Behavioural and Neurophysiological Effects of a Stroke Rehabilitation Program on Emotional Processing in Tuberothalamic Infarct—Case Study

Abstract

The aim of the study was to assess the neurophysiological and behavioural effects of a stroke rehabilitation involving Treatment As Usual (TAU) combined with Social Cognitive Training (SCT) in a right-handed patient suffered from tuberothalamic infarct compared to healthy controls (HCs) (n = 13). Methods: Both HCs and the patient were assessed by means of the following measures: Penn Emotion Perception Battery (ER40, EmoDiff40, PEAT40, PFMT), Reading the Mind in the Eyes Test, and Toronto Alexithymia Scale alongside clinical scales (Mini Mental State Examination, The State-Trait Anxiety Inventory, and Hamilton Depression Scale). The SCT was delivered individually for 60 minutes weekly in a 12-week program (12 sessions). The subject participated twice in a fMRI scanning session including the event-related task of implicit processing of 100% fearful expressions to detect physiological changes after TAU plus SCT and compared them with HCS who underwent the same assessment once. Results: Compared with HCs, the patient before therapy revealed lower scores in emotion recognition; particularly perception of anger was affected alongside worse performance on both emotion discrimination and acuity tests. After therapy, B.D. showed improvement in emotional processing. B.D. had less post-therapy activation maps compared with pretherapy ones and more significantly activated pre-and post-central gyrus and right cerebellum in response to fearful faces. Interestingly, no amygdala was significantly activated as the response to fearful stimuli before or after therapy was completed. Conclusions: Further research was needed to increase understanding about efficacy of SCT and the theory of neuroplasticity, thus helping rehabilitation programs.