Brain mapping of emotional prosody in patients with drug-resistant temporal epilepsy: An indicator of plasticity

Amygdalar lesions may impair emotion recognition in patients with temporal lobe epilepsy: Results from a pilot study

PURPOSE

Deficits in basic emotion recognition have been documented in temporal lobe epilepsy (TLE). Although numerous imaging studies have suggested a critical role for the importance of the amygdalae in emotion recognition, investigations comparing TLE patients with and without amygdalar pathology (AmyD) are lacking. The goal of the present study is to compare these subgroups of patients with TLE.

METHODS

Twenty-five patients with TLE (12 with AmyD, 13 without amygdalar pathology (no AmyD)), and twenty-four healthy controls (CG) performed an animated morph task with faces showing basic emotions gradually changing in their emotional intensity. In an auditory task, subjects listened to neutral sentences spoken with varying emotional prosody.

RESULTS

AmyD patients showed significantly reduced prosody recognition and morph task performance compared to CG. Patients with AmyD showed worse prosody recognition performance compared to no AmyD.

CONCLUSION

In the present study, only TLE patients with amygdalar pathology showed deficits in visual and auditory emotion recognition. These results provide preliminary evidence for the importance of intact amygdalae in TLE for basic emotion processing in both modalities. The findings need to be confirmed in studies with larger samples.

Reorganization of pragmatic language networks in patients with temporal lobe epilepsy

OBJECTIVE

To investigate the neural networks involved in idiomatic expressions (IE) comprehension in healthy controls and patients with drug-resistant temporal lobe epilepsy (TLE), with a functional magnetic resonance imaging (fMRI) task.

METHODS

Thirty-two patients with TLE (left or right) and seventeen healthy controls were evaluated. Activated nodes in the fMRI task were defined as Regions of Interest (ROIs) for a posterior functional connectivity analysis.

RESULTS

All participants completed the task successfully. We found a bilateral fronto-temporal network, lateralized to the right, during IE processing in the overall sample. Compared to controls, patients additionally activated frontal, temporal, and insular areas in both hemispheres. Controls exhibited fewer connections but greater inhibitory connectivity, while the opposite (more connections and increased excitatory connectivity) occurred in patients. Compared to controls, TLE patients recruited additional brain areas on top of the expected bilateral frontotemporal network. The connectivity analysis revealed that controls exhibited more effective inhibitory connectivity, with more modular ROIs. In contrast, patients demonstrated greater excitatory connectivity.

CONCLUSION

The results suggest compensatory neural recruitment in additional areas in TLE during IE comprehension.

SIGNIFICANCE

Exacerbated connections in TLE may reflect the need to recruit alternative regions, resulting in higher costs and lower efficiency of the neural network.

Dynamic facial emotion recognition and affective prosody recognition are associated in patients with temporal lobe epilepsy

Deficits in facial emotion recognition have frequently been established in temporal lobe epilepsy (TLE). However, static, rather than dynamic emotion recognition paradigms have been applied. Affective prosody has been insufficiently studied in TLE, and there is a lack of studies investigating associations between auditory and visual emotion recognition. We wished to investigate potential deficits in a dynamic morph task of facial emotion recognition and in an affective prosody recognition task, as well as associations between both tasks. 25 patients with TLE and 24 healthy controls (CG) performed a morph task with faces continuously changing in their emotional intensity. They had to press a button, as soon as they were able to recognize the emotion expressed, and label it accordingly. In the auditory task, subjects listened to neutral sentences spoken in varying emotional tones, and labeled the emotions. Correlation analyses were conducted across both tasks. TLE patients showed significantly reduced prosody recognition compared to CG, and in the morph task, there was a statistical trend towards significantly reduced performance for TLE. Recognition rates in both tasks were significantly associated. TLE patients show deficits in affective prosody recognition, and they may also be impaired in a morph task with dynamically changing facial expressions. Impairments in basic social-cognitive tasks in TLE seem to be modality-independent.

Affective Empathy, Theory of Mind and Social Functioning in Patients With Focal Epilepsy

OBJECTIVE

Social cognition comprises basic and more complex functions, such as theory of mind (ToM) and affective empathy. Although everyday social interactions may be impaired if such higher-order social cognitive functions are compromised, associations between social functioning and social cognition in people with focal epilepsy (PWFE) are still poorly understood. We used a novel, naturalistic approach to investigate ToM in PWFE by applying the Movie for the Assessment of Social Cognition (MASC). Furthermore, we studied affective empathy, the relationship between social cognitive parameters and measures of social functioning, as well as between epilepsy focus and ToM.

METHODS

Thirty patients with either temporal (TLE) or frontal lobe epilepsy (FLE) were compared to 29 healthy control subjects (HC). In addition to the MASC, we applied questionnaire measures assessing empathy and everyday social functioning.

RESULTS

PWFE, especially with FLE, performed significantly worse than HC on the MASC. Perceived social integration and social activities, but not affective empathy, were reduced in PWFE. Regression analyses revealed associations between perceived social integration, clinical group status, affective empathy and ToM.

CONCLUSION

PWFE displayed ToM deficits during a naturalistic task, whereas affective empathy was unimpaired. FLE may be associated with especially compromised ToM performance. Social cognition and social functioning appear to be interrelated in PWFE, whose self-perceived levels of social integration and social activities are lower than those of HC. More research into the association between social cognition and social functioning in PWFE is needed, in order to develop tailored intervention programs for these patients.