Discrimination of facial identity and of emotions in Alzheimer's disease

Objective: To investigate processing of human faces identity and of emotional expressions in patients with Alzheimer's Disease (AD). Background: Mechanisms responsible fbr discriminating facial identity may be dissociated from those involved in discriminating facial expressions. Patients with prosopagnosia often have preserved capacities for processing emotional facial expressions and occasionally, patients with focal lesions may recognize human faces without being able to recognize their facial expression. Such a dissociation has not been clearly shown in groups of AD patients. Methods: Thirty-one probable AD patients and 14 control subjects were administered tasks of discrimination of faces and of emotions. Results: AD patients were significantly impaired in discriminating facial identities and in naming and pointing to named emotions, but were comparable to controls in discriminating facial expressions of emotion. The deficits of facial discrimination and of identification of emotions were, on the whole, correlated with the MMS and Raven scores. Discrimination of emotions was not correlated to either test, suggesting that this ability is based on cognitive processes different from those underlying the MMS and the PM47. Conclusions: This dissociation implies two separate systems, one dedicated to discrimination of facial identities and the other to discrimination of emotions. This is compatible with the modular organization of cognitive deficits in AD and may explain the well known experience that nonverbal communication often remains effective even in patients with severe dementia. (C) 1998 Elsevier Science Ireland Ltd.