title: Characterization and prediction of theory of mind disorders in temporal lobe epilepsy.
abstract: OBJECTIVE
  Patients with temporal lobe epilepsy (TLE) have impaired theory of mind (ToM). However, ToM involves a variety of processes, such as understanding a person's intentions ("cognitive" ToM) and emotional states ("affective" ToM). The objectives of the present study were to characterize ToM disorders in TLE patients, identify patients at risk of ToM disorders, and study the relationships between psychobehavioral and quality of life factors and ToM disorders.
  
  
  METHODS
  Fifty TLE patients and 50 controls performed ToM tasks assessing their understanding of verbal clumsiness (faux pas), sarcastic remarks, and mentalistic actions. Demographic, cognitive, and psychobehavioral data, and (for TLE patients) clinical and quality of life factors, were recorded.
  
  
  RESULTS
  Compared with controls, TLE patients showed impairments in all ToM tasks: 84% misunderstood faux pas, and around 50% misunderstood sarcasm. A long duration of epilepsy and young age at onset were risk factors for ToM impairments. In TLE patients, ToM impairments were associated with impaired empathy and anhedonia. Their affective states were less positively and more negatively valenced than in controls. Low positive affectivity was predictive of greater cognitive and affective ToM impairments for the faux pas task, and high negative affectivity was predictive of greater cognitive ToM abilities for the sarcasm task. The lack of social support was correlated with impaired ToM but was not a predictive factor.
  
  
  CONCLUSIONS
  Both cognitive and affective ToM processes are impaired in TLE patients. Impaired ToM has an impact on empathy abilities and is related to affective disturbances in TLE patients.
authors: Epilepsy Unit, Department of Clinical Neurophysiology, Lille University Medical Center.
authors: Sophie
authors: S
authors: Hennion
authors: Department of Neurology, Lille University Medical Center.
authors: Xavier
authors: X
authors: Delbeuck
authors: Department of Public Health, Lille University Medical Center.
authors: Alain
authors: A
authors: Duhamel
authors: Department of Neuroradiology, Institute of Predictive Medicine and Therapeutic Research, Lille University Medical Center.
authors: Renaud
authors: R
authors: Lopes
authors: Department of Nuclear Medicine, Lille University Medical Center.
authors: Franck
authors: F
authors: Semah
authors: Epilepsy Unit, Department of Clinical Neurophysiology, Lille University Medical Center.
authors: Louise
authors: L
authors: Tyvaert
authors: Epilepsy Unit, Department of Clinical Neurophysiology, Lille University Medical Center.
authors: Philippe
authors: P
authors: Derambure
authors: Epilepsy Unit, Department of Clinical Neurophysiology, Lille University Medical Center.
authors: William
authors: W
authors: Szurhaj
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000150:complications* / Q000523:psychology; D032882:Comprehension / Q000502:physiology; D004644:Emotions / Q000502:physiology; D004645:Empathy / Q000502:physiology*; D004833:Epilepsy, Temporal Lobe / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011788:Quality of Life; D056345:Theory of Mind / Q000502:physiology*