Objective: Emotion processing abilities might be reduced in amyotrophic lateral sclerosis (ALS). Previous studies of emotion processing in ALS have inconsistent results, and are limited by variations in task difficulty, modalities examined, and participants’ cognitive status. The current study used a battery of emotion processing tasks at differing levels of difficulty and across different modalities (facial affect and voice prosody) to assess the extent of emotion processing deficits in nondemented ALS. Method: 33 ALS participants with intact basic cognition and 22 healthy controls completed the abbreviated Comprehensive Affect Testing System (CATS), which assesses simple and complex facial affect recognition, affective prosody recognition, cross-modal face-prosody integration, and semantic comprehension of affect. Participants also completed measures of executive function, mood, and functional impairment. Results: ALS participants showed impairments on complex facial affect recognition, affective prosody recognition, and cross-modal integration. In contrast, simple facial affect recognition and semantic comprehension of affect were intact. ALS participants did not have significant mood symptoms, and neither mood nor functional impairment was related to emotion processing. Performance on the cross-modal composite was related to executive function, however, this relationship was not apparent for facial or prosody recognition within a single modality. Conclusions: These results indicate that people living with ALS without dementia often have subtle difficulties with recognizing emotions in both faces and voices, even in the context of intact basic cognition. Clinicians should be aware of the potential for these emotion processing difficulties to be present in ALS and to affect interpersonal behavior and quality of life.
