title: Facial emotion recognition impairment in chronic temporal lobe epilepsy.
abstract: OBJECTIVE
  To evaluate facial emotion recognition (FER) in a cohort of 176 patients with chronic temporal lobe epilepsy (TLE).
  
  
  METHODS
  FER was tested by matching facial expressions with the verbal labels for the following basic emotions: happiness, sadness, fear, disgust, and anger. Emotion recognition performances were analyzed in medial (n = 140) and lateral (n = 36) TLE groups. Fifty healthy subjects served as controls. The clinical and neuroradiologic variables potentially affecting the ability to recognize facial expressions were taken into account.
  
  
  RESULTS
  The medial TLE (MTLE) group showed impaired FER (86% correct recognition) compared to both the lateral TLE patients (FER = 93.5%) and the controls (FER = 96.4%), with 42% of MTLE patients recording rates of FER that were lower [by at least 2 standard deviations (SDs)] than the control mean. The MTLE group was impaired compared to the healthy controls in the recognition of all basic facial expressions except happiness. The patients with bilateral MTLE were the most severely impaired, followed by the right and then the left MTLE patients. FER was not affected by type of lesion, number of antiepileptic drugs (AEDs), aura semiology, or gender. Conversely, the early onset of seizures/epilepsy was related to FER deficits. These deficits were already established in young adulthood, with no evidence of progression in older MTLE patients.
  
  
  CONCLUSIONS
  These results on a large cohort of TLE patients demonstrate that emotion recognition deficits are common in MTLE patients and widespread across negative emotions. We confirm that early onset seizures with right or bilateral medial temporal dysfunction lead to severe deficits in recognizing facial expressions of emotions.
authors.affiliation: Department of Neurosciences, Nuovo Ospedale Civile S Agostino-Estense, University of Modena and Reggio Emilia, Modena, Italy. giuseppe.capovilla@ospedalimantova.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Meletti
authors.forename: Francesca
authors.initials: F
authors.lastname: Benuzzi
authors.forename: Gaetano
authors.initials: G
authors.lastname: Cantalupo
authors.forename: Guido
authors.initials: G
authors.lastname: Rubboli
authors.forename: Carlo Alberto
authors.initials: CA
authors.lastname: Tassinari
authors.forename: Paolo
authors.initials: P
authors.lastname: Nichelli
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use; D002908:Chronic Disease; D004192:Discrimination, Psychological; D004644:Emotions / Q000187:drug effects / Q000502:physiology*; D004833:Epilepsy, Temporal Lobe / Q000145:classification / Q000150:complications* / Q000188:drug therapy / Q000523:psychology*; D005149:Facial Expression; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D010364:Pattern Recognition, Visual / Q000187:drug effects / Q000502:physiology; D012189:Retrospective Studies; D013223:Statistics as Topic; D055815:Young Adult
chemical_list: D000927:Anticonvulsants