Facial emotion recognition in focal epilepsy: localization is not the main factor

Area of Science:

• Neurology
• Cognitive Neuroscience
• Psychiatry

Background:

• Facial emotion recognition deficits are common in people with epilepsy (PWE).
• The specific factors influencing these deficits, particularly the role of seizure focus localization and surgical intervention, remain unclear.

Purpose of the Study:

• To investigate the impact of seizure focus localization on facial emotion recognition in PWE.
• To assess how presurgical and postsurgical factors, including cognitive parameters and medication, affect emotion recognition abilities.

Main Methods:

• Retrospective analysis of 233 patients with focal epilepsy and 68 controls.
• Assessment of facial emotion recognition before and after epilepsy surgery.
• Evaluation of demographic, clinical, neuropsychological factors, and seizure focus localization.

Main Results:

• PWE demonstrated poorer overall emotion recognition than controls, with specific impairments in recognizing surprise, disgust, and fear.
• Fear recognition deficits were noted in medial temporal lobe epilepsy and occipito-parietal lobe epilepsy.
• Cognitive parameters (IQ) and antiseizure medication load were significant factors, not seizure focus localization or surgical site.

Conclusions:

• Facial emotion recognition is impaired in PWE, but not significantly influenced by seizure focus location or surgery.
• Fear recognition is specifically impaired preoperatively in medial temporal lobe epilepsy, highlighting the amygdala's role.
• Cognitive status and medication burden are key determinants of emotion recognition deficits in epilepsy.