Preserved social behavior recognition in patients with epilepsy

Recognition of the social behaviors is a multifaceted function on the borderline between neuroscience and social science. In neurological patients, it may be influenced by brain damage, cognition, and psychological distress. This study aimed to clarify whether social behavior recognition can be preserved in patients with temporal lobe epilepsy (TLE) and whether empathy, executive functions and anxiety may play an influential role.

The Social Situations Test (SST), Empathy Questionnaire (EQ), State Trait Anxiety Inventory (STAI), Phonemic Word Fluency (PWF), and Raven Colored Progressive Matrices (RCPM) were used to assess the ability to recognize normative behaviors and violations, empathy, anxiety, strategic search, and abstraction in patients with TLE and healthy controls (HCs).

Compared to 56 HCs, 75 patients with TLE obtained the same SST scores, but showed lower scores at the EQ, PWF, and RCPM and higher levels of anxiety. In the patients' group, the SST scores were predicted by the EQ and PWF scores, while the RCPM and STAI scores, demographics, and epilepsy-related variables had no effects. In the HCs, the EQ score only predicted the SST scores. Patients with different temporal lobe lesions and HCs showed similar SST scores.

Patients with TLE maintain a good ability to recognize the appropriateness of social behavior and violations of social norms, which is closely linked to empathy and strategic research. This study, the first addressing these aspects together in TLE, adds positive information to the cognitive phenotype. Further studies are needed to understand social behavior in epilepsy.