Two years after epilepsy surgery in children: Recognition of emotions expressed by faces.
OBJECTIVE
The purpose of this study was to determine whether children with epilepsy surgery in their history are able to recognize emotions expressed by faces and whether this recognition is associated with demographic variables [age, sex, and verbal intelligence (VIQ)] and/or epilepsy variables (epilepsy duration, side of the surgery, surgery area, resection of the amygdala, etiology, antiepileptic drug use, and seizure freedom).


METHODS
Two years after epilepsy surgery, the Facial Expression of Emotion: Stimuli and Tests (FEEST) was administered to 41 patients (age: 4-20years, mean: 13.5years, 24 girls) and 82 age- and sex-matched healthy controls. Data obtained longitudinally (before surgery and 6, 12, and 24months after surgery) in a small subset (11 patients and 22 matched controls) were explored to obtain clues about the course of REEF from before surgery.


RESULTS
Corrected for VIQ, REEF scored significantly lower in the 41 surgically treated patients than in matched control children. No significant relationship was found between REEF and any epilepsy variable. Only age at assessment predicted REEF score in both patients and controls. The longitudinal data revealed a 'dip' in emotion recognition at the first postsurgical assessment in the six younger patients (age: <12.1years). The older patients (age: 13-17years) showed a continuous increase in REEF scores that was similar to that in controls. Two years after surgery, REEF of the younger patients recovered to, but did not exceed, the presurgical level.


CONCLUSIONS
Neither poor REEF present two years after childhood epilepsy surgery, nor the aberrant course of REEF in younger patients (age: <12.1years) was explained by epilepsy variables or poor verbal intelligence. Disentangling the mechanism of the abnormality is urgently needed, as recognizing emotional expressions is a key component in the development of more complex social perception skills.
Sector of Neuropsychology for Children and Adolescents, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands; Brain Center Rudolf Magnus, Departments of Child Neurology and Neurosurgery, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands; Department of Pediatric Psychology and Social Work, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands; Bio Research Center for Children, Wekeromseweg 8, 6816 VS Arnhem, The Netherlands. Electronic address: obraams@umcutrecht.nl.
Olga
O
Braams
Sector of Neuropsychology for Children and Adolescents, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands; Brain Center Rudolf Magnus, Departments of Child Neurology and Neurosurgery, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands; Bio Research Center for Children, Wekeromseweg 8, 6816 VS Arnhem, The Netherlands. Electronic address: meekes.joost@gmail.com.
Joost
J
Meekes
Brain Center Rudolf Magnus, Departments of Child Neurology and Neurosurgery, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands; Bio Research Center for Children, Wekeromseweg 8, 6816 VS Arnhem, The Netherlands. Electronic address: OnnovanNieuwenhuizen@umcutrecht.nl.
Onno
O
van Nieuwenhuizen
Department of Pediatric Psychology and Social Work, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands. Electronic address: R.Schappin@umcutrecht.nl.
Renske
R
Schappin
Brain Center Rudolf Magnus, Departments of Child Neurology and Neurosurgery, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. Electronic address: P.v.Rijen@umcutrecht.nl.
Peter C
PC
van Rijen
Departments of Neurology and Neurosurgery - Neuropsychology Unit, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands. Electronic address: W.S.Veenstra@umcg.nl.
Wencke
W
Veenstra
Brain Center Rudolf Magnus, Departments of Child Neurology and Neurosurgery, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. Electronic address: K.Braun@umcutrecht.nl.
Kees
K
Braun
Sector of Neuropsychology for Children and Adolescents, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands; Brain Center Rudolf Magnus, Departments of Child Neurology and Neurosurgery, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands; Bio Research Center for Children, Wekeromseweg 8, 6816 VS Arnhem, The Netherlands. Electronic address: A.Jennekens@umcutrecht.nl.
Aag
A
Jennekens-Schinkel
D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000601:surgery; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology* / Q000503:physiopathology; D004827:Epilepsy / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D019260:Expressed Emotion; D000066499:Facial Recognition / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D021641:Recognition, Psychology; D013997:Time Factors; D055815:Young Adult
Child; Emotion recognition; Epilepsy surgery; FEEST