Cognitive and metabolic correlates of emotional vulnerability in patients with temporal lobe epilepsy.
BACKGROUND
Recent investigations have suggested that the occurrence of epileptic seizures is not completely random. In particular, various types of psychological changes or life events may act as triggering factors.


OBJECTIVE
To identify a possible link between self-perception of the impact of affective precipitants, cognitive responses modulated by aversive information and brain metabolic modifications in patients with temporal lobe epilepsy (TLE).


METHODS
The extent to which seizures were elicited or not by emotional precipitants was estimated using a self-reported scale, allowing distinction of two groups: 'Emo-TLE' group (patients reporting to have seizures triggered by emotional events) and 'Other-TLE' group, which were compared with healthy individuals ('control' group). Attentional biases were investigated using the probe detection paradigm, using negative and neutral stimuli. Interictal brain metabolism was studied using FDG-PET, and comparison was made between controls, Emo-TLE and Other-TLE groups.


RESULTS
Patients with emotional vulnerability (Emo-TLE) disclosed specific attentional biases towards negative stimuli compared with the Other-TLE and control groups. Patients with Emo-TLE also exhibited specific hypometabolism in the anterior temporal lobe, including amygdala and hippocampus. The degree of attentional biases correlated with decreased metabolism in these regions.


CONCLUSIONS
This investigation shows that the impact of affective events is the result of self-perception and also that it might be determined by specific cognitive and brain metabolic modifications in TLE.
CHU Timone, Service de Neurophysiologie Clinique,Marseille, France. laura.lanteaume@ap-hm.fr
Laura
L
Lanteaume
Eric
E
Guedj
Mireille
M
Bastien-Toniazzo
Audrey
A
Magalahaes
Olivier
O
Mundler
Fabrice
F
Bartolomei
D000328:Adult; D000679:Amygdala / Q000000981:diagnostic imaging / Q000378:metabolism*; D001288:Attention; D016022:Case-Control Studies; D004644:Emotions / Q000502:physiology; D004833:Epilepsy, Temporal Lobe / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000523:psychology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D059907:Functional Neuroimaging / Q000379:methods / Q000523:psychology; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000378:metabolism*; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods / Q000523:psychology; D057566:Self Report
D019788:Fluorodeoxyglucose F18