled by the FSNBC receiving the information of finger pressure, hand movements, and facial expressions. The four FSNBCs were linked in the CCC to exploit the dependency relationships between the states. The convergence of CCC was reached by 5 iterations at most for all the patients. Results (ROC AUC)) of CCC with the FSNBC are over $0.940 \pm 0.045$ ( $mean \pm std.\,deviation$ ) for the four states. Relationships of mutual exclusion between engagement and all the other states and co-occurrences between pain and anxiety were detected and discussed.

Affective state recognition and in particular the identification of fear is known to be impaired in psychopathy. It is unclear, however, whether this reflects a deficit in basic perception (‘fear blindness’) or a deficit in later cognitive processing. To test for a perceptual deficit, 63 male incarcerated offenders, assessed with the Hare Psychopathy Checklist-Revised (PCL-R), and 59 age-matched control participants detected fearful, neutral, and happy facial expressions rendered invisible through continuous flash suppression (CFS), a strong interocular suppression technique. Consistent with previous CFS studies on children, student and community samples, fearful faces were detected faster than neutral faces, which were detected faster than happy faces. Detection of emotional faces was unimpaired in offenders, with strong evidence for a full-blown fear advantage. Moreover, the fear advantage was not reduced in the 20 offenders qualifying as psychopaths according to the PCL-R, and there was no correlation between the fear advantage and PCL-R scores in the 63 incarcerated offenders. These results show that basic visual detection of fearful faces is unimpaired in psychopathy. Deficits in the processing of fearful facial expressions in psychopathy may thus not reflect fear blindness, but impairments at later post-perceptual processing stages related to attention, memory, decision-making, or language.

Background Individuals with autism spectrum disorder (ASD) exhibit frequent behavioral deficits in facial emotion recognition (FER). It remains unknown whether these deficits arise because facial emotion information is not encoded in their neural signal or because it is encodes but fails to translate to FER behavior (deployment). This distinction has functional implications, including constraining when differences in social information processing occur in ASD, and guiding interventions (i.e., developing prosthetic FER vs. reinforcing existing skills). Methods We utilized a discriminative and contemporary machine learning approach—deep convolutional neural networks—to classify facial emotions viewed by individuals with and without ASD (N = 88) from concurrently recorded electroencephalography signals. Results The convolutional neural network classified facial emotions with high accuracy for both ASD and non-ASD groups, even though individuals with ASD performed more poorly on the concurrent FER task. In fact, convolutional neural network accuracy was greater in the ASD group and was not related to behavioral performance. This pattern of results replicated across three independent participant samples. Moreover, feature importance analyses suggested that a late temporal window of neural activity (1000–1500 ms) may be uniquely important in facial emotion classification for individuals with ASD. Conclusions Our results reveal for the first time that facial emotion information is encoded in the neural signal of individuals with (and without) ASD. Thus, observed difficulties in behavioral FER associated with ASD likely arise from difficulties in decoding or deployment of facial emotion information within the neural signal. Interventions should focus on capitalizing on this intact encoding rather than promoting compensation or FER prostheses.

Expressions of emotion represent an important and unique source of information about the states of others. Being able to effectively understand expressions of emotions to make inferences about others' internal mental states and use these inferences to guide decision-making and behavior is critical to navigating social relationships. Loneliness, the perception that one lacks social connection, has important functional consequences for how individuals attend to signals of emotions in others. However, it is less clear whether loneliness changes how individuals recognize emotions in others. In medical practitioners, being able to accurately recognize emotional cues from patients is critical to effectively diagnosing and reacting with care to those patients. The current study examines the relationship between changes in loneliness during medical school and students' recognition of emotion in others. Measures of loneliness and emotion recognition were collected from 122 medical students during their first 3 years of medical school at the beginning and end of each academic year. Changes in loneliness were related to changes in emotion detection, with increases in loneliness being associated with decreases in the probability of accurately discriminating sad and angry faces from other expressions, decreases in the probability of mislabeling emotion expressions as happy, and increases in the probability of mislabeling other emotional expressions as pained and angry. This study suggests that changes in loneliness during medical school are associated with increases in students' labeling emotional expressions as negative, possibly by shifting attention to cues of negative emotion and away from cues of positive emotion. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

It is as yet unresolved to what extent the pre-attentive detection of auditory deviance is modulated by emotion. The current event-related potential study was designed to investigate simultaneously the auditory and the visual mismatch negativity (MMN), as well as the impact of emotion on the auditory MMN. Thirty healthy participants saw sequences of neutral and fearful face stimuli and were instructed to identify easily detectable target faces by button press, whereas simultaneously presented auditory stimuli did not require any behavioral response. Increased N170 and N250 amplitudes to fearful faces indicated a differential processing of the fearful and neutral faces as standards. A visual MMN was clearly elicited by fearful face deviants, but hardly by neutral face deviants. Neither the auditory MMN nor the processing of visual targets was modulated by the facial emotion. However, the N250 modulation by emotion was surprisingly larger in target than in non-target trials. Findings suggest that the pre-attentive detection of auditory deviance as reflected in the auditory MMN is not substantially modulated by emotion induced by visual stimulation. The wide lack of a significant visual MMN to neutral deviants indicates that this deviance detection is not driven by physical stimulus properties (because otherwise the visual MMN to fearful and neutral deviants should have the same magnitude) but strongly by the emotional significance. The behavioral significance of targets apparently led to an enhanced processing of emotional features even though these features were irrelevant for target detection task.

Kliniker berichten haufig von einer Veranderung des mimisch-affektiven Verhaltens im Laufe der Behandlung posttraumatischer Belastungsstorungen (PTBS). Dabei wird die Zunahme der Mimik in Zusammenhang mit dem Ruckgang der „Numbing“-Symptomatik gebracht. Die Zunahme des mimisch-affektiven Verhaltens (insbesondere des negativen Affekts) im Laufe einer Behandlung in Form des Eye Movement Desensitization and Reprocessing (EMDR) sollte dokumentiert werden. Des Weiteren erfolgte eine explorative Analyse der Zusammenhange der mimischen Veranderungen mit wichtigen Therapie-Outcomes. Das mimisch-affektive Verhalten wahrend der Therapiesitzungen wurde fur 16 Patientinnen, die vor ihrem 18. Lebensjahr traumatisiert wurden, mithilfe des „facial action coding system“ (FACS) im Vorfeld, wahrend und ein Jahr nach einer stationaren EMDR-Behandlung codiert. Zur Quantifizierung der Symptombelastung kamen die Impact of Event Scale Revised (IES-R), die Symptomcheckliste (SCL-90®), das Beck-Depressions-Inventar (BDI-V) sowie der Fragebogen zu Dissoziativen Symptomen (FDS) zum Einsatz. Es zeigt sich uber die 3 Erhebungszeitpunkte hinweg eine bedeutsame Mimikveranderung, die eine Zunahme der Gesamtmimik und den Ausdruck negativen Affekts betraf. Zusammenhange zu den Veranderungen der erhobenen Symptomschwere liesen sich jedoch nicht belegen. Anhand weiterer Untersuchungen wird geklart werden mussen, inwiefern die Zunahme des mimisch-affektiven Verhaltens relevant ist, um insbesondere im Hinblick auf soziale Interaktionen von Behandlungserfolg sprechen zu konnen.

Objective To assess the prevalence of impaired visual emotion recognition in patients who have suffered a minor ischemic stroke in the subacute phase and to determine associated factors of impaired visual emotion recognition. Design A prospective observational study. Setting Stroke-unit of a teaching hospital. Participants 112 patients with minor ischemic stroke. Interventions Not applicable. Main outcome measures Patients with minor stroke underwent a neuropsychological assessment in the sub-acute phase for visual emotion recognition by the Ekman 60 Faces Test and for general cognition. Univariable linear regression analyses were performed to identify associated factors of emotion recognition impairment. Results In 112 minor stroke patients we found a prevalence of 25% of impaired visual emotion recognition. This was significantly correlated with impaired general cognition. Nevertheless 10.9% of patients with normal general cognition still had impaired emotion recognition. Mood was negatively associated. Stroke localization, hemisphere side and gender were not associated. Conclusion Impaired visual emotion recognition is found in about a quarter of patients with minor ischemic stroke.

Emotion recognition from Electroencephalography (EEG) is proved to be a good choice as it cannot be mimicked like speech signals or facial expressions. EEG signals of emotions are not unique and it varies from person to person as each one has different emotional responses to the same stimuli. Thus EEG signals are subject dependent and proved to be effective for subject dependent emotion recognition. However, subject independent emotion recognition plays an important role in situations like emotion recognition from paralyzed or burnt face, where EEG of emotions of the subjects before the incidents are not available to build the emotion recognition model. Hence there is a need to identify common EEG patterns corresponds to each emotion independent of the subjects. In this paper, a subject independent emotion recognition technique is proposed from EEG signals using Variational Mode Decomposition (VMD) as a feature extraction technique and Deep Neural Network as the classifier. The performance evaluation of the proposed method with the benchmark DEAP dataset shows that the combination of VMD and Deep Neural Network performs better compared to the state of the art techniques in subject-independent emotion recognition from EEG.

Transparency estimation, that is, estimating the extent to which one’s mental states are observable to others, requires the simultaneous representation of the self and of others’ perspective on the self. Individuals with borderline personality disorder (BPD) have difficulty integrating multiple perspectives when mentalizing, which may be reflected in impaired transparency estimation. Sixty-two participants high and low in BPD features watched emotionally evocative video clips, and estimated the transparency of their emotional experience while facial expression coding software (FaceReader) quantified their objective transparency. Individuals high in BPD features showed a larger discrepancy between estimated and objective transparency than individuals low in BPD features, showing that they both over- and underestimated their transparency. Indeed, estimated transparency positively predicted objective transparency in individuals low in BPD features, but not in individuals high in BPD features. Moreover, the ability to estimate intraindividual variability in one’s own objective transparency was moderated by self-reported arousal in the participants high in BPD features. Impairments in transparency estimation were correlated with self-report measures of borderline features, attachment, and mentalizing. In conclusion, we found that borderline features relate to a reduced capacity to estimate the extent to which one’s own emotional states are observable to others. Although replication in clinical samples of BPD patients is needed, the present study provides evidence for problems in mentalizing the (embodied) self from another person’s perspective in BPD. ispartof: Personality Disorders-Theory Research And Treatment vol:13 issue:3 pages:1-13 ispartof: location:United States status: Published online

How does facial muscle activity relate to moral judgments across cultures? To explore this question, we used facial electromyography (EMG) among residents of New Zealand (N = 30) and Hong Kong (N = 40), comparing findings to prior data from the United Kingdom. We recorded EMG involved in expressions of disgust (m.levator labii), anger (m.corrugator supercilii), amusement (m.zygomaticus major), and surprise (m.medial frontalis) while participants thought about 90 scenarios that varied in valence and relevance to the harm, fairness, ingroup, authority, and purity moral dimensions. Overall, levator and corrugator activity were associated with more negative judgments in all samples, while only in Hong Kong a decrease in medial frontalis activity was associated with negativity. Both levator and corrugator were cross-culturally associated with negative judgments in purity scenarios. In contrast to prior findings, harm and fairness violations were associated with different levator and/or corrugator activity across samples. We discuss implications for the relationship between spontaneous facial muscle activity and moral versus negativity judgments across cultures. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Pain inadequate treatment is frequent in modern society, with major medical, ethical, and financial implications. In many healthcare environments, pain is quantified prevalently through subjective measures, such as self-reports from patients or health care providers' personal experience. Recently, automatic diagnostic tools have been developed to detect and quantify pain more "objectively" from facial expressions. However, it is still unclear if these approaches can distinguish pain from other aversive (but painless) states. In the present study, we analyzed the facial responses from a database of video-recorded facial reactions evoked by comparably-upleasant painful and disgusting stimuli. We modeled this information as function of subjective unpleasantness, as well as the specific state evoked by the stimuli (pain vs. disgust). Results show that a machine learning algorithm could predict subjective pain unpleasantness from facial information, but mistakenly detected unpleasant disgust, especially in those models relying in great extent on the brow lowerer. Importantly, pain and disgust could be disentangled using an ad hoc algorithm that rely on combined information from the eyes and the mouth. Overall, the facial expression of pain contains both specific and unpleasantness-related information shared with disgust. Automatic diagnostic tools should be guided to account for this confounding effect.

Meta-analysis of functional magnetic resonance imaging (fMRI) data is an effective method for capturing the distributed patterns of brain activity supporting discrete cognitive and affective processes. One opportunity presented by the resulting meta-analysis maps (MAMs) is as a reference for better understanding the nature of individual contrast maps (ICMs) derived from specific task fMRI data. Here, we compared MAMs from 148 neuroimaging studies representing the broad emotion categories of fear, anger, disgust, happiness, and sadness with ICMs from fearful > neutral and angry > neutral facial expressions from an independent dataset of task fMRI (n = 1263). Analyses revealed that both fear and anger ICMs exhibited the greatest pattern similarity to fear MAMs. As the number of voxels included for the computation of pattern similarity became more selective, the specificity of MAM-ICM correspondence decreased. Notably, amygdala activity long considered critical for processing threat-related facial expressions was neither sufficient nor necessary for detecting MAM-ICM pattern similarity effects. Our analyses suggest that both fearful and angry facial expressions are best captured by distributed patterns of brain activity associated with fear. More generally, our analyses demonstrate how MAMs can be leveraged to better understand affective processes captured by ICMs in task fMRI data.

Whilst alterations in emotional face processing, as indicated by event-related potentials (ERPs), are associated with depression and anxiety symptoms in clinical and non-clinical samples, it has remained unclear whether they are related to mental wellbeing. The current study aimed to address this question in a non-clinical sample. The analysis included 402 adult twins from the TWIN-E study. The COMPAS-W and the Depression Anxiety Stress Scale (DASS-42) were used to measure mental wellbeing and depression/anxiety symptoms, respectively. Participants viewed facial expressions under Unmasked (conscious) and Masked (subliminal) conditions while ERPs were recorded. The associations of emotion processing with mental wellbeing and depression/anxiety symptoms were assessed using multivariate linear mixed models. There was a strong association between depression/anxiety symptoms and the N170 amplitude difference for the Fear - Happy contrast in the Masked condition after controlling for wellbeing scores (B = 0.34, p .001). Specifically, higher depression/anxiety symptoms were associated with a lack of differentiation between fearful and happy faces. No associations were found between emotional face processing and mental wellbeing scores. These results indicate that even within a non-clinical sample, alterations in emotional ERPs, namely the N170, reflect differences in depression/anxiety symptoms rather than differences in wellbeing. Furthermore, this effect was limited to automatic processing, rather than conscious processing of emotional stimuli, suggesting the observed differences apply only to the subconscious pathway.

Infants receiving care in the Neonatal Intensive Care Unit (NICU) experience several painful procedures during their hospitalization. Assessing neonatal pain is difficult because the current standard for assessment is subjective, inconsistent, and discontinuous. The intermittent and inconsistent assessment can induce poor treatment and, therefore, cause serious long-term outcomes. In this paper, we present a comprehensive pain assessment system that utilizes facial expressions along with crying sounds, body movement, and vital sign changes. The proposed automatic system generates a standardized pain assessment comparable to those obtained by conventional nurse-derived pain scores. The system achieved 95.56% accuracy using decision fusion of different pain responses that were recorded in a challenging clinical environment. In addition to the decision fusion, we present the performance of multimodal assessment using other fusion schemes as well as a unimodal assessment approach. We also discuss the impact of different factors (e.g., gestational age) on pain, propose several group-specific models for pain assessment (e.g., pre-term and full-term models), and compare the performance of these models with the performance of general models. While further research is needed, our results show that the automatic assessment of neonatal pain is a viable and more efficient alternative to the manual assessment.

Pain assessment in children continues to challenge clinicians and researchers, as subjective experiences of pain require inference through observable behaviors, both involuntary and deliberate. The presented approach supplements the subjective self-report-based method by fusing electrodermal activity (EDA) recordings with video facial expressions to develop an objective pain assessment metric. Such an approach is specifically important for assessing pain in children who are not capable of providing accurate self-pain reports, requiring nonverbal pain assessment. We demonstrate the performance of our approach using data recorded from children in post-operative recovery following laparoscopic appendectomy. We examined separately and combined the usefulness of EDA and video facial expression data as predictors of children's self-reports of pain following surgery through recovery. Findings indicate that EDA and facial expression data independently provide above chance sensitivities and specificities, but their fusion for classifying clinically significant pain vs. clinically nonsignificant pain achieved substantial improvement, yielding 90.91% accuracy, with 100% sensitivity and 81.82% specificity. The multimodal measures capitalize upon different features of the complex pain response. Thus, this paper presents both evidence for the utility of a weighted maximum likelihood algorithm as a novel feature selection method for EDA and video facial expression data and an accurate and objective automated classification algorithm capable ofdiscriminating clinically significant pain from clinically nonsignificant pain in children.

This review summarizes human perception and processing of face and gaze signals. Face and gaze signals are important means of non-verbal social communication. The review highlights that: (1) some evidence is available suggesting that the perception and processing of facial information starts in the prenatal period; (2) the perception and processing of face identity, expression and gaze direction is highly context specific, the effect of race and culture being a case in point. Culture affects by means of experiential shaping and social categorization the way in which information on face and gaze is collected and perceived; (3) face and gaze processing occurs in the so-called 'social brain'. Accumulating evidence suggests that the processing of facial identity, facial emotional expression and gaze involves two parallel and interacting pathways: a fast and crude subcortical route and a slower cortical pathway. The flow of information is bi-directional and includes bottom-up and top-down processing. The cortical networks particularly include the fusiform gyrus, superior temporal sulcus (STS), intraparietal sulcus, temporoparietal junction and medial prefrontal cortex.

Emotion recognition is a crucial application in human–computer interaction. It is usually conducted using facial expressions as the main modality, which might not be reliable. In this study, we proposed a multimodal approach that uses 2-channel electroencephalography (EEG) signals and eye modality in addition to the face modality to enhance the recognition performance. We also studied the use of facial images versus facial depth as the face modality and adapted the common arousal–valence model of emotions and the convolutional neural network, which can model the spatiotemporal information from the modality data for emotion recognition. Extensive experiments were conducted on the modality and emotion data, the results of which showed that our system has high accuracies of 67.8% and 77.0% in valence recognition and arousal recognition, respectively. The proposed method outperformed most state-of-the-art systems that use similar but fewer modalities. Moreover, the use of facial depth has outperformed the use of facial images. The proposed method of emotion recognition has significant potential for integration into various educational applications.

Early diagnosis of Autism Spectrum Disorder (ASD) plays a crucial role in the intervention of ASD. Traditionally, an ASD child needs to be diagnosed by a psychiatrist in the hospital, which is expensive, time-consuming, and influenced by expertise. In this paper, we present an objective, convenient, and effective method for classifying ASD children from raw video sequences by integrating the appearance-based features from facial expressions, head pose, and head trajectory. To better extract facial expression features, we propose a novel attention-based facial expression recognition algorithm to focus on key face areas like eyebrows, mouth, etc. Moreover, we use accumulative histogram to individually extract temporal and spatial information from facial expression, head pose and head trajectory of the video sequence. After fusing these three kinds of features, we feed them to Long Short-Term Memory (LSTM) and achieve a classification accuracy of 96.7% on our self-collected ASD video dataset.

Integrating the spatiotemporal information acquired from the highly dynamic world around us is essential to navigate, reason, and decide properly. Although this is particularly important in a face-to-face conversation, very little research to date has specifically examined the neural correlates of temporal integration in dynamic face perception. Here we present statistically robust observations regarding the brain activations measured via electroencephalography (EEG) that are specific to the temporal integration. To that end, we generate videos of neutral faces of individuals and non-face objects, modulate the contrast of the even and odd frames at two specific frequencies ($$f_1$$ f 1 and $$f_2$$ f 2 ) in an interlaced manner, and measure the steady-state visual evoked potential as participants view the videos. Then, we analyze the intermodulation components (IMs: ($$nf_1\pm mf_2$$ n f 1 ± m f 2 ), a linear combination of the fundamentals with integer multipliers) that consequently reflect the nonlinear processing and indicate temporal integration by design. We show that electrodes around the medial temporal, inferior, and medial frontal areas respond strongly and selectively when viewing dynamic faces, which manifests the essential processes underlying our ability to perceive and understand our social world. The generation of IMs is only possible if even and odd frames are processed in succession and integrated temporally, therefore, the strong IMs in our frequency spectrum analysis show that the time between frames (1/60 s) is sufficient for temporal integration.

Contains fulltext : 287522.pdf (Publisher’s version ) (Open Access) Impaired emotion recognition is common in individuals with attention-deficit/hyperactivity disorder (ADHD) and may, via deficient emotion self-regulation, relate to the frequently co-occurring affective and social problems. The present study used an emotional face-matching task and functional magnetic resonance imaging (fMRI) to investigate neural responses during the processing of angry and fearful faces and visuo-spatial control stimuli. Additionally, measures for emotion dysregulation, ADHD type, and age were investigated in relation to the behavioral and neural fMRI data. We utilized a sample of 61 adolescents/young adults with ADHD and 51 age-matched healthy controls (age range: 12-28 years). Participants with ADHD had higher emotion dysregulation scores than controls. They also reacted slower and less accurate in response to emotional but not visuo-spatial control stimuli. Neural response differences between emotional and visuo-spatial trials were significantly smaller in cases, particularly in the left amygdala. While coupling between the right amygdala and bilateral ventromedial prefrontal cortex was stronger for emotional than visuo-spatial stimuli in control subjects, levels of positive coupling between the trial types did not significantly differ in participants with ADHD. Neither emotion dysregulation scores, nor ADHD type or age were related to the behavioral and neural processing alterations during the emotional face-matching task. Results indicate that emotion recognition deficits in ADHD are particularly associated with lower amygdala activation to emotional stimuli and alterations in the functional connections of the amygdala to medial prefrontal areas. Emotion recognition deficits and associated neural alterations were unrelated to emotion dysregulation, ADHD type, or age.

Although it is well documented that exercising is good for the mental health and cognitive function as well as the physical condition in elderly people, exercising is difficult in elderly individuals with a low motor function. To develop an exercise program targeting elderly individuals unsuited for whole-body exercises, we assessed the effects of facial exercises on the mental health and mood in healthy elderly people. Community-dwelling older adults (N = 75, age range = 65-87 yrs) were randomly divided into a facial exercises group and a wait-listed control group. A facial exercises program of 30 min was given twice a week for 12 weeks. This program consisted of rhythmic facial movement, muscle stretching, facial yoga, and Tanden breathing. The GHQ-12 for mental health were administered to both groups before and after the 12-week study period. In addition, facial expression and EEG were measured. Fifty-three participants completed the protocol. In the intervention group, the GHQ-12, facial expression, and α wave in frontal lobe improved post-intervention. These results suggest that facial exercises are effective in improving the mental health, facial expression, α wave in frontal lobe of elderly people, and that exercises may be useful as a therapeutic modality in this population.

Psychopathy is a neurodevelopmental disorder that has a highly deleterious effect upon both individuals and society at large. Psychopaths grossly neglect and disrespect the interests of others. Their antisocial behavior is thought to originate from a lack of empathy. However, empathy is multidimensional in nature, as evidenced by the considerable heterogeneity in extant theorizing on the subject. Here, we present the "Zipper model of empathy" that reconsiders how both its affective and cognitive components converge in mature empathic behavior. Furthermore, the Zipper model of empathy is expedient for explaining the empathy deficits in psychopathy, insofar as it brings together current theories on the dysfunctional affective components of empathy, violence inhibition, and automatic versus goal-directed attention. According to the literature, the neurobiological underpinnings of these theories are amygdala-centered; however, this article traces this specifically to the basolateral and central amygdala subregions. When viewed together, the cognitive and affective components of empathy are zipped together in a natural fashion in healthy empathic behavior, whereas psychopaths leave the zipper substantially unzipped in pursuit of their purely self-centered goals.

Background Individuals with depression often demonstrate an altered peripheral inflammatory profile, as well as emotion perception difficulties. However, correlations of inflammation with overall depression severity are inconsistent and inflammation may only contribute to specific symptoms. Moreover, measurement of the association between inflammation and emotion perception is sparse in adolescence, despite representing a formative window of emotional development and high-risk period for depression onset. Methods Serum interleukin (IL)-6, tumor necrosis factor (TNF)-α, and IL-1β were measured in 34 adolescents aged 12-17 with DSM-IV depressive disorders (DEP) and 29 healthy controls (HC). Participants were evaluated using the Children's Depression Rating Scale-Revised (CDRS-R) and symptom subscales were extracted based on factor analysis. Participants also completed a performance-based measure of emotion perception, the Facial Emotion Perception Test (FEPT), which assesses the accuracy of categorizing angry, fearful, sad, happy, and neutral facial emotions. Results IL-6 and TNF-α correlated with reported depressed mood and somatic symptoms, respectively, but not total CDRS-R score, anhedonia or observed mood, across both DEP and HC. DEP demonstrated lower accuracy for identifying angry facial expressions. Higher IL-6 was inversely related to accuracy and discrimination of angry and neutral faces across all participants. IL-1β was associated with reduced discrimination of fearful faces. Conclusions Inflammatory markers were sensitive to affective and somatic symptoms of depression and processing of emotional threat in adolescents. In particular, IL-6 was elevated in depressed adolescents and therefore may represent a specific target for modulating depressive symptoms and emotion processing

Background The ability of facial emotion recognition is often impaired in Major depressive disorder (MDD). The impairment of recognizing facial emotions may contribute to the disruption of interpersonal interaction. Perceived social isolation and social rejection are risk factors for suicide. This study aimed to investigate the ability of facial emotion recognition in drug-naive MDD patients with first-episode with suicidal ideation. Methods 98 drug-naive outpatients with the first episode of depression were recruited, including 53 patients with suicidal ideation (SI) and 45 patients without suicidal ideation (NSI). The Beck Scale for Suicide Ideation—Chinese Version was adopted to evaluate the suicidal ideation and suicidal risk in the latest week. Depressive symptoms were assessed with the Hamilton Depression Rating Scale-17 (HDRS-17). Facial Emotion Recognition Test and the repeatable battery for the assessment of neuropsychological status (RBANS) were administered to assess the ability of emotion recognition and cognitive function. Results Our finding indicated that recognizing fear emotions was more accurate in the SI than the NSI group (OR = 1.142; 95% CI = 1.020, 1.280; p = 0.022). Patients with high suicidal risk may have more difficulties recognizing the neutral facial expressions (B=-0.310, 95% CI = -5.031, -0.845, p = 0.007). Limitations Limitations include a small sample size and use of cross-sectional data. Conclusions Our finding suggests that the variation of facial emotion recognition in drug-naive MDD patients with first-episode with suicidal ideation and targeting this signal may help identify suicidal ideation to decrease the risk of suicide behavior in MDD.

Clinicians need accurate, reproducible, fast, and cost-effective grading systems to determine facial functions. There is currently no internationally accepted objective method to report the loss of function at the onset of facial paralysis and subsequent recovery. Our study aimed to test a three-dimensional handheld light scanner's efficacy for grading facial paralysis and monitoring recovery.Sixty-one healthy volunteers (28 men and 33 women) aged between 20 and 75 years (mean 36.4 ± 11.9 years old) and 22 patients with facial palsy (10 male and 12 female patients) aged between 12 and 77 years (mean 47.6 ± 19.7 years old) were included in the study. The healthy individuals' and patients' facial scans were performed with a three-dimensional handheld scanner during different facial expressions at 3-month intervals. The asymmetry and intensity degree of each facial expression were determined in terms of the root mean square.After facial paralysis, a significant larger asymmetry value (1.2 ± 0.4 mm vs. 2.0 ± 0.8 mm and p0.05) was determined as compared to the control group, while a significant smaller intensity value (2.3 ± 1.2 mm vs. 1.7 ± 0.9 mm and p0.05) was observed. At the end of 3 months, both parameters showed a tendency to recover.Our findings suggest that three-dimensional morphological analyses may be an effective method to grade facial palsy. However, our data need to be confirmed by larger cohort size and more extended follow-up periods.

A clear understanding of the anatomy of the facial nerve, or seventh cranial nerve, is vital during head and neck surgery and for prevention and treatment of facial paralysis. There are four main components of the facial nerve, (branchial motor, special sensory, general sensory, and visceral parasympathetic) that control muscles of facial expression, taste, auricular sensation, and glandular secretion, respectively. It is important for surgeons to appreciate the complex course of the facial nerve as it travels intracranially, intratemporally and extratemporally to prevent injury to these components and identify targets for treatment. This chapter provides an overview of the anatomical course of the facial nerve, describing the anatomy and physiology as they correlate to facial nerve deficits and treatment.

Research suggests a relationship between anorexia nervosa and autism spectrum disorder. The aim of the current study was to examine social attention in anorexia nervosa and autism spectrum disorder compared with age- and sex-matched typically developing groups, and to examine whether lowered social motivation could explain reductions in social attention across the two disorders. Participants’ eye movements were tracked while watching a dynamic social scene. The proportion of fixation duration to faces, bodies and non-social areas of interest were compared across groups. Participants with autism spectrum disorder looked at faces significantly less often than controls, however, there were no differences between anorexia nervosa and controls in attention to faces. Typically developing -normed z-scores indicated that attention to faces showed the greatest deviation from normative data compared with body or non-social areas of interest in both autism spectrum disorder and anorexia nervosa, however, differences were larger in autism spectrum disorder than in anorexia nervosa. Social motivation scores did not predict attention to faces in either autism spectrum disorder or anorexia nervosa. Our results do not support the hypothesis that differences in social motivation underlie reduced social attention in both anorexia nervosa and autism spectrum disorder. Lay abstract Research suggests a relationship between autism and anorexia nervosa. For example, rigid and inflexible behaviour, a preference for routine and social difficulties are seen in both conditions. In this study, we examined whether people with anorexia and people with autism show similarities in social attention (where they look while engaging in social interactions or watching a scene with people interacting). This could help us understand why people with anorexia and autism experience difficulties in social situations. Participants with either anorexia or autism, as well as participants with no mental health problems watched a video of a social scene while we recorded which parts of the scene they looked at with an eye-tracker. Participants also completed questionnaires to assess characteristics of autism. We found that autistic participants looked at faces less than typically developing participants. However, participants with anorexia did not show a similar reduction in attention to faces, contrary to our predictions. Autistic features were not related to attention in either group. The results suggest that autistic people may miss important social cues (like facial expressions), potentially contributing to social difficulties. However, this mechanism does not appear explain social difficulties in people with anorexia.

Recent developments suggest that autistic individuals require dynamic angry expressions to have a higher speed in order for them to be successfully identified. Therefore, it is plausible that autistic individuals do not have a 'deficit' in angry expression recognition, but rather their internal representation of these expressions is characterised by very high-speed movement. In this study, matched groups of autistic and non-autistic adults completed a novel emotion-based task which employed dynamic displays of happy, angry and sad point light facial (PLF) expressions. On each trial, participants moved a slider to manipulate the speed of a PLF stimulus until it moved at a speed that, in their 'mind's eye', was typical of happy, angry or sad expressions. Participants were shown three different types of PLFs-those showing the full-face, only the eye region, and only the mouth region, wherein the latter two were included to test whether differences in facial information sampling underpinned any dissimilarities in speed attributions. Across both groups, participants attributed the highest speeds to angry, then happy, then sad, facial motion. Participants increased the speed of angry and happy expressions by 41% and 27% respectively and decreased the speed of sad expressions by 18%. This suggests that participants have 'caricatured' internal representations of emotion, wherein emotion-related kinematic cues are over-emphasised. There were no differences between autistic and non-autistic individuals in the speeds attributed to full-face and partial-face angry, happy and sad expressions respectively. Consequently, we find no evidence that autistic adults possess atypically fast internal representations of anger.

In interactions with caregivers, patients with dementia have communication challenges that are common and worrisome to families. Family and professional caregivers find it challenging to "guess" or "interpret" what their patients with dementia are trying to tell them. In this creative controversy article, we discuss how family and professional caregivers can seek to understand and correctly interpret the nonverbal communications of patients with dementia (behaviors, actions, facial expressions, and vocal sounds). Equipping family and professional caregivers with the resources to interpret the nonverbal communications of patients with dementia requires a commitment to in-service and family education in healthcare facilities. Nurses could play a critical role in raising the awareness among the public about the potential changes and declines in verbal communications of the patients with dementia.

Made available in DSpace on 2022-04-29T08:36:53Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objectives The aim of this study was to verify during facial expressions (happy, sad, fearful, angry, surprised, and disgusted) if: (1) there would be difference in the electromyography (EMG) of the occipitofrontalis, temporal, masseter, and sternocleidomastoid muscles on the normal side (NS) compared with the affected side (AS) (without the use of an ocular prosthesis) in individuals with unilateral absence of the eyeball, and (2) the rehabilitation with a new ocular prosthesis would affect the EMG of the muscles studied on the AS in these individuals. Materials and Methods Thirteen individuals, without temporomandibular disorder, with good health, with unilateral absence of the eyeball (the eye must have been removed by evisceration or enucleation), and users or nonusers of an ocular prosthesis were included. EMG of the occipitofrontalis, temporal, masseter, and sternocleidomastoid muscles was performed during rest and facial expressions (happy, sad, fearful, angry, surprised, and disgusted) before (T0) and 90 days after (T1) rehabilitation with a new ocular prosthesis. The analyses were performed in T0 on NS and AS (without the use of an ocular prosthesis), and in T1 on AS with the new ocular prosthesis. Statistical Analysis All data were submitted to the Student's t -test with p < 0.05. Results There was no statistically significant difference comparing the AS with the NS in T0 for all muscles studied, during all facial expressions evaluated (p > 0.05). There was no statistically significant difference comparing the AS in T0 with itself in T1 for all muscles studied, during all facial expressions evaluated (p > 0.05). Conclusion Eye loss did not affect the EMG of studied muscles when comparing NS with AS (without the use of an ocular prosthesis). The rehabilitation with ocular prosthesis was not capable of changing the EMG on AS. Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University, José Bonifácio Street, 1193, Araçatuba Oral Oncology Center School of Dentistry São Paulo State University, Araçatuba Department of Pediatric and Social Dentistry School of Dentistry São Paulo State University, Araçatuba Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University, José Bonifácio Street, 1193, Araçatuba Oral Oncology Center School of Dentistry São Paulo State University, Araçatuba Department of Pediatric and Social Dentistry School of Dentistry São Paulo State University, Araçatuba

Objetivo: Identificar, através de um levantamento bibliográfico, os efeitos da radiofrequência no rejuvenescimento facial. Métodos: Estudo de revisão integrativa, realizado no período de setembro a outubro de 2020. Pesquisados nos bancos de dados: LILACS, SciELO, Periódicos CAPES e PubMed. Os descritores utilizados e relacionados, com o operador booleno "and'; em português e inglês foram: radiofrequência, expressão da face, pele Rejuvenescimento; Fisioterapia e Radio frequency; Face expression; Skin; Rejuvenation; Physiotherapy. Foram realizadas buscas publicações dos últimos 10 anos. Resultados: Após a leitura minuciosa dos artigos elegíveis, foram selecionados três artigos. Os autores relatam que os efeitos da radiofrequência são significativos na redução da extensão e profundidade das rugas e na melhora da aparência da flacidez pele, além de melhora perceptível da expressão da face. Conclusões: Os efeitos da radiofrequência delinearam-se de maneira bastante evidente, principalmente no que diz respeito a melhora do tônus da pele e da diminuição das rugas.

Odor context can affect the recognition of facial expressions. However, there is no evidence to date that odor can regulate the processing of emotional words conveyed by visual words. An emotional word recognition task was combined with event-related potential technology. Briefly, 49 adults were randomly divided into three odor contexts (pleasant odor, unpleasant odor, and no odor) to judge the valence of emotional words (positive, negative, and neutral). Both behavioral and Electroencephalography (EEG) data were collected. Both the pleasant odor and unpleasant odor contexts shortened the response time of the subjects to emotional words. In addition, negative words induced greater amplitudes of early posterior negativity (EPN) and late positive potential (LPP) than the positive and neutral words. However, the neutral words induced a larger N400 amplitude than the positive and negative words. More importantly, the processing of emotional words was found to be modulated by external odor contexts. For example, during the earlier (P2) processing stages, pleasant and unpleasant odor contexts induced greater P2 amplitudes than the no odor context. In the unpleasant odor context, negative words with the same odor valence induced greater P2 amplitudes than the positive words. During the later (N400) stages, various regions of the brain regions exhibited different results. For example, in the left and right frontal areas of the brain, exposure to positive words in a pleasant odor context resulted in a smaller N400 amplitude than exposure to neutral words in the same context. Meanwhile, in the left and right central regions, emotional words with the same valence as pleasant or unpleasant odor contexts elicited the minimum N400 amplitude. Individuals are very sensitive to emotional information. With deeper processing, different cognitive processes are reflected and they can be modulated by external odors. In the early and late stages of word processing, both pleasant and unpleasant odor contexts exhibited an undifferentiated dominance effect and could specifically modulate affectively congruent words.

The role of age in perception and production of facial expressions is still unclear. Therefore, this work compared, in aged and young subjects, the effects of passive viewing of faces expressing different emotions on perceptive brain regions, such as occipital and temporal cortical areas and on the primary motor cortex (M1) innervating lower face muscles. Seventeen young (24.41 ± 0.71 yr) and seventeen aged (63.82 ± 0.99 yr) subjects underwent recording of event-related potentials (ERP), of motor potentials evoked by transcranial magnetic stimulation of face M1 in the depressor anguli oris muscle and reaction time assessment. In both groups, the P100 and N170 waves, as well as short-latency intracortical inhibition (SICI) and intracortical facilitation (ICF) were probed in face M1 after 300 ms from the presentation of images reporting faces expressing happy, sad, and neutral emotions. ERP data evidenced a major involvement of the right hemisphere in perceptual processing of faces, regardless of age. Compared with young subjects, the aged group showed a delayed N170 wave and a smaller P100 wave following the view of sad but not happy or neutral expressions, along with less accuracy and longer reaction times for recognition of the emotion expressed by faces. Aged subjects presented less SICI than young subjects, but facial expressions of happiness increased the excitability of face M1 with no differences between groups. In conclusion, data suggest that encoding of sad face expressions is impaired in the aged compared with the young group, whereas perception of happiness and its excitatory effects on face M1 remains preserved.NEW & NOTEWORTHY This study shows that aged subjects have less visual attention and impaired perception for sad, but not for happy, face expressions. Conversely, the view of happy, but not sad, faces increases excitability in face M1 bilaterally, regardless of age. The impaired attention for sad expressions, the preserved perception of faces expressing happiness, along with the enhancing effects of the latter on face M1 excitability, likely makes the aged subjects more motivated in approaching positive emotions.

Facial expressions are important social communicators. In addition to communicating social information, the specific muscular movements of expressions may serve additional functional roles. For example, recalibration theory hypothesizes that the anger expression exaggerates facial cues of strength, an indicator of human fighting ability, to increase bargaining power in conflicts. Supporting this theory is evidence that faces displaying one element of an angry expression (e.g. lowered eyebrows) are perceived to be stronger than faces with opposite expression features (e.g. raised eyebrows for fear). The present study sought stronger evidence that more natural manipulations of facial anger also enhance perceived strength. We used expression aftereffects to bias perception of a neutral face towards anger and observed the effects on perceptions of strength. In addition, we tested the specificity of the strength-cue enhancing effect by examining whether two other expressions, fear and happy, also affected perceptions of strength. We found that, as predicted, a face biased to be perceived as angrier was rated as stronger compared to a baseline rating, whereas a face biased to be more fearful was rated as weaker, consistent with the purported function of fear as an act of submission. Interestingly, faces biased towards a happy expression were also perceived as stronger, though the effect was smaller than that for anger. Overall, the results supported the recalibration theory hypothesis that the anger expression enhances cues of strength to increase bargaining power in conflicts, but with some limitations regarding the specificity of the function to anger.

Psychopathy and externalizing are distinct forms of disinhibitory psychopathology whose destructive social behaviors are thought to be underpinned by different aberrations in social cognition. Facial emotion processing is a foundational component of social cognition, yet previous studies on facial emotion processing in psychopathy and externalizing have focused on traditional behavioral measures (e.g., response accuracy), which have limited reliability and precision. Diffusion modeling is a valuable tool for elucidating more reliable and precise sources of performance differences because it estimates parameters that reflect latent cognitive processes, including bias, drift rate (efficiency of evidence accumulation), threshold separation (extent of evidence accumulation), and nondecision time (time spent on non-decision-related processes such as stimulus encoding and motor response execution). In a sample of 92 incarcerated males, we applied diffusion modeling to an emotion identification task in which ambiguous blends of anger, happiness, and fear were identified while contextual threat (i.e., apparent movement of faces) was manipulated. Results indicated that psychopathy was associated with longer nondecision time (i.e., slower processing) across all the emotion blends in the task and particularly for mostly angry faces under greater ambiguity. In direct contrast, externalizing was associated with shorter nondecision time (i.e., faster processing) as well as greater threshold separation (i.e., more extensive evidence accumulation) for mostly angry faces under greater ambiguity, but this pattern of preferential processing of anger was only evident in the absence of contextual threat. These findings link psychopathy and externalizing to different profiles of cognitive processes influencing facial emotion processing. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Previous research has shown an unintuitive effect of facial expression on perceived age: smiling faces are perceived as older compared to neutral faces of the same people. The aging effect of smiling (AES), which is thought to result from the presence of smile-related wrinkles around the eyes, contradicts the common belief that smiling faces should be perceived as younger, not older. Previous research, however, has focused on faces of young adults, where the absence of inherent, age-related wrinkles and other age signs is offset by the weight of the smile-related wrinkles. In a series of experiments, we tested whether the AES extends to male and female faces in older age groups. We replicated the AES in young adults (20–39) and showed that it disappeared in older adults (60–79) of both genders. For photos of middle-aged adults (40–59), however, AES was found only for male, but not for female faces, who showed fewer and less prominent smile-related wrinkles. The results suggest that a person’s apparent age is perceived in a holistic manner in which age-related cues in the region of the eyes are weighted against age cues in other regions of the face.

OBJECTIVE Tuberous sclerosis complex (TSC) is highly associated with autism spectrum disorder (ASD). Objectives of the study were to characterize autistic features in young children with TSC. METHODS Participants included 138 children followed from ages 3 to 36 months with TSC from the Tuberous Sclerosis Complex Autism Center of Excellence Research Network (TACERN), a multicenter, prospective observational study aimed at understanding the underlying mechanisms of ASD in TSC. Developmental and autism-specific assessments were administered, and a clinical diagnosis of ASD was determined for all participants at 36 months. Further analyses were performed on 117 participants with valid autism assessments based on nonverbal mental age greater than 15 months. RESULTS Prevalence of clinical diagnosis of ASD at 36 months was 25%. Nearly all autistic behaviors on the Autism Diagnostic Observation Schedule-2 (ADOS-2) and Autism Diagnostic Interview-Revised (ADI-R) were more prevalent in children diagnosed with ASD; however, autism-specific behaviors were also observed in children without ASD. Overall quality of social overtures, facial expressions, and abnormal repetitive interests and behaviors were characteristics most likely to distinguish children with ASD from those without an ASD diagnosis. Participants meeting ADOS-2 criteria but not a clinical ASD diagnosis exhibited intermediate developmental and ADOS-2 scores compared to individuals with and without ASD. INTERPRETATION ASD is highly prevalent in TSC, and many additional individuals with TSC exhibit a broad range of subthreshold autistic behaviors. Our findings reveal a broader autism phenotype that can be identified in young children with TSC, which provides opportunity for early targeted treatments. ANN NEUROL 2021;90:874-886.

Background Symptoms of social anxiety rise rapidly during adolescence, particularly for girls. Pervasive displays of parental negative affect may increase adolescents' fear of negative evaluation (FNE), thereby increasing risk for social anxiety symptoms. Adolescent displays of negative affect may also exacerbate parents' social anxiety symptoms (via FNE of their child or their parenting skills), yet little research has tested transactional pathways of transmission in families. By early adolescence, rates of parent-child conflict rise, and offspring become increasingly independent in their own displays of negative affect, increasing opportunities for hypothesized transactional pathways between parent-adolescent displays of negative affect and social anxiety symptoms. Methods This study included 129 parents and daughters (11-13; no baseline social anxiety disorder), two-thirds of whom were at high risk for social anxiety due to a shy/fearful temperament. We used actor-partner interdependence models (APIM) to test whether displays of negative facial affect, assessed individually for each parent and daughter during a conflict discussion, would predict their partner's social anxiety symptoms two years later. Automated facial affect coding assessed the frequency of negative affect during the discussion. Clinician ratings of social anxiety symptoms were completed at baseline and two-year follow-up. Results Both parents and daughters who displayed more frequent negative facial affect at baseline had partners with higher follow-up social anxiety symptoms, an effect that was maintained after accounting for actors' and partners' baseline symptoms. Conclusions Findings are consistent with intergenerational models positing that parental negative affective behaviors increase risk for adolescent social anxiety symptoms but also suggest that adolescent negative facial affect may exacerbate parental social anxiety symptoms. These bidirectional effects improve understanding of how social anxiety is maintained within a transactional family structure and highlight that displays of negative affect during parent-adolescent interaction may warrant future examination as a potential treatment target for adolescent social anxiety.

Background Specific phobias have the highest prevalence among anxiety disorders. Cognitive control involving the dorsolateral prefrontal cortex (DLPFC) is crucial for coping abilities in anxiety disorders. However, there is little research on the DLPFC in specific phobia. Methods Using transcranial magnetic stimulation (TMS), we investigated the TMS-evoked potential component N100 in the DLPFC at rest and while watching emotional expressions. The TMS-evoked N100 provides a parameter for gamma-aminobutyric acid (GABA)-B-mediated cortical inhibition. Twenty-two drug-free subjects with specific phobia (21 females and 1 male) were compared with 26 control subjects (23 females and 3 males) regarding N100 in the DLPFC at rest and during an emotional 1-back task with fearful, angry, and neutral facial expressions. Results At rest, we found reduced N100 amplitudes in the specific phobia compared with the control group. Furthermore, the specific phobia group showed a further reduction in N100 amplitude when memorizing fearful compared with neutral facial expressions. Conclusion There appears to be a decrease in GABA-B-mediated inhibition in the DLPFC in subjects with a specific phobia at rest. This decrease was more pronounced under emotional activation by exposure to fearful facial expressions, pointing towards additional state effects of emotional processing on inhibitory function in the DLPFC.

Background Facial expression muscles atrophy is one kind of sequelae after peripheral facial paralysis. It causes critical problems in facial appearance of patient as well as social and psychological problems. This study aims to evaluate the efficacy and safety of Thread-embedding acupuncture (TEA) for the management of facial expression muscles atrophy after peripheral facial paralysis. Methods This is a patient-assessor blinded, randomized, sham-controlled trial. A total of fifty-six eligible patients will be randomly divided into TEA (n=28) and sham TEA (STEA) (n=28) groups. Both groups will receive TEA or STEA treatment at the frontal muscle and the depressor anguli oris muscle, at one predefined points once a week for eight weeks. Additionally, both groups will receive traditional acupuncture treatment at ten acupoints (GB20, LI4, LR3, GB12, ST7, SI18, LI20, BL2, SJ23, ST4) twice a week for eight weeks as a concurrent treatment. B-mode ultrasonography will be used to assess the changes in facial expression muscle thickness ratio of the affected/healthy side at baseline and at 10 weeks after screening, as the primary outcome. House-Brackmann Grade and lip mobility score will be measured and analyzed at baseline and 4, 8, 10, and 12 weeks after screening, as secondary outcomes. Discussion The study will compare TEA with sham TEA to explore the feasibility for TEA in improving facial expression muscles atrophy after peripheral facial paralysis. Trial registration Chinese Clinical Trial Registry, ChiCTR1900027170. Registered on 3 November 2019, http://www.chictr.org.cn/edit.aspx?pid=45173&htm=4

The use of face masks has become ubiquitous. Although mask wearing is a convenient way to reduce the spread of disease, it is important to know how the mask affects our communication via facial expression. For example, when we are wearing the mask and meet a friend, are our facial expressions different compared to when we are not? We investigated the effect of face mask wearing on facial expression, including the area around the eyes. We measured surface electromyography from zygomaticus major, orbicularis oculi, and depressor anguli oris muscles, when people smiled and talked with or without a mask. Only the actions of the orbicularis oculi were facilitated by wearing the mask. We thus concluded that mask wearing may increase the recruitment of the eyes during smiling. In other words, we can express joy and happiness even when wearing a face mask.

Detecting emotional facial expressions is an initial and indispensable component of face-to-face communication. Neuropsychological studies on the neural substrates of this process have shown that bilateral amygdala lesions impaired the detection of emotional facial expressions. However, the findings were inconsistent, possibly due to the limited number of patients examined. Furthermore, whether this processing is based on emotional or visual factors of facial expressions remains unknown. To investigate this issue, we tested a group of patients (n = 23) with unilateral resection of medial temporal lobe structures, including the amygdala, and compared their performance under resected- and intact-hemisphere stimulation conditions. The participants were asked to detect normal facial expressions of anger and happiness, and artificially created anti-expressions, among a crowd with neutral expressions. Reaction times for the detection of normal expressions versus anti-expressions were shorter when the target faces were presented to the visual field contralateral to the intact hemisphere (i.e., stimulation of the intact hemisphere; e.g., right visual field for patients with right hemispheric resection) compared with the visual field contralateral to the resected hemisphere (i.e., stimulation of the resected hemisphere). Our findings imply that the medial temporal lobe structures, including the amygdala, play an essential role in the detection of emotional facial expressions, according to the emotional significance of the expressions.