| dc.description.abstract | Introduction: Mild right-hemisphere ischemic stroke can affect socioemotional
functioning even in patients with excellent functional recovery, yet facial emotion
identification and habitual emotion regulation remain undercharacterized in this
population. This study examined both domains in stroke survivors with little-to-no
residual disability compared to healthy controls.
Methods: Fifty-three mild right-hemisphere ischemic stroke survivors (modified
Rankin Scale < 2; chronic phase, 12–24 months post-stroke) and 60 neurologi-
cally healthy controls completed a 24-item forced-choice identification task
covering six basic emotions and the Emotion Regulation Questionnaire (ERQ).
Group differences and the associations between regulation and recognition were
examined with repeated-measures ANOVA and ANCOVA, including general cog-
nitive status (MoCA) and ERQ indices as covariates.
Results: In the unadjusted model, stroke participants showed lower overall accu-
racy and a significant Emotion × Group interaction, with the clearest group differ-
ences for anger, disgust, and fear. The stroke group also reported markedly higher
expressive suppression and lower cognitive reappraisal. When MoCA was included
as the sole covariate, the between-subjects group effect on overall accuracy was
no longer significant, indicating that the global accuracy decrement is substan-
tially tied to the mild cognitive sequelae of right-hemisphere stroke; however, the
Emotion × Group interaction retained significance with an identical effect size,
becoming non-significant only in the extended model that simultaneously con-
trolled for both MoCA and ERQ indices. Expressive suppression showed a signifi-
cant emotion-dependent association with recognition accuracy after adjustment
for both ERQ and MoCA, whereas reappraisal did not. Formal ANCOVAs confirmed
that regulation differences were not accounted for by cognitive status.
Discussion: These findings reveal a functional dissociation: the overall level of facial
emotion identification is sensitive to general cognitive integrity, whereas habitual
emotion regulation represents a higher-order, cognitively independent dimension of
socioemotional functioning that is robustly and independently affected by mild stroke.
The results argue for dedicated socioemotional assessment —and particularly reg-
ulation-focused characterization— in well-recovered stroke survivors, and motivate
future work linking these profiles to lesion mechanisms and targeted interventions. | es |
