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Rainer LJ, Kuchukhidze G, Trinka E, Braun M, Kronbichler M, Langthaler P, Zimmermann G, Kronbichler L, Said-Yürekli S, Kirschner M, Zamarian L, Schmid E, Jokeit H, Höfler J. Recognition and perception of emotions in juvenile myoclonic epilepsy. Epilepsia 2023; 64:3319-3330. [PMID: 37795683 DOI: 10.1111/epi.17783] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Perception and recognition of emotions are fundamental prerequisites of human life. Patients with juvenile myoclonic epilepsy (JME) may have emotional and behavioral impairments that might influence socially desirable interactions. We aimed to investigate perception and recognition of emotions in patients with JME by means of neuropsychological tests and functional magnetic resonance imaging (fMRI). METHODS Sixty-five patients with JME (median age = 27 years, interquartile range [IQR] = 23-34) were prospectively recruited at the Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria. Patients were compared to 68 healthy controls (median age = 24 years, IQR = 21-31), matched for sex, age, and education. All study participants underwent the Networks of Emotion Processing test battery (NEmo), an fMRI paradigm of "dynamic fearful faces," a structured interview for psychiatric and personality disorders, and comprehensive neuropsychological testing. RESULTS JME patients versus healthy controls demonstrated significant deficits in emotion recognition in facial and verbal tasks of all emotions, especially fear. fMRI revealed decreased amygdala activation in JME patients as compared to healthy controls. Patients were at a higher risk of experiencing psychiatric disorders as compared to healthy controls. Cognitive evaluation revealed impaired attentional and executive functioning, namely psychomotor speed, tonic alertness, divided attention, mental flexibility, and inhibition of automated reactions. Duration of epilepsy correlated negatively with parallel prosodic and facial emotion recognition in NEmo. Deficits in emotion recognition were not associated with psychiatric comorbidities, impaired attention and executive functions, types of seizures, and treatment. SIGNIFICANCE This prospective study demonstrated that as compared to healthy subjects, patients with JME had significant deficits in recognition and perception of emotions as shown by neuropsychological tests and fMRI. The results of this study may have importance for psychological/psychotherapeutic interventions in the management of patients with JME.
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Affiliation(s)
- Lucas Johannes Rainer
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, Center for Cognitive Neuroscience Salzburg, member of the European Reference Network EpiCARE, Salzburg, Austria
- Neuroscience Institute, Christian Doppler University Hospital, Center for Cognitive Neuroscience, Salzburg, Austria
- Department of Child and Adolescent Psychiatry, Christian Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Giorgi Kuchukhidze
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, Center for Cognitive Neuroscience Salzburg, member of the European Reference Network EpiCARE, Salzburg, Austria
- Neuroscience Institute, Christian Doppler University Hospital, Center for Cognitive Neuroscience, Salzburg, Austria
| | - Eugen Trinka
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, Center for Cognitive Neuroscience Salzburg, member of the European Reference Network EpiCARE, Salzburg, Austria
- Neuroscience Institute, Christian Doppler University Hospital, Center for Cognitive Neuroscience, Salzburg, Austria
- Department of Public Health, Health Services Research and Health Technology Assessment, University for Health Sciences, Medical Informatics, and Technology, Hall in Tirol, Austria
- Karl-Landsteiner Institute for Neurorehabilitation and Space Neurology, Salzburg, Austria
| | - Mario Braun
- Center for Cognitive Neuroscience/Department of Psychology, Faculty of Natural Sciences, Paris Lodron University, Salzburg, Austria
| | - Martin Kronbichler
- Neuroscience Institute, Christian Doppler University Hospital, Center for Cognitive Neuroscience, Salzburg, Austria
- Center for Cognitive Neuroscience/Department of Psychology, Faculty of Natural Sciences, Paris Lodron University, Salzburg, Austria
| | - Patrick Langthaler
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, Center for Cognitive Neuroscience Salzburg, member of the European Reference Network EpiCARE, Salzburg, Austria
- Department of Mathematics, Faculty of Natural Sciences, Paris Lodron University, Salzburg, Austria
| | - Georg Zimmermann
- Team Biostatistics and Big Medical Data, Lab for Intelligent Data Analytics Salzburg, Paracelsus Medical University, Salzburg, Austria
- Research and Innovation Management, Paracelsus Medical University, Salzburg, Austria
| | - Lisa Kronbichler
- Neuroscience Institute, Christian Doppler University Hospital, Center for Cognitive Neuroscience, Salzburg, Austria
- Department of Child and Adolescent Psychiatry, Christian Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Sarah Said-Yürekli
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, Center for Cognitive Neuroscience Salzburg, member of the European Reference Network EpiCARE, Salzburg, Austria
- Center for Cognitive Neuroscience/Department of Psychology, Faculty of Natural Sciences, Paris Lodron University, Salzburg, Austria
| | - Margarita Kirschner
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, Center for Cognitive Neuroscience Salzburg, member of the European Reference Network EpiCARE, Salzburg, Austria
| | - Laura Zamarian
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Elisabeth Schmid
- Department of Child and Adolescent Psychiatry, Christian Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
| | | | - Julia Höfler
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, Center for Cognitive Neuroscience Salzburg, member of the European Reference Network EpiCARE, Salzburg, Austria
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