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Facial emotion processing in patients with seizure disorders
Jerzy P Szaflarski1, Jane B Allendorfer1, Rodolphe Nenert2
1Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA; UAB Epilepsy Center, University of Alabama at Birmingham, Birmingham, AL, USA.
Epilepsy & Behavior : E&B
|January 9, 2018
Summary
Psychogenic nonepileptic seizures (PNES) patients show altered facial emotion processing and increased amygdala connectivity compared to temporal lobe epilepsy (TLE) and healthy controls (HCs). These findings suggest neurophysiologic markers for PNES pathophysiology.
Area of Science:
- Neuroscience
- Psychiatry
- Medical Imaging
Background:
- Understanding the pathophysiology of psychogenic nonepileptic seizures (PNES) requires investigation into emotion processing deficits.
- Facial emotion processing differences between PNES, temporal lobe epilepsy (TLE), and healthy controls (HCs) remain underexplored.
Purpose of the Study:
- To examine differences in facial emotion processing and resting-state functional connectivity in patients with PNES compared to TLE and HCs.
- To identify potential neurophysiologic markers associated with PNES.
Main Methods:
- Functional magnetic resonance imaging (fMRI) was used to assess facial emotion processing (happy, sad, fearful, neutral faces) and resting-state connectivity.
- Participants included 12 patients with PNES, 12 with TLE, and 24 HCs.
- Regions of interest (ROIs) included amygdala and functionally defined seed regions based on differential fMRI responses.
Main Results:
- PNES patients showed altered fMRI responses to various facial emotions compared to TLE patients, including increased responses to happy/neutral/fearful faces and decreased responses to sad faces.
- PNES patients exhibited increased functional connectivity in visual, motor, cerebellar, and frontotemporal regions compared to TLE and HCs.
- Increased functional connectivity was observed between the amygdala and emotion regulation/motor control circuits in PNES patients compared to TLE patients.
Conclusions:
- Patients with PNES demonstrate distinct alterations in facial emotion processing and increased amygdala functional connectivity relative to TLE patients and HCs.
- These findings highlight potential neurophysiologic markers related to neural circuitry alterations in PNES.
- Further research can explore the role of emotion processing in the development and maintenance of PNES.
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