title: Impaired facial emotion recognition in patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE-HS): Side and age at onset matters.
abstract: To define the determinants of impaired facial emotion recognition (FER) in patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE-HS), we examined 76 patients with unilateral MTLE-HS, 36 prior to antero-mesial temporal lobectomy (AMTL) and 40 after AMTL, and 28 healthy control subjects with a FER test consisting of 60 items (20 each for anger, fear, and happiness). Mean percentages of the accurate responses were calculated for different subgroups: right vs. left MTLE-HS, early (age at onset <6 years) vs. late-onset, and before vs. after AMTL. After controlling for years of education, duration of epilepsy and number of antiepileptic drugs (AEDs) taken, on multivariate analysis, fear recognition was profoundly impaired in early-onset right MTLE-HS patients compared to other MTLE patients and control subjects. Happiness recognition was significantly better in post-AMTL MTLE-HS patients compared to pre-AMTL patients while anger and fear recognition did not differ. We conclude that patients with right MTLE-HS with age at seizure onset <6 years are maximally predisposed to impaired fear recognition. In them, right AMTL does not further worsen FER abilities. Longitudinal studies comparing FER in the same patients before and after AMTL will be required to refine and confirm our cross-sectional observations.
authors.affiliation: R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
authors.forename: Ulf
authors.initials: U
authors.lastname: Hlobil
authors.forename: Chaturbhuj
authors.initials: C
authors.lastname: Rathore
authors.forename: Aley
authors.initials: A
authors.lastname: Alexander
authors.forename: Sankara
authors.initials: S
authors.lastname: Sarma
authors.forename: Kurupath
authors.initials: K
authors.lastname: Radhakrishnan
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging; D000704:Analysis of Variance; D038481:Anterior Temporal Lobectomy / Q000379:methods; D004644:Emotions / Q000502:physiology*; D004833:Epilepsy, Temporal Lobe / Q000150:complications* / Q000601:surgery; D005149:Facial Expression; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology*; D009483:Neuropsychological Tests; D010364:Pattern Recognition, Visual / Q000502:physiology; D010775:Photic Stimulation / Q000379:methods; D012598:Sclerosis / Q000150:complications / Q000473:pathology; D018709:Statistics, Nonparametric