TY - GEN A1 - Nanning, Felix A1 - Braune, Katharina A1 - Uttner, Ingo A1 - Ludolph, Albert Christian A1 - Gorges, Martin A1 - Lulé, Dorothée T1 - Altered Gaze Control During Emotional Face Exploration in Patients With Amyotrophic Lateral Sclerosis T2 - Neurology N2 - Objectives Up to 50% of patients with amyotrophic lateral sclerosis (ALS) present with cognitive problems and behavioral dysfunctions including recognition of human faces presenting different emotions. We investigated whether impaired processing of emotional faces is associated with abnormal scan paths during visual exploration. Methods Cognitively unimpaired patients with ALS (n = 45) and matched healthy controls (n = 37) underwent neuropsychological assessment and video-based eye tracking. Eye movements were recorded while participants visually explored faces expressing different emotions (neutral, disgusted, happy, fearful, and sad) and houses mimicking faces. Results Compared with controls, patients with ALS fixated significantly longer to regions which are not relevant for emotional information when faces expressed fear (p = 0.007) and disgust (p = 0.006), whereas the eyes received less attention in faces expressing disgust (p = 0.041). Fixation duration in any area of interest was not significantly associated with the cognitive state or clinical symptoms of disease severity. Discussion In cognitively unimpaired patients with ALS, altered gaze patterns while visually exploring faces expressing different emotions might derive from impaired top-down attentional control with possible involvement of subliminal frontotemporal areas. This may account for indistinctness in emotion recognition reported in previous studies because nonsalient features retrieve more attention compared with salient areas. Current findings may indicate distinct emotion processing dysfunction of ALS pathology, which may be different from, for example, executive dysfunction. KW - Amyotrophic lateral sclerosis KW - Clinical Neurology KW - Clinical neurology examination KW - Neuro-ophthalmology KW - Neuromuscular Disease KW - Visual processing Y1 - 2023 U6 - https://doi.org/10.1212/WNL.0000000000207214 SN - 0028-3878 VL - 101 IS - 6 SP - 264 EP - 269 ER -