The importance of theory of mind in epilepsy

Recent studies have shown that frontal and temporal lobe epilepsy, the most common forms of focal epilepsy, may impair theory of mind (ToM) by impacting on key zones of ToM's underlying neural network. Clinical research has characterized the severity and specificity of ToM impairments, as well as model methods of assessment, thereby extending the potential of ToM to expand the scope of the neuropsychology of epilepsy. Theory of mind deficits have been linked to self-rating and coping styles, suggesting a role for ToM in awareness and subjective well-being. The study of ToM in epilepsy is important not only for advancing understanding of its underlying neural network but also for clinical care. A task for the future is to identify patients with and without impaired ToM and the subsequent associations with personality complications and vulnerability to psychiatric comorbidities. Knowledge of the type and direction of the relationship between ToM, personality, and behavior might contribute to characterizing the neurobehavioral consequences of specific epilepsy syndromes as well as planning nonpharmacological treatments for alleviating psychobehavioral distress and social maladjustment.