Elisabetta Sarasso (Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy)
Martina Putzolu (Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy)
Elisa Canu (Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy)
Andrea Gardoni (Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy)
Elisa Ravizzotti (Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy)
Lucia Zenere (Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy)
Susanna Mezzarobba (Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy)
Silvia Basaia (Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy)
Federica Agosta (Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy) – Laura Avanzino (IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy)
Massimo Filippi (Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy) – Elisa Pelosin (Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy)
Evidence suggests that action observation training can enhance spatio-temporal gait parameters in Parkinson’s disease (PD). Given the complex interplay between emotion and gait, gait videos with emotional contents might be useful in studying the interaction between gait and emotion in PD. The overall aim of the study was to investigate whether the observation of emotional gait conditions can modulate spatio-temporal gait parameters and gait-related functional brain correlates in healthy subjects and PD patients by evoking those emotions. To reach this overall objective, we first aimed at developing and testing gait videos evoking specific emotions in a large population of healthy subjects and then in a preliminary sample of PD.
We developed a questionnaire containing videos of an actress walking with different gait patterns according to specific emotions (happiness, sadness, fear, anxiety, anger, disgust, surprise and neutral). The actress was instructed to walk while embodying these emotions, and her facial expressions were intentionally blurred to promote emotion recognition through body movements. Participants were asked to select the emotion they believe the actress is experiencing from a list of emotions and to rate the valence and the intensity of the emotion perceived. To identify the most effective video for each emotion the percentage of correct answers and the mean value of valence and intensity were calculated. This step allows for the selection of videos based on data from a healthy population. The selected videos have been subsequently tested in a small sample of PD that were also asked to mimic the observed emotional gait. Gait parameters changes were assessed using wearable motion sensors.
110 healthy subjects answered the questionnaire. Sadness, anger, neutral and happiness emotions were the most frequently recognized, with between 90 and 100% of subjects providing the correct answer. Participants attributed negative valence to sadness and anger, while positive valence to happiness. Fear and anxiety tend to be confused by healthy subjects, thus we decided to consider them as a unique feeling and to select a single video representing fear/anxiety. Regarding intensity, all emotions, except for the neutral video, were rated around 7 or 8 on a scale ranging from 0 to 10. The selected emotional gait videos (neutral, happiness, sadness and fear/anxiety) were administered to 10 PD patients that demonstrated 100% emotion recognition. During emotional gait imitation, PD subjects importantly modified spatio-temporal gait parameters, with positive emotions increasing step, arm and trunk movement amplitude and negative emotions altering gait speed, clearance and trunk kinematics.
Effective videos for sadness, anger, fear/anxiety, neutral and happiness were identified. Probably surprise and disgust cannot be unequivocally detected from body movements as they are emotions transmitted though facial expression. Therefore, we excluded these emotions from our experiment. The selected emotional gait videos were easily recognized by a sample of 10 PD patients. Preliminary findings from wearable sensors suggested the possibility to modulate spatio-temporal gait parameters of PD patients through imitation of emotional gait patterns. To conclude, we developed effective emotional gait videos in healthy subjects and PD, which will help studying the interaction between gait and emotion in PD.
