Facial Affect Recognition in CADASIL Patients

We explored the capacity of Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) patients to recognize facial expressions. Twenty-three consecutive CADASIL patients and 23 age-matched, gender-matched, and education-matched controls were assessed with a semi-structured psychiatric interview, cognitive tests, and the Ekman and Friesen test. Cases and controls (5 males, 18 females) had a mean age (+SD) of 52.4 + 15.7 and 54.0 + 15.3 years, respectively, and a Mini-Mental State Examination (MMSE) mean score of 27.8 + 2.2 and 28.9 + 1.3 (p < .05). Eighteen out of the 23 (78.3%) CADASIL patients and 10 (43.5%) controls were diagnosed as affected by major depression according to DSM-IV criteria (p < .05). The CADASIL patients had an impaired ability of emotion recognition in comparison with controls, particularly for fear expression. This effect was not mediated by depression, cognitive impairment, and MMSE score. Facial affect recognition is reduced in the CADASIL patients and this impairment might represent an early manifestation of the disease.