title: Recognition of facial emotions and identity in patients with mesial temporal lobe and idiopathic generalized epilepsy: an eye-tracking study.
abstract: OBJECTIVE
  To describe visual scanning pattern for facial identity recognition (FIR) and emotion recognition (FER) in patients with idiopathic generalized (IGE) and mesial temporal lobe epilepsy (MTLE). Secondary endpoint was to correlate the results with cognitive function.
  
  
  METHODS
  Benton Facial Recognition Test (BFRT) and Ekman&Friesen series were performed for FIR and FER respectively in 23 controls, 20 IGE and 19 MTLE patients. Eye movements were recorded by a Hi-Speed eye-tracker system. Neuropsychological tools explored cognitive function.
  
  
  RESULTS
  Correct FIR rate was 78% in controls, 70.7% in IGE and 67.4% (p=0.009) in MTLE patients. FER hits reached 82.7% in controls, 74.3% in IGE (p=0.006) and 73.4% in MTLE (p=0.002) groups. IGE patients failed in disgust (p=0.005) and MTLE ones in fear (p=0.009) and disgust (p=0.03). FER correlated with neuropsychological scores, particularly verbal fluency (r=0.542, p<0.001). Eye-tracking revealed that controls scanned faces more diffusely than IGE and MTLE patients for FIR, who tended to top facial areas. A longer scanning of the top facial area was found in the three groups for FER. Gap between top and bottom facial region fixation time decreased in MTLE patients, with more but shorter fixations in bottom facial region. However, none of these findings were statistically significant.
  
  
  CONCLUSIONS
  FIR was impaired in MTLE patients, and FER in both IGE and MTLE, particularly for fear and disgust. Although not statistically significant, those with impaired FER tended to perform more diffuse eye-tracking over the faces and have cognitive dysfunction.
authors.affiliation: Department of Neurology and Neurosurgery, Clinica Universidad de Navarra, Pamplona, Spain. Electronic address: asiergomez81@gmail.com.
authors.forename: Asier
authors.initials: A
authors.lastname: Gomez-Ibañez
authors.affiliation: Service of Neurophisiology, Clinica Universidad de Navarra, Pamplona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Urrestarazu
authors.affiliation: Department of Neurology and Neurosurgery, Clinica Universidad de Navarra, Pamplona, Spain.
authors.forename: Cesar
authors.initials: C
authors.lastname: Viteri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D004644:Emotions / Q000502:physiology*; D004829:Epilepsy, Generalized / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D005145:Face / Q000503:physiopathology; D005149:Facial Expression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D013702:Temporal Lobe / Q000503:physiopathology*; D055815:Young Adult
keywords: Emotion; Epilepsy; Eye-tracking; Facial identification