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Faces of emotion in Parkinsons disease: Micro-expressivity and bradykinesia during voluntary facial expressions

  • DAWN BOWERS (a1) (a2), KIMBERLY MILLER (a1) (a2), WENDELYN BOSCH (a2), DIDEM GOKCAY (a2), OTTO PEDRAZA (a1) (a2), UTAKA SPRINGER (a1) (a2) and MICHAEL OKUN (a2) (a3)...


In humans, the neural circuitry underlying facial expressions differs, depending on whether facial expressions are spontaneously (i.e., limbic, subcortical) or voluntarily initiated (i.e., frontal cortex). Previous investigators have suggested that the “masked face” of Parkinson's disease involves spontaneous, but not intentional, facial expressions. In contrast, we hypothesized that intentional facial expressions may be slowed (bradykinetic) and involve less movement, in much the same way that other intentional movements are affected by Parkinson's disease. To test this hypothesis, we used sophisticated computer imaging techniques to quantify dynamic facial movement. Relative to controls, Parkinson patients had reduced facial movement (entropy) and were significantly slowed in reaching a peak expression (i.e., bradykinesia). These findings are consistent with the view that the basal ganglia play a role in affecting intentional facial movements. This possibly occurs because of diminished efficiency and/or activation of face representation areas in the frontal cortical regions (i.e., motor, premotor, and supplementary motor area) or because of movement-based suppression secondary to dopaminergic reduction in frontostriatal pathways. Taken together, the characterization of Parkinson's disease as a model system for the neuroanatomic dissociation between voluntary and spontaneous expressions may be unjustified. (JINS, 2006, 12, 765–773.)


Corresponding author

Correspondence and reprint requests to: Dr. Dawn Bowers, Department of Clinical & Health Psychology, P.O. Box 100165, University of Florida, Gainesville, FL 32601, USA. E-mail:


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Alexander, G.E., DeLong, M.R., & Strick, P.L. (1986). Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annual Review of Neuroscience, 9, 357381.
Berardelli, A., Rothwell, J.C., Thompson, P.D., & Hallett, M. (2001). Pathophysiology of bradykinesia in Parkinson's disease. Brain, 124, 21312146.
Borod, J., Welkowitz, J., Alpert, M., Brozgold, A., Martin, C., Peselow, E., & Diller, L. (1990). Parameters of emotional processing in neuropsychiatric disorders: Conceptual issues and a battery of tests. Journal of Communicative Disorders, 23, 247271.
Buck, R. & Duffy, R. (1980). Nonverbal communication of affect in brain-damaged patients. Cortex, 16, 351362.
Darwin, C. (1872, 1879, 1996). The expression of emotion in animals and man (3rd ed.). New York: Oxford University Press.
Desai, A., Gokcay, D., Richardson, C., Hamby, M., & Bowers, D. (2001, February). Digitizing the moving face during emotional displays: Movement asymmetries and gender. Chicago: International Neuropsychology Society.
Dick, J., Rothwell, J., Day, B., Cantello, R., Buruma, O., Gioux, M., Benecke, R., Berardelli, A., Thompson, P., & Marsden, C. (1989). The Bereitschaftspotential is abnormal in Parkinson's disease. Brain, 112, 233244.
Ekman, P. & Friesen, W. (1971). Constants across culture in the face and emotion. Journal of Personality and Social Psychology, 17, 124129.
Fahn, S., Marsden, C., Calne, D., & Goldstein, M. (1987). Recent developments in Parkinson's disease, Vol. 2 (pp. 153–163, 293–304). Florham Park, NJ: Macmillan Health Care Information.
Fahn, S. (2003). Description of Parkinson's disease as a clinical syndrome. Annals of the New York Academy of Sciences, 991, 114.
Folstein, M., Folstein, S., & McHugh, P. (1975). Mini-Mental State: A practical method for grading the state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.
Fridlund, J. (1994). Human facial expression: An evolutionary view. San Diego: Academic Press.
Gosain, A., Birn, R., & Hyde, J. (2001). Localization of the cortical response to smiling using new imaging paradigms with functional magnetic resonance imaging. Plastic and Reconstructive Surgery, 108, 11361144.
Hiatt, J. & Gartner, L. (1987). Textbook of head and neck anatomy (2nd ed.). Baltimore: Williams & Wilkins.
Hoehn, M. & Yahr, M. (1967). Parkinsonism: Onset, progression, and mortality. Neurology, 17, 427442.
Horstmann, G. (2003). What do facial expressions convey: Feeling states, behavioral intentions, or action requests? Emotion, 3, 150166.
Jacobs, D., Shuren, J., Bowers, D., & Heilman, K. (1995). Emotional facial imagery, perception, and expression in Parkinson's disease. Neurology, 45, 16961702
Jenkins, I., Jahanshahi, M., Jueptner, M., Passingham, R., & Brooks, D. (2000). Self-initiated versus externally triggered movements. II. The effect of movement predictability on regional cerebral blood flow. Brain, 123, 12161228.
Katsikitis, M. & Pilowsky, I. (1988). A study of facial expression in Parkinson's disease using a novel microcomputer-based method. Journal of Neurology, Neurosurgery, and Psychiatry, 51, 362366
Leonard, C., Voeller, K.K.S., & Kuldau, J.M. (1991). When's a smile a smile? Or how to detect a message by digitizing the signal. Psychological Science, 2, 166172.
Liscic, R.M. & Zidar, J. (1998). Functional organization of the facial motor system in man. Collegium Antropologicum, 22, 545550.
Monrad-Krohn, G.H. (1924). On the dissociation of voluntary and emotional innervation in facial paresis of central origins. Brain, 47, 2235.
Morecraft, R.J., Louie, J.L., Herrick, J.L., & Stilwell-Morecraft, K.S. (2001). Cortical innervation of the facial nucleus in the non-human primate: A new interpretation of the effects of stroke and related subtotal brain trauma on the muscles of facial expression. Brain, 124, 176208.
Morecraft, R.J. & Van Hoesen, G.W. (1998). Convergence of limbic input to the cingulate motor cortex in the rhesus monkey. Brain Research Bulletin, 45, 209232.
Nambu, A. (2005). A new approach to understanding the pathophysiology of Parkinson's disease. Journal of Neurology, 252(Suppl. 4), IV/1IV/4.
Pitcairn, T., Clemie, S., Gray, J., & Pentland, B. (1990). Non-verbal cues in the self-presentation of Parkinsonian patients. British Journal of Clinical Psychology, 29, 177184.
Ras, F., Habets, L., Ginkel, F., & Prahi-Anderson, B. (1995). Method for quantifying facial asymmetries in 3 dimensions using stereophotogrammetry. The Angle Orthodontist, 65, 233239.
Richardson, C., Bowers, D., Bauer, R., Heilman, K.M., & Leonard, C.M. (2000). Digitizing the moving face during dynamic expressions of emotion. Neuropsychologia, 38, 10261037.
Rinn, W. (1984). The neuropsychology of facial expressions: A review of neurological and psychological mechanisms for producing facial expressions. Psychological Bulletin, 95, 5277.
Schwartz, G., Fair, P., Salt, P., Mandel, M., & Klerman, G. (1976). Facial expression and imagery in depression: An electromyographic study. Psychosomatic Medicine, 38, 337347.
Simons, G., Smith Pasqualini, M., Reddy, V., & Wood, J. (2004). Emotional and nonemotional facial expressions in people with Parkinson's disease. Journal of International Neuropsychological Society, 10, 521555.
Sloan, D., Bradley, M., Dimoulas, E., & Lang, P. (2002). Looking at facial expressions: Dysphoria and facial EMG. Biological Psychiatry, 60, 7990.
Smith, M.C., Smith, M.K., & Ellgring, H. (1996). Spontaneous and posed facial expression in Parkinson's disease. Journal of International Neuropsychology Society, 2, 383391.
Triggs, W., Ghacibeh, G., Springer, U., & Bowers, D. (2005). Lateralized asymmetry of facial motor evoked potentials. Neurology, 65, 541544.
Urban, P., Beer, S., & Hopf, H. (1997). Cortioco-bulbar fibers to orofacial muscles: Recordings with enoral surface electrodes. Electroencephalography and Clinical Neurophysiology, 105, 814.
Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M.B., & Leirer, V.O. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 3749.


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Faces of emotion in Parkinsons disease: Micro-expressivity and bradykinesia during voluntary facial expressions

  • DAWN BOWERS (a1) (a2), KIMBERLY MILLER (a1) (a2), WENDELYN BOSCH (a2), DIDEM GOKCAY (a2), OTTO PEDRAZA (a1) (a2), UTAKA SPRINGER (a1) (a2) and MICHAEL OKUN (a2) (a3)...


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