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

Background: 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. Objective: To compare the perception of emotional facial expressions in stroke patients with and without depressive symptoms. Methods: Twenty-two stroke patients participated whose depressive symptoms were classified using the Montgomery-Asberg Depression Rating Scale (cutoff = 10) and who were compared with healthy controls. Emotion recognition was measured using morphed images of facial expressions. Results: 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. Conclusions: 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.