NEW PERSPECTIVES ON TRANSCRANIAL DIRECT CURRENT STIMULATION (TDCS) FOR EMOTIONAL RECOGNITION IN PARKINSON’S DISEASE: A SYSTEMATIC REVIEW
Abstract
Transcranial Direct Current Stimulation (tDCS) has been used as a complementary treatment for Parkinson's Disease (PD) for motor and non-motor symptoms, as well as for Emotional Recognition. Objective: To conduct a Systematic Review (SR) on the effects of tDCS on Emotional Recognition in individuals with PD. Methods: Registration in PRÓSPERO (CRD42024575949) and guiding question: "What are the new perspectives on Emotional Recognition in Parkinson's Disease under the effect of transcranial direct current stimulation - tDCS?". Language limit: Portuguese and English, from the last ten years. Descriptors: “Parkinson Disease, Transcranial Direct Current Stimulation, Emotional Recognition, Face Recognition”, in the following databases: PubMed, Lilacs, Embase, Cochrane Central Register of Controlled Trials, Science Direct, Web of Science, Scopus, Scielo, Psychoanalytic Electronic Publishing (PEP), PsycINFO, Google Scholar, and Open Grey. Results: PRISMA Diagram (2020): 374 articles were found in the databases during the Identification phase. 176 duplicate articles were removed in EndNote®, and 191 articles were excluded for not meeting the inclusion criteria, leaving a total of 7 articles for full reading. Two articles were included in the Systematic Review after excluding articles with incorrect sources (n=4), results (n=0), or comparators (n=1). The publications presented cerebellar tDCS neuromodulation for the treatment of Parkinson's disease with an outcome related to emotional recognition, and showed that the cerebellum makes an important contribution to the recognition of negative valence emotions. Conclusion: tDCS appears to be a promising and efficient neuromodulation technology for emotional recognition in Parkinson's disease.
Author Biographies
Graduação em Fonoaudiologia - Institutos Paraibanos de Educação- UNIPÊ (2001). Fonoaudióloga Clínica - Especialização em Motricidade Orofacial pela Universidade Potiguar (UNP) e em Gerontologia pela Universidade Integrada de Patos (FIP). Título de Especialista em M.O. e Voz pelo CFFa. Mestre (2015) e Doutora (2025) em Neurociências Cognitiva e Comportamento pela Universidade Federal da Paraíba (UFPB). Formação no Método Photo Science Fono - Fotobiomodulação e Fototerapia na Fonoaudiologia. Formação em Estimulação Transcraniana por Corrente Contínua - tDCS pela NEURONUS.
Graduação em Psicologia na Universidade de São Paulo - Ribeirão Preto;
Mestrado e Doutorado em Psicobiologia na Universidade de São Paulo - Ribeirão Preto;
Pós-Doutorado em Neurociências (Universidade de Lorraine, França); Professor do Programa de Pós Graduação em Neurociências Cognitivo e Comportamento - PPGNeC - UFPB; Responsável pelo Lacop da UFPB.
Professora do Departamento de Psicologia da Universidade Federal de Pernambuco (UFPE), Doutora em Neurociências e Comportamento (USP, 2012), Mestre em Psicologia (UFPB, 2008) e Graduada em Psicologia (UFPB, 2006).
References
1. Pohl A, Anders S, Chen H, Patel HJ, Heller J, Reetz K, Mathiak K, Binkofski F. Impaired emotional mirroring in Parkinson’s disease: a study on brain activation during processing of facial expressions. Front Neurol. 2017;8:682 DOI: https://doi.org/10.3389/fneur.2017.00682
2. Ricciardi L, Visco-Comandini F, Erro R, Morgante F, Bologna M, Fasano A, et al. Facial emotion recognition and expression in Parkinson's disease: an emotional mirror mechanism? PLoS One. 2017;12(1):e0169110 DOI: https://doi.org/10.1371/journal.pone.0169110
3. Behlau M, Barbara M. Comunicação consciente: o que comunico quando me comunico. Rio de Janeiro: Thieme Revinter; 2022. 256 p.
4. Ferruccia R, Giannicola G, Rosa M, Fumagalli M, Boggio PS, Hallett M, et al. Cerebellum and processing of negative facial emotions: cerebellar transcranial DC stimulation specifically enhances the emotional recognition of facial anger and sadness. Cogn Emot. 2012;26(5):786–799 DOI: https://doi.org/10.1080/02699931.2011.619520
5. Machado DGS, Rodrigues AC, Bikson M, Andrade SM, Okano AH, Simplicio H, Pegado R, Morya E. Transcranial direct current stimulation on Parkinson’s disease: systematic review and meta-analysis. Front Neurol. 2022;12:794784 DOI: https://doi.org/10.3389/fneur.2021.794784
6. Shamseer L, Moher D, Clark M, Gheresi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P): elaboration and explanation. BMJ. 2015;349:g7647 DOI: https://doi.org/10.1136/bmj.g7647
7. Ruggiero F, Dini M, Cortese F, et al. Anodal transcranial direct current stimulation over the cerebellum enhances sadness recognition in Parkinson’s disease patients: a pilot study. Cerebellum. 2022;21:234–243 DOI: https://doi.org/10.1007/s12311-021-01295-y
8. Ruggiero F, Cortese F, Nigro M, Bocci T, Borellini L, Vergari M, Mameli F, Priori A, Ferrucci R. Cerebellar tDCS modulates negative emotions recognition in Parkinson's disease. Mov Disord. 2018;33(Suppl 2) DOI: https://doi.org/10.1002/mds.27529
9. Reisch LM, Wegrzyn M, Woermann FG, Bien CG, Kissler J. Negative content enhances stimulus-specific cerebral activity during free viewing of pictures, faces, and words. Hum Brain Mapp. 2020;41(15):4332–4354 DOI: https://doi.org/10.1002/hbm.25128
10. Assogna F, Pontieri FE, Caltagirone C, Spalletta G. The recognition of facial emotion expressions in Parkinson's disease. Eur Neuropsychopharmacol. 2008;18(11) DOI: https://doi.org/10.1016/j.euroneuro.2008.07.004
11. Nejati V, Khorrami AS, Fonoudi M. Neuromodulation of facial emotion recognition in health and disease: a systematic review. Neurophysiol Clin. 2022;52(3):183–201 DOI: https://doi.org/10.1016/j.neucli.2022.03.005
12. Lukito S, Fortea L, Groppi F, Wykret KZ, Tosi E, Oliva V, Damiani S, Radua J, Fusar-Poli P. Should perception of emotions be classified according to threat detection rather than emotional valence? An updated meta-analysis for a whole-brain atlas of emotional faces processing. J Psychiatry Neurosci. 2023;48(5):E376–E389 DOI: https://doi.org/10.1503/jpn.230065
13. Fusar-Poli P, Placentino A, Carletti F, Landi P, Allen P, Surguladze S, Benedetti F, Abbamonte M, Gasparotti R, Barale F, Perez J, McGuire P, Politi P. Functional atlas of emotional faces processing: a voxel-based meta-analysis of 105 functional magnetic resonance imaging studies. J Psychiatry Neurosci. 2009;34(6):418-432.
14. Mirzai N, Polet K, Morisot A, Hesse S, Pesce A, Chapelle S, Iakimova G. Can the ability to recognize facial emotions in individuals with neurodegenerative disease be improved? A systematic review and meta-analysis. Cogn Behav Neurol. 2023;36(4):202-218 DOI: https://doi.org/10.1097/WNN.0000000000000348
15. Wei W, Yi X, Ruan J, Duan X, Luo H. The efficacy of repetitive transcranial magnetic stimulation on emotional processing in apathetic patients with Parkinson’s disease: a placebo-controlled ERP study. J Affect Disord. 2021;282:776-785 DOI: https://doi.org/10.1016/j.jad.2020.12.099
16. Albuquerque L, Coelho M, Martins M, et al. STN-DBS does not change emotion recognition in advanced Parkinson’s disease. Parkinsonism Relat Disord. 2014;20:166-169 DOI: https://doi.org/10.1016/j.parkreldis.2013.10.010
17. Enrici I, Mitkova A, Castelli L, et al. Deep brain stimulation of the subthalamic nucleus does not negatively affect social cognitive abilities of patients with Parkinson’s disease. Sci Rep. 2017;7:9413 DOI: https://doi.org/10.1038/s41598-017-09737-6
18. Péron J, Biseul I, Leray E, et al. Subthalamic nucleus stimulation affects fear and sadness recognition in Parkinson’s disease. Neuropsychology. 2010;24:1–8 DOI: https://doi.org/10.1037/a0017433
19. Wagenbreth C, Kuehne M, Voges J, et al. Deep brain stimulation of the subthalamic nucleus selectively modulates emotion recognition of facial stimuli in Parkinson’s patients. J Clin Med. 2019;8:1335 DOI: https://doi.org/10.3390/jcm8091335
20. Aiello M, Eleopra R, Lettieri C, et al. Emotion recognition in Parkinson’s disease after subthalamic deep brain stimulation: differential effects of microlesion and STN stimulation. Cortex. 2014;51:35–45 DOI: https://doi.org/10.1016/j.cortex.2013.11.003
21. McIntosh LG, Mannava S, Camalier CR, et al. Emotion recognition in early Parkinson’s disease patients undergoing deep brain stimulation or dopaminergic therapy: a comparison to healthy participants. Front Aging Neurosci. 2015;6:349 DOI: https://doi.org/10.3389/fnagi.2014.00349
22. Mermillod M, Mondillon L, Rieu I, et al. Dopamine replacement therapy and deep brain stimulation of the subthalamic nuclei induce modulation of emotional processes at different spatial frequencies in Parkinson’s disease. J Parkinsons Dis. 2014;4:97–110 DOI: https://doi.org/10.3233/JPD-130256
23. Mondillon L, Mermillod M, Musca SC, et al. The combined effect of subthalamic nuclei deep brain stimulation and L-dopa increases emotion recognition in Parkinson’s disease. Neuropsychologia. 2012;50:2869–2879 DOI: https://doi.org/10.1016/j.neuropsychologia.2012.08.016
License
Copyright (c) 2026 RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218
This work is licensed under a Creative Commons Attribution 4.0 International License.
Os direitos autorais dos artigos/resenhas/TCCs publicados pertecem à revista RECIMA21, e seguem o padrão Creative Commons (CC BY 4.0), permitindo a cópia ou reprodução, desde que cite a fonte e respeite os direitos dos autores e contenham menção aos mesmos nos créditos. Toda e qualquer obra publicada na revista, seu conteúdo é de responsabilidade dos autores, cabendo a RECIMA21 apenas ser o veículo de divulgação, seguindo os padrões nacionais e internacionais de publicação.