title: Selective amygdalohippocampectomy versus standard temporal lobectomy in patients with mesiotemporal lobe epilepsy and unilateral hippocampal sclerosis: post-operative facial emotion recognition abilities.
abstract: Surgical treatment of mesial temporal lobe epilepsy (mTLE) patients involves the removal either of the left or the right hippocampus. Since the mesial temporal lobe is responsible for emotion recognition abilities, we aimed to assess facial emotion recognition (FER) in two homogeneous patient cohorts that differed only in the administered surgery design since anterior temporal lobectomy (ATL) or selective amygdalohippocampectomy (SAH) were performed independently of the underlying electroclinical conditions. The patient selection for the two respective surgical procedures was carried out retrospectively between 2000 and 2009 by two independent epilepsy centres, the Kork Epilepsy Centre, Germany and the University Hospital of Strasbourg, France. All included patients had presented with unilateral hippocampus sclerosis (HS) without associated dysplasia or white matter blurring and had become seizure-free postoperatively. Psychometric evaluation was carried out with the Ekman 60 Faces Test and screened for depression and psychosomatic symptoms with the SCL-90 R and the BDI. Thirty healthy volunteers participated as control subjects. Sixty patients were included, 27 had undergone SAH and 33 ATL. Patients and controls obtained comparable scores in FER for surprise, happiness, anger and sadness. Concerning fear and disgust the patient group scored significantly worse. Left-sided operations led to the the most pronounced impairment. The ATL group scored significantly worse for recognition of fear compared with SAH patients. Inversely, after SAH scores for disgust were significantly lower than after ATL, independently of the side of resection. Unilateral temporal damage impairs FER. Different neurosurgical procedures may affect FER differently.
authors.affiliation: Kork Epilepsy Center, Kehl-Kork, Germany; Laboratoire d'Imagerie et Neurosciences Cognitives (CNRS UMR 7237), University of Strasbourg, Strasbourg, France. Electronic address: awendling@epilepsiezentrum.de.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Wendling
authors.affiliation: Kork Epilepsy Center, Kehl-Kork, Germany. Electronic address: bsteinhoff@epilepsiezentrum.de.
authors.forename: Bernhard J
authors.initials: BJ
authors.lastname: Steinhoff
authors.affiliation: University Hospital of Strasbourg, Strasbourg, France. Electronic address: frederic170475@orange.fr.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Bodin
authors.affiliation: Kork Epilepsy Center, Kehl-Kork, Germany. Electronic address: astaack@epilepsiezentrum.de.
authors.forename: Anke M
authors.initials: AM
authors.lastname: Staack
authors.affiliation: Department of Neurosurgery, University of Freiburg, Freiburg, Germany. Electronic address: josef.zentner@uniklinik-freiburg.de.
authors.forename: Josef
authors.initials: J
authors.lastname: Zentner
authors.affiliation: University Hospital of Strasbourg, Strasbourg, France. Electronic address: julia.scholly@chru-strasbourg.fr.
authors.forename: Julia
authors.initials: J
authors.lastname: Scholly
authors.affiliation: University Hospital of Strasbourg, Strasbourg, France. Electronic address: mapival@wanadoo.fr.
authors.forename: Maria-Paula
authors.initials: MP
authors.lastname: Valenti
authors.affiliation: Epilepsy Center, University of Freiburg, Freiburg, Germany. Electronic address: andreas.schulze-bonhage@uniklinik-freiburg.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schulze-Bonhage
authors.affiliation: University Hospital of Strasbourg, Strasbourg, France. Electronic address: edouard.hirsch@chru-strasbourg.fr.
authors.forename: Edouard
authors.initials: E
authors.lastname: Hirsch
mesh_terms: D000328:Adult; D038481:Anterior Temporal Lobectomy / Q000009:adverse effects / Q000523:psychology; D004644:Emotions; D004833:Epilepsy, Temporal Lobe / Q000523:psychology / Q000601:surgery*; D005145:Face; D005149:Facial Expression; D005260:Female; D007839:Functional Laterality; D006624:Hippocampus / Q000601:surgery*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010364:Pattern Recognition, Visual; D011184:Postoperative Period; D012189:Retrospective Studies; D012598:Sclerosis / Q000523:psychology / Q000601:surgery*
keywords: Anterior temporal resection; Epilepsy surgery; Facial emotion recognition; Outcome; Selective amygdalohippocampectomy