Emotion recognition deficits in temporal lobe epilepsy are non-lateralized and independent of surgery

To examine whether patients with unilateral temporal lobe epilepsy (TLE) show deficits in recognizing emotions from facial expressions and vocal prosody, and whether these impairments differ by seizure focus or surgical status.

Thirty-four patients with TLE were evaluated before or after temporal lobe resection for drug-resistant epilepsy. Thirty right-handed healthy controls without neurological or psychiatric history were included. Emotion recognition was assessed using the Emotion Recognition Test (ERT), consisting of a Facial ERT (adapted from Ekman and Friesen's facial expression set) and a Prosody ERT developed in collaboration with professional actors using two neutral Czech sentences. Both subtests included five emotions: anger, disgust, fear, happiness, and sadness.

TLE patients showed a general impairment in emotion recognition across both modalities. Total prosody and facial emotion scores were significantly lower than in controls. Prosody deficits and facial emotion scores were independent of age, disease duration, and education. No significant differences were found between right and left TLE, or between pre- and postoperative groups.

Deficits in emotion recognition from face and voice in patients with TLE were not lateralized and did not differ between pre- and postoperative TLE groups. This may indicate persistent socio-emotional processing abnormalities that may contribute to the social and behavioral difficulties observed in TLE people. Longitudinal studies are needed in this field.