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Ogurcakova V, Kajsova M, Marusic P, Amlerova J. Social cognition in Idiopathic generalised epilepsies. Behav Brain Res 2024; 469:115044. [PMID: 38734033 DOI: 10.1016/j.bbr.2024.115044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/27/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024]
Abstract
Social cognition is a set of mental skills necessary to create satisfactory interpersonal relationships and feel a sense of belonging to a social group. Its deficits significantly reduce the quality of life in people with epilepsy. Studies on social cognition and its impairments focus predominantly on people with focal epilepsies. Idiopathic generalised epilepsies are a group of diseases that share similar clinical, prognostic and electrographic characteristics. Despite their typically normal intelligence, people with Idiopathic generalised epilepsies can suffer from learning disabilities and executive dysfunctions. Current studies also suggest social cognition impairments, but their results are inconsistent. This review offers the latest knowledge of social cognition in adults with Idiopathic generalised epilepsies. In addition, we provide an overview of the most frequently used assessment methods. We explain possible reasons for different outcomes and discuss future research perspectives.
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Affiliation(s)
- Viktoria Ogurcakova
- Department of Neurology, Second Faculty of Medicine and Motol University Hospital, Charles University, ERN EpiCARE, Prague, Czech Republic.
| | - Michaela Kajsova
- Department of Neurology, Second Faculty of Medicine and Motol University Hospital, Charles University, ERN EpiCARE, Prague, Czech Republic
| | - Petr Marusic
- Department of Neurology, Second Faculty of Medicine and Motol University Hospital, Charles University, ERN EpiCARE, Prague, Czech Republic
| | - Jana Amlerova
- Department of Neurology, Second Faculty of Medicine and Motol University Hospital, Charles University, ERN EpiCARE, Prague, Czech Republic
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Watanabe RGS, Thais MERDO, Marmentini EL, Freitas TG, Wolf P, Lin K. Theory of mind in epilepsy. Epilepsy Behav 2024; 158:109910. [PMID: 38959746 DOI: 10.1016/j.yebeh.2024.109910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/28/2024] [Accepted: 06/15/2024] [Indexed: 07/05/2024]
Abstract
Epilepsy is characterized by recurrent, chronic, and unprovoked seizures. Epilepsy has a significant negative impact on a patient's quality of life even if seizures are well controlled. In addition to the distress caused by seizures, patients with epilepsy (PwE) may suffer from cognitive impairment with serious social consequences such as poor interpersonal relationships, loss of employment, and reduced social networks. Pathological changes and functional connectivity abnormalities observed in PwE can disrupt the neural network responsible for the theory of mind. Theory of mind is the ability to attribute mental states to other people (intentions, beliefs, and emotions). It is a complex aspect of social cognition and includes cognitive and affective constructs. In recent years, numerous studies have assessed the relationship between social cognition, including the theory of mind, in PwE, and suggested impairment in this domain. Interventions targeting the theory of mind can be potentially helpful in improving the quality of life of PwE.
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Affiliation(s)
- Rafael Gustavo Sato Watanabe
- Medical Sciences Graduate Program, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil; Neurology Division, UFSC, Florianópolis, SC, Brazil.
| | | | | | - Tatiana Goes Freitas
- Medical Sciences Graduate Program, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Peter Wolf
- Medical Sciences Graduate Program, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil; Neurology Division, UFSC, Florianópolis, SC, Brazil; Danish Epilepsy Centre, Dianalund, Denmark
| | - Katia Lin
- Medical Sciences Graduate Program, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil; Neurology Division, UFSC, Florianópolis, SC, Brazil; Centre for Applied Neurosciences, UFSC, SC, Brazil
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Ferrario R, Parisi A, Tallarita G, Parente A, Pastori C, Giovagnoli AR. Sensitivity to moral and conventional rules in temporal lobe epilepsy. Epilepsy Behav 2024; 158:109889. [PMID: 38936307 DOI: 10.1016/j.yebeh.2024.109889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/06/2024] [Accepted: 06/08/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES Sensitivity to moral and conventional rules (SMCR) is supported by bilateral brain networks and psychosocial input both of which may be altered in temporal lobe epilepsy (TLE). This study evaluated the components of SMCR in patients with TLE, aiming to clarify their preservation and link to psychopathological and cognitive aspects. METHODS Adult patients with unilateral TLE and healthy controls were evaluated using neuropsychological tests for SMCR, memory, language, and executive functions, the Empathy Questionnaire (EQ), and the Symptom Checklist-90-R (SCL-90-R). RESULTS The SMCR test items showed good reliability and validity, yielding the Severity and Rules factors distinct from the Executive, Lexical and Memory factors. Patients with right TLE scored worse in moral rules recognition than controls, but this difference was nullified by a significant influence for age and sex. The Severity and Rules factors related to semantic fluency and age and, respectively, TLE side and psychoticism. However, these factors did predict TLE membership. CONCLUSIONS In adult patients with TLE, the SMCR test reflects a distinct cognitive domain. Conventional rules are well-retained, while moral reasoning may be only affected in right TLE if unfavorable demographics coexist. Although age, TLE side, semantic abilities, and psychoticism cooperate to determine SMCR, impairment of such domain is not a distinctive feature of TLE.
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Affiliation(s)
- Rosalba Ferrario
- Unit of Neurology and Neuropathology, IRCCS Foundation "Carlo Besta" Neurological Institute, Milano, Italy
| | - Alessandra Parisi
- Unit of Neurology and Neuropathology, IRCCS Foundation "Carlo Besta" Neurological Institute, Milano, Italy
| | - Giulia Tallarita
- Unit of Neurology and Neuropathology, IRCCS Foundation "Carlo Besta" Neurological Institute, Milano, Italy
| | - Annalisa Parente
- Unit of Neurology and Neuropathology, IRCCS Foundation "Carlo Besta" Neurological Institute, Milano, Italy
| | - Chiara Pastori
- Unit of Clinical and Experimental Epileptology, IRCCS Foundation "Carlo Besta" Neurological Institute, Milano, Italy
| | - Anna Rita Giovagnoli
- Unit of Neurology and Neuropathology, IRCCS Foundation "Carlo Besta" Neurological Institute, Milano, Italy.
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Li X, Shen M, Shen Z, Han Z, Jiao J, Tong X. Reading the mind in the eyes in patients with idiopathic REM sleep behavior disorder. Neurol Sci 2024; 45:2697-2703. [PMID: 38190083 DOI: 10.1007/s10072-024-07303-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/01/2024] [Indexed: 01/09/2024]
Abstract
OBJECTIVES Idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) is characterized by vocalizations, jerks, and motor behaviors during REM sleep, often associated with REM-related dream content, which is considered a prodromal stage of α-synucleinopathy. The results of the Reading the Mind in the Eyes (RME) reflecting affective Theory of Mind (ToM) are inconsistent in α-synucleinopathy. The present study tried to investigate the RME in patients with iRBD. METHODS A total of 35 patients with iRBD and 26 healthy controls were included in the study. All participants were administered the RME and the cognitive assessments according to a standard procedure. The patients with iRBD were further divided into two groups (high or low RME) according to the scores of the RME (> 21, or ≤ 20). RESULTS The patients with iRBD had worse scores on cognitive tests compared with healthy controls involving global cognitive screening, memory, and visuospatial abilities (p < 0.05), but the scores of the RME were similar between the two groups (20.83 ± 3.38, 20.58 ± 3.43) (p ˃ 0.05). Patients with low RME had more obvious cognitive impairments than healthy controls. After applying Bonferroni correction for multiple tests, the low REM group only performed worse on the Sum of trials 1 to 5 and delayed recall of the RAVLT compared with the healthy control group (p < 0.001, = 0.002). The RME correlated with the scores of cognitive tests involving executive function, attention, memory, and visuospatial function. CONCLUSIONS The changes in RME had a relationship with cognitive impairments, especially memory, in patients with iRBD.
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Affiliation(s)
- Xudong Li
- Department of Cognitive Disorder, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, South 4th Ring Road West 119, Beijing, 100070, China.
- China National Clinical Research Center for Neurological Diseases, Beijing, China.
| | - Miaoxin Shen
- Department of Cognitive Disorder, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, South 4th Ring Road West 119, Beijing, 100070, China
| | | | - Ziling Han
- Department of Cognitive Disorder, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, South 4th Ring Road West 119, Beijing, 100070, China
| | - Jinsong Jiao
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Xiaopeng Tong
- Department of Microbiology and Immunology, Medical School, Xizang Minzu University, Xianyang, China
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Bala A, Olejnik A, Mojżeszek M, Rysz A, Kunert P. Navigating Social Waters: Understanding Theory-of-Mind Challenges in Patients with Mesial Temporal Lobe Epilepsy. J Clin Med 2024; 13:1410. [PMID: 38592233 PMCID: PMC10932399 DOI: 10.3390/jcm13051410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/07/2024] [Accepted: 02/26/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Temporal lobe epilepsy is a common neurological disease that affects many areas of patients' lives, including social competence. The aim of the study was to assess theory of mind in patients with temporal lobe epilepsy and to investigate the demographic and clinical factors associated with this function. Methods: A total of 65 participants took part in the study, which included 44 patients with epilepsy and 21 demographically matched healthy individuals. The following neuropsychological tests were used to examine theory of mind: the Faux Pas Test, the Hinting Task, the Emotion Comprehension Test, and a cognitive function screen, the Montreal Cognitive Assessment. Results: Patients with epilepsy scored lower on all measures of the theory-of-mind tests. Moreover, in the clinical group, numerous moderate and strong correlations were found between the theory-of-mind tests and education, age at onset of epilepsy, lateralization of epileptic focus, cognitive status, and, to a lesser degree, number of anti-epileptic drugs, frequency of seizures, and age. In contrast, in the control group, significant correlations were found mostly between the theory-of-mind tests and sex, and, to a lesser degree, age. Education and cognitive functioning were not associated. Conclusions: Patients with epilepsy experience difficulties in theory of mind, which may have a negative impact on the quality of their social relationships. The level of theory-of-mind abilities correlates with particular clinical and demographic indicators. Recognizing these issues allows clinicians to implement tailored interventions, potentially improving patients' quality of life.
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Affiliation(s)
- Aleksandra Bala
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183 Warsaw, Poland
| | - Agnieszka Olejnik
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183 Warsaw, Poland
| | - Maria Mojżeszek
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183 Warsaw, Poland
| | - Andrzej Rysz
- Department of Neurosurgery, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Przemysław Kunert
- Department of Neurosurgery, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
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Paungarttner J, Quartana M, Patti L, Sklenárová B, Farham F, Jiménez IH, Soylu MG, Vlad IM, Tasdelen S, Mateu T, Marsico O, Reina F, Tischler V, Lampl C. Migraine - a borderland disease to epilepsy: near it but not of it. J Headache Pain 2024; 25:11. [PMID: 38273253 PMCID: PMC10811828 DOI: 10.1186/s10194-024-01719-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Migraine and epilepsy are two paroxysmal chronic neurological disorders affecting a high number of individuals and being responsible for a high individual and socioeconomic burden. The link between these disorders has been of interest for decades and innovations concerning diagnosing and treatment enable new insights into their relationship. FINDINGS Although appearing to be distinct at first glance, both diseases exhibit a noteworthy comorbidity, shared pathophysiological pathways, and significant overlaps in characteristics like clinical manifestation or prophylactic treatment. This review aims to explore the intricate relationship between these two conditions, shedding light on shared pathophysiological foundations, genetic interdependencies, common and distinct clinical features, clinically overlapping syndromes, and therapeutic similarities. There are several shared pathophysiological mechanisms, like CSD, the likely underlying cause of migraine aura, or neurotransmitters, mainly Glutamate and GABA, which represent important roles in triggering migraine attacks and seizures. The genetic interrelations between the two disorders can be observed by taking a closer look at the group of familial hemiplegic migraines, which are caused by mutations in genes like CACNA1A, ATP1A2, or SCN1A. The intricate relationship is further underlined by the high number of shared clinical features, which can be observed over the entire course of migraine attacks and epileptic seizures. While the variety of the clinical manifestation of an epileptic seizure is naturally higher than that of a migraine attack, a distinction can indeed be difficult in some cases, e.g. in occipital lobe epilepsy. Moreover, triggering factors like sleep deprivation or alcohol consumption play an important role in both diseases. In the period after the seizure or migraine attack, symptoms like speech difficulties, tiredness, and yawning occur. While the actual attack of the disease usually lasts for a limited time, research indicates that individuals suffering from migraine and/or epilepsy are highly affected in their daily life, especially regarding cognitive and social aspects, a burden that is even worsened using antiseizure medication. This medication allows us to reveal further connections, as certain antiepileptics are proven to have beneficial effects on the frequency and severity of migraine and have been used as a preventive drug for both diseases over many years. CONCLUSION Migraine and epilepsy show a high number of similarities in their mechanisms and clinical presentation. A deeper understanding of the intricate relationship will positively advance patient-oriented research and clinical work.
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Affiliation(s)
| | - Martina Quartana
- Department of Sciences for Health Promotion and Mother-and Childcare "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Lucrezia Patti
- Department of Sciences for Health Promotion and Mother-and Childcare "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Barbora Sklenárová
- St. Anne's University Hospital and Masaryk University, Brno, Czech Republic
| | - Fatemeh Farham
- Headache Department, Iranian Center of Neurological Researchers, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - M Gokcen Soylu
- Department of Neurology, Bakırköy Prof. Dr. Mazhar Osman Mental Health and Neurological Diseases Education and Research Hospital, Istanbul, Turkey
| | - Irina Maria Vlad
- Department of Neurosciences, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Semih Tasdelen
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Teresa Mateu
- Department of Neurology, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Neurology, Fundació Sanitària Mollet, Mollet del Vallès, Barcelona, Spain
| | - Oreste Marsico
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
- Regional Epilepsy Centre, Great Metropolitan "Bianchi-Melacrino-Morelli Hospitall", Reggio Calabria, Italy
| | - Federica Reina
- NeuroTeam Life&Science, Spin-off University of Palermo, Palermo, Italy
| | - Viktoria Tischler
- Headache Medical Center Linz, Linz, Austria
- Department of Neurology and Stroke Unit, Konventhospital Barmherzige Brüder Linz, Linz, Austria
| | - Christian Lampl
- Headache Medical Center Linz, Linz, Austria.
- Department of Neurology and Stroke Unit, Konventhospital Barmherzige Brüder Linz, Linz, Austria.
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7
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Ferrario R, Giovagnoli AR. Processing speed in temporal lobe epilepsy. A scoping review. Epilepsy Behav 2023; 142:109169. [PMID: 36963317 DOI: 10.1016/j.yebeh.2023.109169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/16/2023] [Accepted: 02/28/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Impaired processing speed (PS) can affect patients with temporal lobe epilepsy (TLE). However, it is usually considered a nonspecific clinical feature and is not measured, but this raises lexical and methodological problems. This review aims to evaluate the existing terminology and assessment methods of PS in patients with TLE. METHODS A scoping review was conducted based on the extended guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. The electronic literature search was conducted on Medline-PubMed, American Psychological Association-PsycINFO, Elton Bryson Stephens Company, and Google Scholar, using the keywords "temporal lobe epilepsy" and "speed" or "slowing" plus "processing," "cognitive," "psychomotor," or "mental." Peer-reviewed articles published before December 2022 were analyzed if they were in English, including patients older than 14 years and at least one neuropsychological measure, reported original research focused on PS and had the selected keywords in the title, keywords, and abstract. RESULTS Seven articles published between December 2004 and September 2021 were selected. The terms "processing speed," "psychomotor speed," and "information processing speed," based on similar theoretical constructs, were the most frequently used. Assessment methods included non-computerized or paper-and-pencil tests (WAIS-III Digit Symbol and Symbol Search subtests, Purdue Pegboard and Grooved Pegboard Tests, Trail Making Test and Stroop Color-Word Test) and computerized tests (Sternberg Memory Scanning Test, Pattern Comparison Processing Speed, Computerized Visual Searching). In some studies, impairment was associated with white and gray matter damage in the brain, independent of clinical and treatment variables. CONCLUSION Clinical research on TLE has focused inconsistently on PS. Different evaluation terms and methods have been used while referring to similar theoretical constructs. These findings highlight a gap between the clinical importance of PS and its assessment. Studies are needed to share terms and tools among clinical centers and clarify the position of PS in the TLE phenotype.
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Affiliation(s)
- Rosalba Ferrario
- Department of Diagnostics and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milano, Italy
| | - Anna Rita Giovagnoli
- Department of Diagnostics and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milano, Italy.
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Zhu Q, Mishra A, Park JS, Liu D, Le DT, Gonzalez SZ, Anderson-Crannage M, Park JM, Park GH, Tarbay L, Daneshvar K, Brandenburg M, Signoretti C, Zinski A, Gardner EJ, Zheng KL, Abani CP, Hu C, Beaudreault CP, Zhang XL, Stanton PK, Cho JH, Velíšek L, Velíšková J, Javed S, Leonard CS, Kim HY, Chung S. Human cortical interneurons optimized for grafting specifically integrate, abort seizures, and display prolonged efficacy without over-inhibition. Neuron 2023; 111:807-823.e7. [PMID: 36626901 PMCID: PMC10023356 DOI: 10.1016/j.neuron.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/11/2022] [Accepted: 12/08/2022] [Indexed: 01/11/2023]
Abstract
Previously, we demonstrated the efficacy of human pluripotent stem cell (hPSC)-derived GABAergic cortical interneuron (cIN) grafts in ameliorating seizures. However, a safe and reliable clinical translation requires a mechanistic understanding of graft function, as well as the assurance of long-term efficacy and safety. By employing hPSC-derived chemically matured migratory cINs in two models of epilepsy, we demonstrate lasting efficacy in treating seizures and comorbid deficits, as well as safety without uncontrolled growth. Host inhibition does not increase with increasing grafted cIN densities, assuring their safety without the risk of over-inhibition. Furthermore, their closed-loop optogenetic activation aborted seizure activity, revealing mechanisms of graft-mediated seizure control and allowing graft modulation for optimal translation. Monosynaptic tracing shows their extensive and specific synaptic connections with host neurons, resembling developmental connection specificity. These results offer confidence in stem cell-based therapy for epilepsy as a safe and reliable treatment for patients suffering from intractable epilepsy.
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Affiliation(s)
- Qian Zhu
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Akanksha Mishra
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Joy S Park
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Dongxin Liu
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Derek T Le
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Sasha Z Gonzalez
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | | | - James M Park
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Gun-Hoo Park
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Laura Tarbay
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Kamron Daneshvar
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Matthew Brandenburg
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Christina Signoretti
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Amy Zinski
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Edward-James Gardner
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Kelvin L Zheng
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Chiderah P Abani
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Carla Hu
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Cameron P Beaudreault
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Xiao-Lei Zhang
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Patric K Stanton
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA
| | - Jun-Hyeong Cho
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, Riverside, CA, USA
| | - Libor Velíšek
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA; Department of Neurology, New York Medical College, Valhalla, Mount Pleasant, NY 01595, USA; Department of Pediatrics, New York Medical College, Valhalla, Mount Pleasant, NY 01595, USA
| | - Jana Velíšková
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA; Department of Neurology, New York Medical College, Valhalla, Mount Pleasant, NY 01595, USA; Department of Obstetrics & Gynecology New York Medical College, Valhalla, Mount Pleasant, NY 01595, USA
| | - Saqlain Javed
- Department of Physiology, New York Medical College, Valhalla, Mount Pleasant, NY 01595, USA
| | - Christopher S Leonard
- Department of Physiology, New York Medical College, Valhalla, Mount Pleasant, NY 01595, USA
| | - Hae-Young Kim
- Department of Public Health, New York Medical College, Valhalla, Mount Pleasant, NY, USA
| | - Sangmi Chung
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 01595, USA.
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Social Cognition in Temporal and Frontal Lobe Epilepsy: Systematic Review, Meta-analysis, and Clinical Recommendations. J Int Neuropsychol Soc 2023; 29:205-229. [PMID: 35249578 DOI: 10.1017/s1355617722000066] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Despite the importance of social cognitive functions to mental health and social adjustment, examination of these functions is absent in routine assessment of epilepsy patients. Thus, this review aims to provide a comprehensive overview of the literature on four major aspects of social cognition among temporal and frontal lobe epilepsy, which is a critical step toward designing new interventions. METHOD Papers from 1990 to 2021 were reviewed and examined for inclusion in this study. After the deduplication process, a systematic review and meta-analysis of 44 and 40 articles, respectively, involving 113 people with frontal lobe epilepsy and 1482 people with temporal lobe epilepsy were conducted. RESULTS Our results indicated that while patients with frontal or temporal lobe epilepsy have difficulties in all aspects of social cognition relative to nonclinical controls, the effect sizes were larger for theory of mind (g = .95), than for emotion recognition (g = .69) among temporal lobe epilepsy group. The frontal lobe epilepsy group exhibited significantly greater impairment in emotion recognition compared to temporal lobe. Additionally, people with right temporal lobe epilepsy (g = 1.10) performed more poorly than those with a left-sided (g = .90) seizure focus, specifically in the theory of mind domain. CONCLUSIONS These data point to a potentially important difference in the severity of deficits within the emotion recognition and theory of mind abilities depending on the laterlization of seizure side. We also suggest a guide for the assessment of impairments in social cognition that can be integrated into multidisciplinary clinical evaluation for people with epilepsy.
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Hadad S, Ibrahim HK, Desoky T, Suleiman SM, Sayed TA. The ability of executive functions to predict deterioration in social abstraction in adolescents with idiopathic generalized epilepsy. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00223-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Epilepsy is a prevalent disease worldwide. Executive functions and social cognition are essential in daily living functioning, academic performance, and social adjustment. This study attempts to investigate the executive functions and ability to abstract social concepts in adolescents who have idiopathic generalized epilepsy and assess if the deterioration in executive functions can predict deterioration in the ability to abstract social concepts. Sixty adolescents with idiopathic generalized epilepsy aged between 12 and 19 collected from the neurology outpatient clinic at Sohag University Hospital in Upper Egypt were compared with 60 age- and sex-matched healthy adolescents regarding performance on executive function tests and ability to abstract social concepts tests. We used the Tower test to assess planning, the design fluency test to assess cognitive flexibility, the verbal fluency test to assess verbal fluency, and the Stroop test (overlapping between colour and word test) to assess inhibition and ability to abstract the social concepts test, which is composed of verbal part and performance part.
Results
Adolescents who have idiopathic generalized epilepsy have worse executive function impairment in all executive functions than control adolescents. Adolescents with idiopathic epilepsy have significantly more impairment in the ability to abstract social concepts (verbal and performance) compared to control adolescents. There is a significant correlation between executive functions and the ability to abstract social concepts (verbal and performance) in epileptic and control adolescents. Impairment in some executive functions can predict impairment in the ability to abstract social concepts (verbal and performance) in epileptic and control adolescents. Executive function impairment is correlated with the duration of illness, frequency of seizures per year, time since last epileptic fit, and presence of interictal epileptic discharge in EEG in the patient group.
Conclusions
Executive functions and the ability to abstract social concepts are significantly impaired in adolescents who have idiopathic generalized epilepsy. Impairment in executive functions can predict impairment in the ability to abstract social concepts. There is a need to screen executive functions and social abilities of adolescents with epilepsy and programmes to enhance these abilities.
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11
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Eicher M, Jokeit H. Toward social neuropsychology of epilepsy: a meta-analysis on social cognition in epilepsy phenotypes and a critical narrative review on assessment methods. ACTA EPILEPTOLOGICA 2022. [DOI: 10.1186/s42494-022-00093-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The aim of this review is to (a) characterize social cognition impairments in the domains of emotion recognition (ER) and theory of mind (ToM) in patients with epilepsy and (b) to review assessment tools with a focus on their validity and usability in clinical practice.
Methods
An electronic search for clinical studies investigating social cognition in epilepsy populations vs healthy control subjects (HC) yielded 53 studies for the meta-analysis and descriptive review.
Results
Results suggest that (1) social cognition is significantly impaired in patients with temporal lobe epilepsy (TLE), frontal lobe epilepsy (FLE) and patients with epilepsy not originating within the temporal or frontal lobes including idiopathic generalized epilepsies (eTLE/eFLE); (2) there is no significant difference between eTLE/eFLE and TLE regarding ER, while TLE and FLE patients perform worse than those with eTLE/eFLE, without significant differences between FLE and TLE regarding ToM ability. A descriptive analysis of the most commonly used assessment tools and stimulus material in this field revealed a lack of ecological validity, usability, and economic viability for everyday clinical practice.
Conclusions
Our meta-analysis shows that patients with epilepsy are at a significantly increased risk of deficits in social cognition. However, the underlying multifactorial mechanisms remain unclear. Future research should therefore specifically address the impairment of processing and methodological problems of testing.
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12
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Facial emotion perception and recognition deficits in acute ischemic stroke. J Clin Neurosci 2022; 106:219-225. [DOI: 10.1016/j.jocn.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/29/2022] [Accepted: 10/01/2022] [Indexed: 11/11/2022]
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13
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Pavlova MA, Sokolov AA. Reading language of the eyes. Neurosci Biobehav Rev 2022; 140:104755. [PMID: 35760388 DOI: 10.1016/j.neubiorev.2022.104755] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/20/2022] [Accepted: 06/23/2022] [Indexed: 12/19/2022]
Abstract
The need for assessment of social skills in clinical and neurotypical populations has led to the widespread, and still increasing use of the 'Reading the Mind in the Eyes Test' (RMET) developed more than two decades ago by Simon Baron-Cohen and colleagues for evaluation of social cognition in autism. By analyzing most recent clinical and brain imaging data, we illuminate a set of factors decisive for using the RMET. Converging evidence indicates: (i) In neurotypical individuals, RMET scores are tightly correlated with other social skills (empathy, emotional intelligence, and body language reading); (ii) The RMET assesses recognition of facial affect, but also heavily relies on receptive language skills, semantic knowledge, and memory; (iii) RMET performance is underwritten by the large-scale ensembles of neural networks well-outside the social brain; (iv) The RMET is limited in its capacity to differentiate between neuropsychiatric conditions as well as between stages and severity of a single disorder, though it reliably distinguishes individuals with altered social cognition or elevated pathological traits from neurotypical persons; (v) Merely gender (as a social construct) rather than neurobiological sex influences performance on the RMET; (vi) RMET scores do not substantially decline in healthy aging, and they are higher with higher education level, cognitive abilities, literacy, and mental well-being; (vii) Accuracy on the RMET, and engagement of the social brain, are greater when emotions are expressed and recognized by individuals with similar cultural/ethnic background. Further research is required to better inform usage of the RMET as a tool for swift and reliable examination of social cognition. In light of comparable visual input from the RMET images and faces covered by masks due to COVID-19 regulations, the analysis is of value for keeping efficient social interaction during the current pandemic, in particular, in professional settings related to social communication.
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Affiliation(s)
- Marina A Pavlova
- Department of Psychiatry and Psychotherapy, Tübingen Center for Menthal Health (TüCMH), Medical School and University Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany.
| | - Arseny A Sokolov
- Service de neuropsychologie et de neuroréhabilitation, Département des neurosciences cliniques, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
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14
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Morningstar M, Grannis C, Mattson WI, Nelson EE. Functional patterns of neural activation during vocal emotion recognition in youth with and without refractory epilepsy. Neuroimage Clin 2022; 34:102966. [PMID: 35182929 PMCID: PMC8859003 DOI: 10.1016/j.nicl.2022.102966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/12/2022] [Accepted: 02/11/2022] [Indexed: 01/10/2023]
Abstract
Epilepsy has been associated with deficits in the social cognitive ability to decode others' nonverbal cues to infer their emotional intent (emotion recognition). Studies have begun to identify potential neural correlates of these deficits, but have focused primarily on one type of nonverbal cue (facial expressions) to the detriment of other crucial social signals that inform the tenor of social interactions (e.g., tone of voice). Less is known about how individuals with epilepsy process these forms of social stimuli, with a particular gap in knowledge about representation of vocal cues in the developing brain. The current study compared vocal emotion recognition skills and functional patterns of neural activation to emotional voices in youth with and without refractory focal epilepsy. We made novel use of inter-subject pattern analysis to determine brain areas in which activation to emotional voices was predictive of epilepsy status. Results indicated that youth with epilepsy were comparatively less able to infer emotional intent in vocal expressions than their typically developing peers. Activation to vocal emotional expressions in regions of the mentalizing and/or default mode network (e.g., right temporo-parietal junction, right hippocampus, right medial prefrontal cortex, among others) differentiated youth with and without epilepsy. These results are consistent with emerging evidence that pediatric epilepsy is associated with altered function in neural networks subserving social cognitive abilities. Our results contribute to ongoing efforts to understand the neural markers of social cognitive deficits in pediatric epilepsy, in order to better tailor and funnel interventions to this group of youth at risk for poor social outcomes.
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Affiliation(s)
- M Morningstar
- Department of Psychology, Queen's University, Kingston, ON, Canada; Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, United States.
| | - C Grannis
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States
| | - W I Mattson
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States
| | - E E Nelson
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, United States
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15
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Operto FF, Scuoppo C, Padovano C, Vivenzio V, Belfiore G, de Simone V, Pistola I, Rinaldi R, Diaspro G, Mazza R, Pastorino GMG. Migraine and epilepsy: Social cognition skills in pediatric population. Eur J Paediatr Neurol 2022; 37:68-74. [PMID: 35134658 DOI: 10.1016/j.ejpn.2022.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/30/2021] [Accepted: 01/18/2022] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The goal of the present study was to comparatively analyze Social Cognition skills in a pediatric population diagnosed with Migraine or Epilepsy, compared to Typically Developing children (TD). The secondary aim was to relate Social Cognition skills with other migraine- or epilepsy-related variables and with executive and cognitive functions. MATERIALS AND METHODS In our cross-sectional observational study 119 children and adolescents (aged 6-16) with Migraine or Focal Epilepsy and 61 TD peers were recruited. Both the clinical groups and TD peers performed a neuropsychological evaluation through standardized test to assess Theory of Mind (TM), Emotion Recognition through facial expression (ER), executive function and non-verbal cognitive abilities. RESULTS Children and adolescents with Migraine or Focal Epilepsy showed comparable scores between each other, however their scores were significantly lower than their TD peers, in both ER and TM. Social Cognition skills were significantly related to executive functions. CONCLUSION Our study suggests that some chronic neurological conditions in childhood, such as Migraine and Epilepsy, may be associated with difficulties in Social Cognition skills, and that these difficulties may be related to a deficit in executive functions. The relationship between these two higher cognitive abilities should be further explored in future studies. Our results also suggest the importance of monitoring cognitive abilities in pediatric patients with Migraine or Epilepsy, in order to detect early impairment and ensure the necessary support.
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Affiliation(s)
- Francesca Felicia Operto
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy.
| | - Chiara Scuoppo
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Chiara Padovano
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Valentina Vivenzio
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Gilda Belfiore
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Valeria de Simone
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Ilaria Pistola
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Rosetta Rinaldi
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Giuseppe Diaspro
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Roberta Mazza
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
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16
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Qi L, Zhao J, Zhao P, Zhang H, Zhong J, Pan P, Wang G, Yi Z, Xie L. Theory of mind and facial emotion recognition in adults with temporal lobe epilepsy: A meta-analysis. Front Psychiatry 2022; 13:976439. [PMID: 36276336 PMCID: PMC9582667 DOI: 10.3389/fpsyt.2022.976439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/16/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Mounting studies have investigated impairments in social cognitive domains (including theory of mind [ToM] and facial emotion recognition [FER] in adult patients with temporal lobe epilepsy (TLE). However, to date, inconsistent findings remain. METHODS A search of PubMed, Web of Science, and Embase databases was conducted until December 2021. Hedges g effect sizes were computed with a random-effects model. Meta-regressions were used to assess the potential confounding factors of between-study variability in effect sizes. RESULTS The meta-analysis included 41 studies, with a combined sample of 1,749 adult patients with TLE and 1,324 healthy controls (HCs). Relative to HCs, adult patients with TLE showed large impairments in ToM (g = -0.92) and cognitive ToM (g = -0.92), followed by medium impairments in affective ToM (g = -0.79) and FER (g = -0.77). Besides, no (statistically) significant differences were observed between the magnitude of social cognition impairment in adult with TLE who underwent and those who did not undergo epilepsy surgery. Meta-regressions exhibited that greater severity of executive functioning was associated with more severe ToM defects, and older age was associated with more severe FER defects. CONCLUSIONS Results of this meta-analysis suggest that adult patients with TLE show differential impairments in the core aspects of social cognitive domains (including ToM and FER), which may help in planning individualized treatment with appropriate cognitive and behavioral interventions.
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Affiliation(s)
- Liang Qi
- Department of Neurosurgery, The Affiliated Huai'an Hospital of Xuzhou Medical University, The Second People's Hospital of Huai'an, Huaian, China
| | - Jing Zhao
- Department of Central Laboratory, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China
| | - PanWen Zhao
- Department of Central Laboratory, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China
| | - Hui Zhang
- Department of Central Laboratory, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China
| | - JianGuo Zhong
- Department of Neurology, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China
| | - PingLei Pan
- Department of Central Laboratory, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China.,Department of Neurology, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China
| | - GenDi Wang
- Department of Neurology, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China
| | - ZhongQuan Yi
- Department of Central Laboratory, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China
| | - LiLi Xie
- Department of Neurology, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China
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Sun Y, Zhao J, Zhao P, Zhang H, Zhong J, Pan P, Wang G, Yi Z, Xie L. Social cognition in children and adolescents with epilepsy: A meta-analysis. Front Psychiatry 2022; 13:983565. [PMID: 36186867 PMCID: PMC9520261 DOI: 10.3389/fpsyt.2022.983565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022] Open
Abstract
Many studies have investigated impairments in two key domains of social cognition (theory of mind [ToM] and facial emotion recognition [FER]) in children and adolescents with epilepsy. However, inconsistent conclusions were found. Our objective was to characterize social cognition performance of children and adolescents with epilepsy. A literature search was conducted using Web of Science, PubMed, and Embase databases. The article retrieval, screening, quality assessment (Newcastle-Ottawa-Scale), and data extraction were performed independently by two investigators. A random-effects model was used to examine estimates. The meta-analysis included 19 studies, with a combined sample of 623 children and adolescents with epilepsy (mean [SD] age, 12.13 [2.62] years; 46.1% female) and 677 healthy controls [HCs]) (mean [SD] age, 11.48 [2.71] years; 50.7% female). The results revealed that relative to HCs, children and adolescents with epilepsy exhibited deficits in ToM (g = -1.08, 95% CI [-1.38, -0.78], p < 0.001, the number of studies [k] = 13), FER (g = -0.98, 95% CI [-1.33, -0.64], p < 0.001, k = 12), and ToM subcomponents (cognitive ToM: g = -1.04, 95% CI [-1.35, -0.72], p < 0.001, k = 12] and affective ToM: g = -0.73, 95% CI [-1.12, -0.34], p < 0.001, k = 8). In addition, there were no statistically significant differences in social cognition deficits between children and adolescents with focal epilepsy and generalized epilepsy. Meta-regressions confirmed the robustness of the results. These quantitative results further deepen our understanding of the two core domains of social cognition in children and adolescents with epilepsy and may assist in the development of cognitive interventions for this patient population. Systematic review registration: https://inplasy.com/inplasy-2022-3-0011/, identifier INPLASY202230011.
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Affiliation(s)
- Yang Sun
- Department of Clinical Laboratory, The Fourth Affiliated Hospital of Nantong University, The First People's Hospital of Yancheng, Yancheng, Jiangsu, China
| | - Jing Zhao
- Department of Central Laboratory, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, Jiangsu, China
| | - PanWen Zhao
- Department of Central Laboratory, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, Jiangsu, China
| | - Hui Zhang
- Department of Central Laboratory, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, Jiangsu, China
| | - JianGuo Zhong
- Department of Neurology, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, Jiangsu, China
| | - PingLei Pan
- Department of Neurology, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, Jiangsu, China.,Department of Central Laboratory, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, Jiangsu, China
| | - GenDi Wang
- Department of Neurology, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, Jiangsu, China
| | - ZhongQuan Yi
- Department of Central Laboratory, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, Jiangsu, China
| | - LiLi Xie
- Department of Neurology, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, Jiangsu, China
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18
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Metternich B, Wagner K, Geiger MJ, Schulze-Bonhage A, Hirsch M, Schönenberg M. Affective Empathy, Theory of Mind and Social Functioning in Patients With Focal Epilepsy. Front Psychiatry 2022; 13:887411. [PMID: 35898635 PMCID: PMC9309689 DOI: 10.3389/fpsyt.2022.887411] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Social cognition comprises basic and more complex functions, such as theory of mind (ToM) and affective empathy. Although everyday social interactions may be impaired if such higher-order social cognitive functions are compromised, associations between social functioning and social cognition in people with focal epilepsy (PWFE) are still poorly understood. We used a novel, naturalistic approach to investigate ToM in PWFE by applying the Movie for the Assessment of Social Cognition (MASC). Furthermore, we studied affective empathy, the relationship between social cognitive parameters and measures of social functioning, as well as between epilepsy focus and ToM. METHODS Thirty patients with either temporal (TLE) or frontal lobe epilepsy (FLE) were compared to 29 healthy control subjects (HC). In addition to the MASC, we applied questionnaire measures assessing empathy and everyday social functioning. RESULTS PWFE, especially with FLE, performed significantly worse than HC on the MASC. Perceived social integration and social activities, but not affective empathy, were reduced in PWFE. Regression analyses revealed associations between perceived social integration, clinical group status, affective empathy and ToM. CONCLUSION PWFE displayed ToM deficits during a naturalistic task, whereas affective empathy was unimpaired. FLE may be associated with especially compromised ToM performance. Social cognition and social functioning appear to be interrelated in PWFE, whose self-perceived levels of social integration and social activities are lower than those of HC. More research into the association between social cognition and social functioning in PWFE is needed, in order to develop tailored intervention programs for these patients.
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Affiliation(s)
- Birgitta Metternich
- Department of Neurosurgery, Epilepsy Center, Medical Center - University of Freiburg, Freiburg, Germany
| | - Kathrin Wagner
- Department of Neurosurgery, Epilepsy Center, Medical Center - University of Freiburg, Freiburg, Germany
| | - Maximilian J Geiger
- Department of Neurosurgery, Epilepsy Center, Medical Center - University of Freiburg, Freiburg, Germany
| | - Andreas Schulze-Bonhage
- Department of Neurosurgery, Epilepsy Center, Medical Center - University of Freiburg, Freiburg, Germany
| | - Martin Hirsch
- Department of Neurosurgery, Epilepsy Center, Medical Center - University of Freiburg, Freiburg, Germany
| | - Michael Schönenberg
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
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19
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Lin YH, Hsin YL, Li RH, Liu CK, Wang RY, Wang WH. The effect of facial expression intensity on emotion recognition and psychosocial performance in patients with frontal or temporal lobe epilepsy. Epilepsy Behav 2022; 126:108462. [PMID: 34896784 DOI: 10.1016/j.yebeh.2021.108462] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/02/2021] [Accepted: 11/24/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE No studies have examined the relationship between the intensity of facial emotion expression and theory of mind (ToM) ability in people with epilepsy. This study aimed to explore facial emotion recognition in a group of patients with frontal (FLE) or temporal lobe epilepsy (TLE) and its relationship with the intensities of perceived facial emotion expressions, ToM, and social functioning. METHODS Twenty-six patients with FLE or TLE and 30 matched controls were included in the study. All participants completed the facial emotion recognition test, Faux Pas Recognition (FPR) test measuring advanced ToM, Symptom Checklist-90-Revised, Social and Occupational Functioning Scale for Epilepsy (SOFSE), and background neuropsychological tests. RESULTS The patient group was significantly worse than the control group in recognizing facial expressions of negative emotions, particularly for medium-intensity facial expression of fear. There was no significant difference between the groups in recognizing high-intensity fear facial expressions. The scores of FPR (overall and affective ToMs) in the patient group were significantly lower than those in the control group. Additionally, the facial emotion recognition was significantly associated with the total score of FPR, and the FPR total score remarkably correlated with the Communication subscale score of the SOFSE. CONCLUSIONS Patients with FLE or TLE had impaired ability to recognize medium-intensity facial expressions of fear. Moreover, patients' ToM deficit significantly correlated not only with their emotion recognition problem but also with their social-communicative competence. Nevertheless, we also found that increasing the intensity of expression can improve the accuracy of emotion recognition in patients with epilepsy. These findings may provide considerations for further longitudinal studies and interventions on the social difficulties of people with epilepsy.
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Affiliation(s)
- Yen-Hsi Lin
- Department of Psychology, Chung Shan Medical University, Taichung, Taiwan
| | - Yue-Loong Hsin
- Department of Neurology, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ren-Hau Li
- Department of Psychology, Chung Shan Medical University, Taichung, Taiwan
| | - Chun-Kai Liu
- Department of Psychology, Chung Shan Medical University, Taichung, Taiwan
| | - Ren-You Wang
- Department of Psychology, Chung Shan Medical University, Taichung, Taiwan
| | - Wei-Han Wang
- Department of Psychology, Kaohsiung Medical University and Department of Medical Research, Kaohsiung Medical University Hospital, Taiwan.
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20
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Kozunova G, Novikov A, Stroganova T, Chernyshev B. Intolerance of Uncertainty and Challenges in Decision-making in Adults with High-Functioning Autism. КЛИНИЧЕСКАЯ И СПЕЦИАЛЬНАЯ ПСИХОЛОГИЯ 2022. [DOI: 10.17759/cpse.2022110402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
<p style="text-align: justify;">Individuals with high-functioning autism have difficulties in decision-making in face of incomplete or ambiguous information, particularly in the context of social interaction. Tasks demanding an immediate response or deviation from the usual behavior make them feel excessive anxiety which restricts their social and professional activity. Attempts to camouflage their conservatism to others are one of the risk factors for comorbid depression. Therefore, they avoid new and non-routine situations, thus restricting their own social activity and professional development. On the other hand, insisting on sameness and clarity may give individuals with autism an advantage in long-lasting monotonous tasks. The aim of this review is to consider these symptoms from the perspective of predictive coding. A range of experimental studies has shown that most of the subjects with autism have difficulty in predicting the outcomes based on the cumulative history of interacting with the environment, as well as updating expectations as new evidence becomes available. These peculiarities of the analysis and pragmatic weighting of information may cause the trait intolerance of uncertainty and novelty avoidance of most people with autism.</p>
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21
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Wang H, Zhao P, Zhao J, Zhong J, Pan P, Wang G, Yi Z. Theory of Mind and Empathy in Adults With Epilepsy: A Meta-Analysis. Front Psychiatry 2022; 13:877957. [PMID: 35573343 PMCID: PMC9093035 DOI: 10.3389/fpsyt.2022.877957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/04/2022] [Indexed: 12/18/2022] Open
Abstract
Mounting evidence suggests that social cognitive abilities [including theory of mind (ToM) and empathy] are impaired in adult patients with epilepsy. Although the deficits in overall ToM in epilepsy have been documented well, the effects of epilepsy on empathic ability and specific subcomponents of ToM remain unclear. The primary aim of this study was to provide the first meta-analytic integration of ToM and empathy in adult patients with epilepsy, and to decompose these constructs to clearly differentiate their distinct (cognitive ToM and affective empathy) and overlapping (affective ToM/cognitive empathy) components. This meta-analysis included 28 studies. Adult patients with temporal lobe epilepsy (TLE) and frontal lobe epilepsy (FLE) showed impairments in cognitive ToM and affective ToM/cognitive empathy compared to the healthy controls (HCs); no group differences were identified for affective empathy. Besides, cognitive ToM was impaired in adult patients with idiopathic generalized epilepsy (IGE) and focal seizures (caused by epileptogenic foci) outside the temporal and frontal lobes (extra-TLE/FLE) and no group differences were evident for affective ToM/cognitive empathy compared to the HCs. Moreover, relative to the HCs, no group differences were identified for affective empathy in adult patients with IGE. Additionally, no (statistically) significant difference was observed between the magnitude of ToM/empathy impairment in adult patients who underwent and those who did not undergo epilepsy surgery. These quantitative findings suggest differential impairment of the core aspects of social cognitive processing in adult patients with epilepsy, which may contribute to the development of structured cognitive interventions (i.e., social cognitive training) for adult patients with epilepsy.
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Affiliation(s)
- HongZhou Wang
- Department of Neurology, Anting Hospital, Shanghai, China
| | - PanWen Zhao
- Department of Central Laboratory, Yancheng Third People's Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
| | - Jing Zhao
- Department of Central Laboratory, Yancheng Third People's Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
| | - JianGuo Zhong
- Department of Neurology, Yancheng Third People's Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
| | - PingLei Pan
- Department of Central Laboratory, Yancheng Third People's Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China.,Department of Neurology, Yancheng Third People's Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
| | - GenDi Wang
- Department of Neurology, Yancheng Third People's Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
| | - ZhongQuan Yi
- Department of Central Laboratory, Yancheng Third People's Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
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22
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Mikula B, Lencsés A, Borbély C, Demeter G. Emotion recognition and theory of mind after temporal lobe epilepsy surgery: A systematic review. Seizure 2021; 93:63-74. [PMID: 34710833 DOI: 10.1016/j.seizure.2021.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 09/13/2021] [Accepted: 10/04/2021] [Indexed: 01/14/2023] Open
Abstract
In order to navigate in our complex social world successfully, it is crucial to maintain and practice cognitive skills that are dedicated to adaptive social functioning. Emerging evidence suggests that besides deficits in declarative memory, executive functions, and language, impairments in social cognition (SC, e.g., emotion recognition, theory of mind) are also present in temporal lobe epilepsy (TLE). The organic and psycho-social consequences of epilepsy surgery might have additional implications regarding this deficit. Here we qualitatively synthesize longitudinal and cross-sectional findings on SC after TLE surgery. A literature search using PubMed and Scopus identified 275 potential articles. Studies were eligible if they (1) included patients with a diagnosis of TLE, (2) included a healthy comparison group, (3) reported original research, (4) were published in peer-reviewed journals and in English language, (5) reported the intervention of epilepsy surgery. Articles that (1) were case studies, (2) did not focus on SC abilities, (3) used interviews or self-report questionnaires to examine SC functions were excluded. A total of 16 original studies assessing emotion recognition (ER) and/or theory of mind (ToM) matched our criteria. The literature suggests that neither ER nor ToM abilities change after surgery: post-surgery patients show similar impairment patterns to pre-surgery patients. Nevertheless, individual improvement or decline could be masked by group comparisons and results should be considered in light of methodological heterogeneity among studies.
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Affiliation(s)
- Bernadett Mikula
- Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary.
| | - Anita Lencsés
- Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary
| | - Csaba Borbély
- National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary
| | - Gyula Demeter
- Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary; Rehabilitation Department of Brain Injuries, National Institute of Medical Rehabilitation, Budapest, Hungary
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23
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Gürsoy SC, Ergün S, Midi İ, Topçuoğlu V. Theory of mind and its relationship with alexithymia and quality of life in patients with psychogenic nonepileptic seizures: Comparisons with generalised epilepsy and healthy controls. Seizure 2021; 91:251-257. [PMID: 34246053 DOI: 10.1016/j.seizure.2021.06.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Psychogenic nonepileptic seizures (PNES) are associated with high alexithymia, social cognition problems and low quality of life (QoL). Theory of Mind (ToM) has been studied in several conditions as a significant predictor of QoL. We aimed to assess the relationship between ToM abilities, alexithymia and subjective QoL in PNES patients and compare with generalised epilepsy (ES) patients and healthy controls. METHOD Patients with PNES (n = 28), ES (n = 28) and healthy volunteers (n = 28) were evaluated for alexithymia and quality of life (QoL) with Toronto Alexithymia Scale-20 (TAS-20) and Short Form-36 (SF-36). Reading the Mind in the Eyes test was used for assessment of affective ToM and Hinting Task and Strange Stories tests for cognitive ToM abilities. RESULTS Analyses revealed lower SF-36 scores and poorer ToM performance in the PNES group compared to healthy group and poorer cognitive ToM performance than ES group. Cognitive ToM performance was inversely correlated with TAS-20 "difficulty identifying feelings" subscale and "physical functioning" subscale of SF-36 in the PNES group. CONCLUSION These results are consistent with previous research on PNES and other somatoform disorders and suggest that PNES is associated with impaired ToM task performance. ToM task performance might be related to specific aspects of alexithymia and QoL.
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Affiliation(s)
- Süha Can Gürsoy
- Marmara University Pendik Education and Research Hospital, Department of Psychiatry, Fevzi Çakmak, Muhsin Yazıcıoğlu Cd No:10, 34899 Pendik/İstanbul, Turkey.
| | - Serhat Ergün
- Marmara University Pendik Education and Research Hospital, Department of Psychiatry, Fevzi Çakmak, Muhsin Yazıcıoğlu Cd No:10, 34899 Pendik/İstanbul, Turkey
| | - İpek Midi
- Marmara University Pendik Education and Research Hospital, Deparment of Neurology, Fevzi Çakmak, Muhsin Yazıcıoğlu Cd No:10, 34899 Pendik/İstanbul, Turkey
| | - Volkan Topçuoğlu
- Marmara University Pendik Education and Research Hospital, Department of Psychiatry, Fevzi Çakmak, Muhsin Yazıcıoğlu Cd No:10, 34899 Pendik/İstanbul, Turkey
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24
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Morningstar M, French RC, Mattson WI, Englot DJ, Nelson EE. Social brain networks: Resting-state and task-based connectivity in youth with and without epilepsy. Neuropsychologia 2021; 157:107882. [PMID: 33964273 DOI: 10.1016/j.neuropsychologia.2021.107882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 03/22/2021] [Accepted: 04/30/2021] [Indexed: 12/19/2022]
Abstract
Individuals with epilepsy often experience social difficulties and deficits in social cognition. It remains unknown how disruptions to neural networks underlying such skills may contribute to this clinical phenotype. The current study compared the organization of relevant brain circuits-the "mentalizing network" and a salience-related network centered on the amygdala-in youth with and without epilepsy. Functional connectivity between the nodes of these networks was assessed, both at rest and during engagement in a social cognitive task (facial emotion recognition), using functional magnetic resonance imaging. There were no group differences in resting-state connectivity within either neural network. In contrast, youth with epilepsy showed comparatively lower connectivity between the left posterior superior temporal sulcus and the medial prefrontal cortex-but greater connectivity within the left temporal lobe-when viewing faces in the task. These findings suggest that the organization of a mentalizing network underpinning social cognition may be disrupted in youth with epilepsy, though differences in connectivity within this circuit may shift depending on task demands. Our results highlight the importance of considering functional task-based engagement of neural systems in characterizations of network dysfunction in epilepsy.
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Affiliation(s)
- M Morningstar
- Department of Psychology, Queen's University, Kingston, ON, Canada; Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
| | - R C French
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - W I Mattson
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - D J Englot
- Department of Neurological Surgery, Radiology and Radiological Sciences, and Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - E E Nelson
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
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25
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Koo SJ, Kim YJ, Han JH, Seo E, Park HY, Bang M, Park JY, Lee E, An SK. "Reading the Mind in the Eyes Test": Translated and Korean Versions. Psychiatry Investig 2021; 18:295-303. [PMID: 33849244 PMCID: PMC8103020 DOI: 10.30773/pi.2020.0289] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 12/28/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The Reading the Mind in the Eyes Test (RMET) was developed by using Caucasian eyes, which may not be appropriate to be used in Korean. The aims of the present study were 1) to develop a Korean version of the RMET (K-RMET) by using Korean eye stimuli and 2) to examine the psychometric properties of the Korean-translated version of the RMET and the K-RMET. METHODS Thirty-six photographs of Korean eyes were selected. A total of 196 (101 females) healthy subjects were asked to take the Korean-translated version of the RMET and K-RMET. To assess internal consistency reliability, Cronbach's alpha coefficients were computed, and test-retest reliability was assessed by the intraclass correlation coefficient (ICC) and Bland-Altman plots. Confirmatory factor analysis (CFA) and item analysis were also conducted. RESULTS Internal consistency, measured by Cronbach's alpha, was 0.542 for the Korean-translated version of the RMET, and 0.540 for the K-RMET. Test-retest reliability (n=25), measured by the ICC, was 0.787 for the Korean-translated version of the RMET, and 0.758 for the K-RMET. In CFA, the assumed single and 3-factor model fit indices were not good in the both types of RMETs. There was difficulty in discrimination in nine items of the Korean-translated version of the RMET and 10 items of the K-RMET. CONCLUSION The psychometric properties of both the Korean-translated version of the RMET and the K-RMET are acceptable. Both tests are applicable to the clinical population, as well as the general population in Korea.
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Affiliation(s)
- Se Jun Koo
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Graduate Program in Cognitive Science, Yonsei University, Seoul, Republic of Korea
| | - Ye Jin Kim
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung Hwa Han
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eunchong Seo
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Hye Yoon Park
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Minji Bang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Jin Young Park
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yonsei University College of Medicine, Yongin Severance Hospital, Yongin, Republic of Korea
| | - Eun Lee
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Suk Kyoon An
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Graduate Program in Cognitive Science, Yonsei University, Seoul, Republic of Korea.,Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
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26
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van den Berg L, de Weerd AW, Reuvekamp MHF, van der Meere JJ. Associating executive dysfunction with behavioral and socioemotional problems in children with epilepsy. A systematic review. Child Neuropsychol 2021; 27:661-708. [PMID: 33726631 DOI: 10.1080/09297049.2021.1888906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
As children with epilepsy may have a number of learning and behavioral problems, it is important that insight into the underlying neurocognitive differences in these children, which may underlie these areas of challenge is gained. Executive function (EF) problems particularly are associated with specific learning abilities as well as behavioral problems. We aim to review systematically the current status of empirical studies on the association between EF problems and behavior and socioemotional problems in children with epilepsy. After search, 26 empirical studies were identified, most of them of moderate quality. Overall, attention problems were the most reported cognitive deficit in test assessment and the most reported problem by parents. In 54% of the studies, children with epilepsy scored below average compared to controls/normative samples on different aspects of EF. Most studies reported behavior problems, which ranged from mild to severe. Forty-two percent of the studies specifically reported relationships between EF deficits and behavioral problems. In the remaining studies, below average neuropsychological functioning seemed to be accompanied by above average reported behavioral problems. The association was most pronounced for cognitive control and attention in relation to externalizing behavior problems. This cognitive control is also associated with social functioning. Relevant epilepsy variables in this relationship were early age at onset and high seizure frequency.Future research should distinguish specific aspects of EF and take age into account, as this provides more insight on the association between EF and behavior in pediatric epilepsy, which makes it possible to develop appropriate and early intervention.
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Affiliation(s)
- Lydia van den Berg
- Psychology Department, Stichting Epilepsie Instellingen Nederland, Zwolle, Netherlands.,RijksUniversiteitGroningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Groningen, Netherlands
| | - Al W de Weerd
- Psychology Department, Stichting Epilepsie Instellingen Nederland, Zwolle, Netherlands
| | - Marieke H F Reuvekamp
- Psychology Department, Stichting Epilepsie Instellingen Nederland, Zwolle, Netherlands
| | - Jaap J van der Meere
- RijksUniversiteitGroningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Groningen, Netherlands
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27
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Operto FF, Pastorino GMG, Mazza R, Di Bonaventura C, Marotta R, Pastorino N, Matricardi S, Verrotti A, Carotenuto M, Roccella M. Social cognition and executive functions in children and adolescents with focal epilepsy. Eur J Paediatr Neurol 2020; 28:167-175. [PMID: 32718867 DOI: 10.1016/j.ejpn.2020.06.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Deficits in facial emotion recognition and Theory of Mind are frequent in patients with epilepsy. Although this evidence, studies on pediatric age are few and the relation between these abilities and other cognitive domain remains to be better elucidated. The purpose of our study is to evaluate facial emotion recognition and Theory of Mind in children and adolescents with focal epilepsy, and correlate them with intelligence and executive functions. MATERIALS AND METHODS Our work is a cross-sectional observational study. Sixty-two children and adolescents aged between 7-16 years diagnosed by focal epilepsy and 32 sex/age-matched controls were recruited. All participants were administered a standardized battery tests to assess social cognition (NEPSY-II), executive functions (EpiTrack Junior) and cognitive non-verbal level (Raven Progressive Matrices). RESULTS Emotion recognition mean score was significantly lower in the epilepsy group than in the controls to Student's t-test (p<0.05). Epilepsy group showed an impairment in happiness, sadness, anger and fear recognition, compared to controls (p<0.05). Theory of Mind mean score was also significantly lower in epilepsy group than controls (p<0.05). Deficits in emotion recognition seemed to be related to low age at onset of epilepsy, long duration of disease, low executive functions and low non-verbal intelligence. Deficits in Theory of Mind seemed to be related to a high seizure frequency. CONCLUSIONS Our results suggest that children and adolescents with focal epilepsy had deficit in facial emotion recognition and Theory of Mind, compared to their peer. Both these difficulties seem to be related to some features of epilepsy itself. Our results also suggest that deficits in facial emotion recognition are potentially related to difficulties in executive functions and non-verbal intelligence. More studies are needed to confirm these hypotheses.
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Affiliation(s)
- Francesca Felicia Operto
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy.
| | - Grazia Maria Giovanna Pastorino
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy; Department of Mental Health, Physical and Preventive Medicine, Clinic of Child and Adolescent Neuropsychiatry, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Roberta Mazza
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Carlo Di Bonaventura
- Epilepsy Unit, Department of Neurosciences/Mental Health, "Sapienza" University, Rome, Italy
| | - Rosa Marotta
- Department of Health Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Nazareno Pastorino
- Department of Cultural Heritage Sciences, University of Salerno, Salerno, Italy
| | - Sara Matricardi
- Department of Pediatrics, University of Chieti, Chieti, Italy
| | - Alberto Verrotti
- Department of Pediatrics, University of L'Aquila, L'Aquila, Italy
| | - Marco Carotenuto
- Department of Mental Health, Physical and Preventive Medicine, Clinic of Child and Adolescent Neuropsychiatry, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Michele Roccella
- Department of Psychological, Pedagogical and Educational Sciences, University of Palermo, Palermo, Italy
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28
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Mirabel H, Guinet V, Voltzenlogel V, Pradier S, Hennion S. Social cognition in epilepsy: State of the art and perspectives. Rev Neurol (Paris) 2020; 176:468-479. [PMID: 32418700 DOI: 10.1016/j.neurol.2020.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The neuropsychology of epilepsy has been a major area of study for almost a century and cognitive impairments are an integral part of the new definition of epilepsy. Among such impairments, social cognition (SC) dysfunctions are of relatively recent interest. SC abilities refer to the body of knowledge and processes involved in establishing satisfying and appropriate social interactions. In particular, they allow the recognition of emotions in others, emotional experiences which are suitably adapted to social situations, and the ability to infer mental states in oneself and others. METHODS An overeview was conducted of the available data within the literature, with the objective of presenting the SC disorders associated with certain types of epilepsy and the possible risk factors already explored i.e., localisation of epileptic focus, age of onset/duration of the disease, and effects of treatments including surgery. Studies investigating the potential repercussions of these disorders on patients' daily life have also been included. RESULTS Social cognition disorders are an integral part of the cognitive disorders traditionally described in epilepsy. Indeed, a growing number of studies highlight the increased prevalence of SC disorders in various domains, and some patients appear to be more at risk than others. These disorders could be a major determining factor in the deterioration of patients' quality of life (QOL), particularly patients' support and social integration. This highlights the importance of assessing and managing these disorders in patients with epilepsy (PWE). Perspectives in the field of research and clinical practice are also evoked, such as exploring the links between disruptions in SC abilities and treatments, or developing specific tools for assessment and rehabilitation within the context of epilepsy.
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Affiliation(s)
- H Mirabel
- Neurology department, CHU de Toulouse, hôpital Pierre-Paul Riquet, Toulouse, France.
| | - V Guinet
- Department of functional neurology and epileptology, hospices civils de Lyon, Lyon, France
| | - V Voltzenlogel
- CERPPS, EA 7411, department of psychology, university of Toulouse, Toulouse, France
| | - S Pradier
- Functional explorations of the nervous system, clinical neurosciences center, university hospital center Pellegrin, Bordeaux, France
| | - S Hennion
- U1171 degenerative and vascular cognitive disorders, Inserm, epilepsy unit, reference center rare epilepsies, CHU Lille, university Lille, Lille, France
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29
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Lima EM, Rzezak P, Montenegro MA, Guerreiro MM, Valente KDR. Social cognition in childhood epilepsy with centrotemporal spikes. Seizure 2020; 78:102-108. [PMID: 32335335 DOI: 10.1016/j.seizure.2020.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/30/2020] [Accepted: 03/23/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Social cognition is involved in the perception, processing, and interpretation of social information. For this reason, social cognition is a crucial domain for successful communication and interpersonal relationships. With this in mind, we aimed to assess social cognition in children with Self-Limited Childhood Epilepsy with Centrotemporal Spikes (CECTS) and its association with traditional executive function tests and clinical variables of epilepsy. METHODS We evaluated 23 patients with CECTS (65% male, mean age of 10.64 years) and 20 healthy children (75% male, mean age of 10.15 years). We used the Faux-Pas Child Task (FP) to analyze social cognition and a comprehensive battery of neuropsychological tests to evaluate domains of classic executive functions. RESULTS Patients with CECTS had impairments in FP compared to healthy children [p < 0.001]. Impairments in some areas of traditional executive functions were related to worse social cognition in patients with CECTS. Epilepsy-related factors did not impair the performance on FP, except for the number of antiseizure medication [p = 0.016]. CONCLUSIONS Social cognition is impaired in children and adolescents with CECTS. The presence of ongoing seizures and frequent epileptiform activity were not correlated with social cognition. Therefore, epilepsy per se was more relevant for social cognition than its severity.
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Affiliation(s)
- Ellen Marise Lima
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo - HCFMUSP, São Paulo, Brazil.
| | - Patrícia Rzezak
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo - HCFMUSP, São Paulo, Brazil
| | | | | | - Kette D R Valente
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo - HCFMUSP, São Paulo, Brazil.
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30
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Beaudoin C, Leblanc É, Gagner C, Beauchamp MH. Systematic Review and Inventory of Theory of Mind Measures for Young Children. Front Psychol 2020; 10:2905. [PMID: 32010013 PMCID: PMC6974541 DOI: 10.3389/fpsyg.2019.02905] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 12/09/2019] [Indexed: 12/23/2022] Open
Abstract
Theory of mind (TOM), the ability to infer mental states to self and others, has been a pervasive research theme across many disciplines including developmental, educational, neuro-, and social psychology, social neuroscience and speech therapy. TOM abilities have been consistently linked to markers of social adaptation and have been shown to be affected in a broad range of clinical conditions. Despite the wealth and breadth of research dedicated to TOM, identifying appropriate assessment tools for young children remains challenging. This systematic review presents an inventory of TOM measures for children aged 0-5 years and provides details on their content and characteristics. Electronic databases (1983-2019) and 9 test publisher catalogs were systematically reviewed. In total, 220 measures, identified within 830 studies, were found to assess the understanding of seven categories of mental states and social situations: emotions, desires, intentions, percepts, knowledge, beliefs and mentalistic understanding of non-literal communication, and pertained to 39 types of TOM sub-abilities. Information on the measures' mode of presentation, number of items, scoring options, and target populations were extracted, and psychometric details are listed in summary tables. The results of the systematic review are summarized in a visual framework "Abilities in Theory of Mind Space" (ATOMS) which provides a new taxonomy of TOM sub-domains. This review highlights the remarkable variety of measures that have been created to assess TOM, but also the numerous methodological and psychometric challenges associated with developing and choosing appropriate measures, including issues related to the limited range of sub-abilities targeted, lack of standardization across studies and paucity of psychometric information provided.
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Affiliation(s)
- Cindy Beaudoin
- Department of Psychology, University of Montreal, Montreal, QC, Canada
- Sainte-Justine Hospital Research Center, Montreal, QC, Canada
| | - Élizabel Leblanc
- Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Charlotte Gagner
- Department of Psychology, University of Montreal, Montreal, QC, Canada
- Sainte-Justine Hospital Research Center, Montreal, QC, Canada
| | - Miriam H. Beauchamp
- Department of Psychology, University of Montreal, Montreal, QC, Canada
- Sainte-Justine Hospital Research Center, Montreal, QC, Canada
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31
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Stewart E, Lah S, Smith ML. Patterns of impaired social cognition in children and adolescents with epilepsy: The borders between different epilepsy phenotypes. Epilepsy Behav 2019; 100:106146. [PMID: 30894295 DOI: 10.1016/j.yebeh.2019.01.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/22/2019] [Accepted: 01/23/2019] [Indexed: 01/06/2023]
Abstract
Over the past decade, a growing number of studies have shown that children and adolescents with focal and generalized epilepsies have marked impairments in social cognition, including deficits in facial emotion perception (FEP) and Theory of Mind (ToM). At present, it remains unclear whether FEP and ToM impairments are comparable in children with focal and generalized epilepsies or whether distinct syndrome-specific deficits have emerged. This question of whether unique or overlapping social cognitive profiles exist in epilepsy is of interest, given that the revised International League Against Epilepsy (ILAE) classification guidelines propose that seizures arise from a diseased network (i.e., network account), rather than being confined to discrete regions near the site of seizure foci (i.e., localization account). The purpose of this review was as follows: (1) to summarize studies examining FEP and ToM in pediatric patients with epilepsy, (2) to examine epilepsy and psychosocial correlates of these difficulties, and (3) to determine whether patterns of sociocognitive impairment better support a localization or neural network account of epilepsy. Twelve studies were reviewed examining FEP (N = 5) and/or ToM (N = 8). Findings revealed significant FEP and ToM impairments across the studied subgroups with epilepsy, which did not differ between children with generalized and focal (localization-related) epilepsies nor among children with different subtypes of localization-related epilepsy. Similarly, other epilepsy variables (i.e., seizure frequency, side of seizure focus, number of antiepileptic drugs (AEDs) or surgical status) were not related to FEP or ToM, with the exception of younger age at seizure onset and longer duration of epilepsy. Several studies documented a significant relationship between impaired ToM and reduced social competence in pediatric patients with epilepsy, whereas evidence for a relationship between FEP and psychosocial functioning is currently weak. In conclusion, findings suggest that social cognitive impairments represent a shared feature of epilepsy in childhood. The results support a neural network account of epilepsy, in which a shared neural network of dysfunction may be underlying social cognitive deficits in this group. Further research is needed to examine the functional correlates of social cognitive impairments, as well as to evaluate screening tools and treatment methods to identify and address significant social and emotional difficulties in this patient group. This article is part of the Special Issue "Epilepsy and social cognition across the lifespan".
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Affiliation(s)
- Elizabeth Stewart
- School of Psychology, University of Sydney, Camperdown, NSW 2007, Australia
| | - Suncica Lah
- School of Psychology, University of Sydney, Camperdown, NSW 2007, Australia
| | - Mary Lou Smith
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON L5L 1C6, Canada; Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.
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32
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Giovagnoli AR. Theory of mind across lifespan from ages 16 to 81 years. Epilepsy Behav 2019; 100:106349. [PMID: 31375413 DOI: 10.1016/j.yebeh.2019.05.044] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 05/22/2019] [Accepted: 05/28/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Impaired theory of mind (ToM) is a neurobehavioral phenotype of epilepsy. Given that the age transitions affect cognitive development and decline, it is important to refine ToM across the lifespan. This study evaluated ToM in healthy subjects, taking into account education, gender, and other functions, aiming to clarify its specificity and relationships to major demographic and cognitive domains. METHODS A hundred and seventy subjects from ages 16 to 81 years (68 men) who received five to 17 years of schooling were evaluated using a Faux Pas Task (FPT) that is solved at the end of childhood and is highly sensitive to brain damage and tests for language, memory, praxis, visual perception, initiative, attention, shifting, and planning. Factor analysis, analysis of variance, and correlation and regression analyses were used to assess the data. RESULTS The analysis yielded six factors: Beliefs, Delusions, and Facts, which express the understanding of mental states and contextual details; Matching-Learning, Executive, and Working Memory. On this basis, six composite scores (CSs) were computed. Age and schooling showed significant effects on the Matching-Learning, Executive, and Working Memory CSs. The FPT raw scores and CSs were unrelated to age or schooling, while females showed better performance than males. The Beliefs CS and FPT scores were predicted by the Executive, Working Memory, Delusions, and Facts CSs and gender. CONCLUSIONS Theory of mind is a specific cognitive domain independent of age and formal education, but related to gender. Working memory, executive functions, and reality examination support some ToM processes. These findings may provide reference points against which impairment can be assessed. This article is part of the Special Issue "Epilepsy and social cognition across the lifespan".
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Affiliation(s)
- Anna Rita Giovagnoli
- Department of Diagnostics and Technology, Fondazione IRCCS Istituto Neurologico C. Besta, Milano, Italy.
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33
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Guida M, Caciagli L, Cosottini M, Bonuccelli U, Fornai F, Giorgi FS. Social cognition in idiopathic generalized epilepsies and potential neuroanatomical correlates. Epilepsy Behav 2019; 100:106118. [PMID: 30824176 DOI: 10.1016/j.yebeh.2019.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/03/2019] [Accepted: 01/03/2019] [Indexed: 12/13/2022]
Abstract
Social cognition allows us to elaborate mental representations of social relationships and use them appropriately in a social environment. One of its main attributes is the so-called Theory of Mind (ToM), which consists of the ability to attribute beliefs, intentions, emotions, and feelings to self and others. Investigating social cognition may help understand the poor social outcome often experienced by persons with Idiopathic Generalized Epilepsies (IGE), who otherwise present with normal intelligence. In recent years, several studies have addressed social cognition in subjects with focal epilepsies, while literature on social cognition in IGE is scarce, and findings are often conflicting. Some studies on samples of patients with mixed IGE showed difficulties in emotion attribution tasks, which were not replicated in a homogeneous population of patients with Juvenile Myoclonic Epilepsy alone. Impairment of higher order social skills, such as those assessed by Strange Stories Test and Faux Pas Tasks, were consistently found by different studies on mixed IGE, suggesting that this may be a more distinctive IGE-associated trait, irrespective of the specific syndrome subtype. Though an interplay between social cognition and executive functions (EF) was suggested by several authors, and their simultaneous impairment was shown in several epilepsy syndromes including IGE, no formal correlations among the two domains were identified in most studies. People with IGE exhibit subtle brain structural alterations in areas potentially involved in sociocognitive functional networks, including mesial prefrontal and temporoparietal cortices, which may relate to impairment in social cognition. Heterogeneity in patient samples, mostly consisting of groups with mixed IGE, and lack of analyses in specific IGE subsyndromes, represent evident limitations of the current literature. Larger studies, focusing on specific subsyndromes and implementing standardized test batteries, will improve our understanding of sociocognitive processing in IGE. Concomitant high-resolution structural and functional neuroimaging may aid the identification of its neural correlates. This article is part of the Special Issue "Epilepsy and social cognition across the lifespan".
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Affiliation(s)
- Melania Guida
- Neurology Unit, Pisa University Hospital, Pisa, Italy
| | - Lorenzo Caciagli
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom; MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire SL9 0RJ, United Kingdom
| | - Mirco Cosottini
- Neuroradiology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Ubaldo Bonuccelli
- Neurology Unit, Pisa University Hospital, Pisa, Italy; Section of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesco Fornai
- Human Anatomy, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy; I.R.C.C.S. I.N.M. Neuromed, Pozzilli, Isernia, Italy
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Yogarajah M, Mula M. Social cognition, psychiatric comorbidities, and quality of life in adults with epilepsy. Epilepsy Behav 2019; 100:106321. [PMID: 31253548 DOI: 10.1016/j.yebeh.2019.05.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/01/2019] [Accepted: 05/16/2019] [Indexed: 10/26/2022]
Abstract
Deficits in social cognition are an increasingly recognized complication of epilepsy and contribute to the deficits in social functioning and well-being experienced by patients with epilepsy. Although there has been an increase in studies exploring the measurement and biology of social cognition in patients with epilepsy, there are relatively few examining its clinical implications. Those studies that have been published highlight that social cognitive deficits contribute to impaired quality of life (QoL) in patients with epilepsy, independent of other comorbidities such as depression, anxiety, seizure frequency, and impairment in other cognitive domains. This raises the possibility of novel therapeutic approaches to improving the social well-being of patients with epilepsy.
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Affiliation(s)
- Mahinda Yogarajah
- Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust, London, United Kingdom; Institute of Molecular and Clinical Sciences, St George's University of London, United Kingdom.
| | - Marco Mula
- Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust, London, United Kingdom; Institute of Medical and Biomedical Education, St George's University of London, United Kingdom
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Javor A, Ciumas C, Ibarrola D, Ryvlin P, Rheims S. Social cognition, behaviour and therapy adherence in frontal lobe epilepsy: a study combining neuroeconomic and neuropsychological methods. ROYAL SOCIETY OPEN SCIENCE 2019; 6:180850. [PMID: 31598216 PMCID: PMC6731699 DOI: 10.1098/rsos.180850] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 07/23/2019] [Indexed: 05/30/2023]
Abstract
Social behaviour of healthy humans and its neural correlates have been extensively studied in social neuroscience and neuroeconomics. Whereas it is well established that several types of epilepsies, such as frontal lobe epilepsy, lead to social cognitive impairments, experimental evidence on how these translate into behavioural symptoms is scarce. Furthermore, it is unclear whether social cognitive or behavioural disturbances have an impact on therapy adherence, which is critical for effective disease management, but generally low in these patients. In order to investigate the relationship between social cognition, social behaviour, and therapy adherence in patients with frontal lobe epilepsies (FLE), we designed a study combining conventional neuropsychological with behavioural economic and functional magnetic resonance imaging (fMRI) methodology. Fifteen patients and 15 healthy controls played a prisoners' dilemma game (an established game to operationalize social behaviour) while undergoing fMRI. Additionally, social cognitive, basic neuropsychological variables, and therapy adherence were assessed. Our results implicate that social behaviour is indeed affected and can be quantified using neuroeconomic methods in patients with FLE. Impaired social behaviour in these patients might be a consequence of altered brain activation in the medial prefrontal cortex and play a role in low therapy adherence. Finally, this study serves as an example of how to integrate neuroeconomic methods in neurology.
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Affiliation(s)
- Andrija Javor
- Department of Neurology 2, Kepler University Clinic, Linz, Austria
| | - Carolina Ciumas
- Translational and Integrative Group in Epilepsy Research (TIGER), INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, University Lyon 1, Lyon, France
- Department of Clinical Neurosciences, CHUV, Lausanne, Switzerland
- Epilepsy Institute (IDEE), Lyon, France
| | - Danielle Ibarrola
- CERMEP - Imagerie du vivant, MRI department and CNRS UMS3453, Lyon, France
| | - Philippe Ryvlin
- Department of Clinical Neurosciences, CHUV, Lausanne, Switzerland
- Epilepsy Institute (IDEE), Lyon, France
| | - Sylvain Rheims
- Translational and Integrative Group in Epilepsy Research (TIGER), INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, University Lyon 1, Lyon, France
- Epilepsy Institute (IDEE), Lyon, France
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and University of Lyon, Lyon, France
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Mesraoua B, Deleu D, Kullmann DM, Shetty AK, Boon P, Perucca E, Mikati MA, Asadi-Pooya AA. Novel therapies for epilepsy in the pipeline. Epilepsy Behav 2019; 97:282-290. [PMID: 31284159 DOI: 10.1016/j.yebeh.2019.04.042] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/17/2019] [Accepted: 04/24/2019] [Indexed: 02/06/2023]
Abstract
Despite the availability of many antiepileptic drugs (AEDs) (old and newly developed) and, as recently suggested, their optimization in the treatment of patients with uncontrolled seizures, more than 30% of patients with epilepsy continue to experience seizures and have drug-resistant epilepsy; the management of these patients represents a real challenge for epileptologists and researchers. Resective surgery with the best rates of seizure control is not an option for all of them; therefore, research and discovery of new methods of treating resistant epilepsy are of extreme importance. In this article, we will discuss some innovative approaches, such as P-glycoprotein (P-gp) inhibitors, gene therapy, stem cell therapy, traditional and novel antiepileptic devices, precision medicine, as well as therapeutic advances in epileptic encephalopathy in children; these treatment modalities open up new horizons for the treatment of patients with drug-resistant epilepsy.
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Affiliation(s)
- Boulenouar Mesraoua
- Hamad Medical Corporation and Weill Cornell Medical College-Qatar, Doha, Qatar.
| | - Dirk Deleu
- Hamad Medical Corporation and Weill Cornell Medical College-Qatar, Doha, Qatar.
| | | | - Ashok K Shetty
- Institute for Regenerative Medicine, Department of Molecular and Cellular Medicine, Texas A&M University College of Medicine, College Station, TX, USA.
| | - Paul Boon
- Reference Center for Refractory Epilepsy, Ghent University Hospital Belgium - Academic Center for Epileptology, Heeze-Maastricht, the Netherlands.
| | - Emilio Perucca
- Unit of Clinical and Experimental Pharmacology, Department of Internal Medicine and Therapeutics, University of Pavia, and Clinical Trial Center, IRCCS Mondino Foundation, Pavia, Italy.
| | - Mohamad A Mikati
- Division of Pediatric Neurology and Developmental Medicine, Duke University Medical Center, Durham, USA.
| | - Ali A Asadi-Pooya
- Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, USA.
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Eddy CM. What Do You Have in Mind? Measures to Assess Mental State Reasoning in Neuropsychiatric Populations. Front Psychiatry 2019; 10:425. [PMID: 31354534 PMCID: PMC6636467 DOI: 10.3389/fpsyt.2019.00425] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/29/2019] [Indexed: 12/12/2022] Open
Abstract
Social interaction is closely associated with both functional capacity and well-being. Previous research has not only revealed evidence of social dysfunction in individuals with a wide range of psychiatric and neurological disorders but also generated an abundance of potential measures for assessing social cognition. This review explores the most popular measures used within neuropsychiatric populations to investigate the ability to recognize or reason about the mental states of others. Measures are also critically analyzed in terms of strengths and limitations to aid task selection in future clinical studies. The most frequently applied assessment tools use verbal, visual or audiovisual forms of presentation and assess recognition of mental states from facial features, self-rated empathy, the understanding of other's cognitive mental states such as beliefs and intentions, or the ability to combine knowledge of other's thoughts and emotions in order to understand subtle communications or socially inappropriate behavior. Key weaknesses of previous research include limited investigation of relationships with clinical symptoms, and underutilization of measures of everyday social functioning that offer a useful counterpart to traditional "lab" tasks. Future studies should aim to carefully select measures not only based on the range of skills to be assessed but also taking into account potential difficulties with interpretation and the need to gain insight into the application of social cognitive skills as well as ability per se. Some of the best measures include those with well-matched control trials (e.g., Yoni Task) or those that restrict the influence of verbal deficits (e.g., intentions comic strip task), elicit spontaneous mentalizing (e.g., Animations Task), and possess greater ecological validity (e.g., Movie for the Assessment of Social Cognition). Social cognitive research within psychiatric populations will be further enhanced through the development of more closely matched control tasks, and the exploration of relationships between task performance, medication, strategy use, and broader emotional and motor functions.
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Affiliation(s)
- Clare M. Eddy
- Research and Innovation, BSMHFT National Centre for Mental Health, Birmingham, United Kingdom
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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Braams O, Maher C, Jennekens-Schinkel A, Braun K, van Nieuwenhuizen O, van Schooneveld M, Schappin R. Social functioning of children after epilepsy surgery: A literature review. Epilepsy Behav 2019; 96:210-218. [PMID: 31174069 DOI: 10.1016/j.yebeh.2019.04.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/17/2019] [Accepted: 04/19/2019] [Indexed: 11/30/2022]
Abstract
This literature review on social functioning of children after epilepsy surgery is based on 24 papers addressing two categories of social functioning: social cognition (n = 4) and general social functioning (n = 20). Overall, studies that compared with healthy peers revealed children who had undergone epilepsy surgery to have more problems in both social cognition and general social functioning. Half of the studies found some improvement in social functioning in the first year(s) after epilepsy surgery, but this pertained to general social functioning, not to social cognition. The persistence of the problems in social cognition after surgery may be related to the critical period of brain maturation, lacking improvement of impairments in related cognitive domains or to a defective underlying brain condition - rather than to the epilepsy. Problems in general social functioning may be explained by the adjustments the children and their families had to make because of the child's drug-resistant epilepsy and difficulties to adjust to the new situation after surgery. The neurological and behavioral explanations are likely to be interrelated in light of the multifaceted and complex nature of social functioning. Epilepsy surgery does not appear to solve the problems in social functioning associated with having had drug-resistant epilepsy. As social functioning is an important aspect of healthy development, it should be assessed comprehensively in order to obtain a knowledge base that allows 1) proper treatment of children with epilepsy (CwE) and 2) counseling patients and families prior to and after epilepsy surgery.
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Affiliation(s)
- Olga Braams
- Department of Pediatric Psychology and Social Work, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, the Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands.
| | - Caragh Maher
- Department of Pediatric Psychology and Social Work, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, the Netherlands.
| | - Aag Jennekens-Schinkel
- Brain Center Rudolf Magnus, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands.
| | - Kees Braun
- Brain Center Rudolf Magnus, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands; Department of Child Neurology, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, the Netherlands.
| | - Onno van Nieuwenhuizen
- Brain Center Rudolf Magnus, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands.
| | - Monique van Schooneveld
- Department of Pediatric Psychology and Social Work, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, the Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands.
| | - Renske Schappin
- Department of Pediatric Psychology and Social Work, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, the Netherlands.
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Mogi T, Tsunoda T, Yoshino A. Altered upright face recognition and presence of face inversion effect in temporal lobe epilepsy: An event-related potential study. Psychiatry Clin Neurosci 2019; 73:269-276. [PMID: 30734399 DOI: 10.1111/pcn.12829] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 12/14/2018] [Accepted: 02/05/2019] [Indexed: 12/19/2022]
Abstract
AIM Facial recognition can be assessed by examining an event-related potential component, namely the N170. The amplitude of the N170 is larger in response to inverted faces than to upright faces. To examine facial processing in patients with temporal lobe epilepsy (TLE), we investigated the amplitude of the N170, the face inversion effect, and the association between social functioning and face-specific configuration processing. METHODS Sixteen patients with TLE and 17 normal controls (NC) participated in this study. Event-related potentials in response to upright or inverted neutral faces and bicycles were recorded. Social functioning was assessed by the socioeconomic status of the participants using the 5-point Hollingshead-Redlich Scale. RESULTS Compared with NC, patients with TLE had decreased N170 amplitudes. The inversion effect was observed for face stimuli in both groups; however, no inversion effect was observed for bicycle stimuli. Additionally, in TLE patients, but not in NC, socioeconomic status was significantly correlated with the N170 amplitudes in response to upright faces. CONCLUSION In a social context, upright faces are processed as a whole. This process is impaired in TLE. Conversely, inverted faces are processed analytically. This function is normal in TLE. Abnormal face-specific configuration processing may contribute to lower social functioning in TLE.
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Affiliation(s)
- Taichi Mogi
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Japan
| | - Tomoya Tsunoda
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Japan.,Department of Neuropsychiatry, Fukushima Prefectural Yabuki Hospital, Yabuki-machi, Japan
| | - Aihide Yoshino
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Japan
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Stewart E, Catroppa C, Lah S. A novel cognitive behavioural intervention with Theory of Mind (ToM) training for children with epilepsy: protocol for a case series feasibility study. Pilot Feasibility Stud 2019; 5:12. [PMID: 30680226 PMCID: PMC6339364 DOI: 10.1186/s40814-019-0393-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 01/03/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Children with epilepsy have significant social impairments, yet evidence-based interventions to address these social difficulties are lacking. Emerging research has shown that social difficulties in children with epilepsy relate to underlying impairments in Theory of Mind (ToM). This paper outlines the protocol for a pilot study that will evaluate the feasibility, acceptability, and efficacy of a novel cognitive behavioural intervention with ToM training for children with epilepsy. METHODS The intervention will be evaluated in a single-arm case series feasibility study. Ten to 12 children with common forms of epilepsy (8 to 12 years old) will be recruited to participate in 4 small group workshops, held over 4 consecutive weeks. Parents will attend a brief review at the end of each session with their child. Children will complete 4 one-to-one assessments with an investigator assessing ToM and social competence: twice at baseline (4 weeks and 1 day before the intervention), at post-intervention (last day of the intervention) and at follow-up (4 weeks post intervention). Parents will complete online questionnaires at these same 4 time points assessing ToM and social competence of their child. Parents and children will both complete a weekly measure of social competence from baseline 1 to follow-up. Following completion of the intervention, parents will complete two standardised questionnaires assessing treatment acceptability and barriers and facilitators to attendance; children will complete a single questionnaire on treatment acceptability. Information about feasibility outcomes (i.e. recruitment and retention, processing time, suitability of tasks) will be gathered by investigators during the trial. Together, outcomes will be used to refine research methods and make a decision about whether the intervention should be evaluated in a larger scale trial. DISCUSSION To our knowledge, this is the first psychosocial intervention to address social competence problems in children with epilepsy. Findings will provide information about a potentially effective treatment that could improve longer term social outcomes for this group. TRIAL REGISTRATION Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12618000974202, registered June 8 2018.
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Affiliation(s)
- Elizabeth Stewart
- School of Psychology, University of Sydney, 94 to 100 Mallet Street, Camperdown, Sydney, New South Wales 2040 Australia
- Australian Research Council Centre of Excellence for Cognition and its Disorders (ARC CCD), Sydney, Australia
- Australian Catholic University, Sydney, Australia
| | - Cathy Catroppa
- Murdoch Children’s Research Institute, Melbourne, Australia
- Royal Children’s Hospital, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | - Suncica Lah
- School of Psychology, University of Sydney, 94 to 100 Mallet Street, Camperdown, Sydney, New South Wales 2040 Australia
- Australian Research Council Centre of Excellence for Cognition and its Disorders (ARC CCD), Sydney, Australia
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Human induced pluripotent stem cell-derived MGE cell grafting after status epilepticus attenuates chronic epilepsy and comorbidities via synaptic integration. Proc Natl Acad Sci U S A 2018; 116:287-296. [PMID: 30559206 PMCID: PMC6320542 DOI: 10.1073/pnas.1814185115] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
This study provides evidence that human induced pluripotent stem cell (hiPSC)-derived medial ganglionic eminence (MGE) cell grafting into the hippocampus after status epilepticus can greatly reduce the frequency of spontaneous seizures in the chronic phase through both antiepileptogenic and antiepileptic effects. The antiepileptogenic changes comprised reductions in host interneuron loss, abnormal neurogenesis, and aberrant mossy fiber sprouting, whereas the antiepileptic effects were evident from an increased occurrence of seizures after silencing of graft-derived interneurons. Additional curative impacts of grafting comprised improved cognitive and mood function. The results support the application of autologous human MGE cell therapy for temporal lobe epilepsy. Autologous cell therapy is advantageous as such a paradigm can avoid immune suppression and promote enduring graft–host integration. Medial ganglionic eminence (MGE)-like interneuron precursors derived from human induced pluripotent stem cells (hiPSCs) are ideal for developing patient-specific cell therapy in temporal lobe epilepsy (TLE). However, their efficacy for alleviating spontaneous recurrent seizures (SRS) or cognitive, memory, and mood impairments has never been tested in models of TLE. Through comprehensive video- electroencephalographic recordings and a battery of behavioral tests in a rat model, we demonstrate that grafting of hiPSC-derived MGE-like interneuron precursors into the hippocampus after status epilepticus (SE) greatly restrained SRS and alleviated cognitive, memory, and mood dysfunction in the chronic phase of TLE. Graft-derived cells survived well, extensively migrated into different subfields of the hippocampus, and differentiated into distinct subclasses of inhibitory interneurons expressing various calcium-binding proteins and neuropeptides. Moreover, grafting of hiPSC-MGE cells after SE mediated several neuroprotective and antiepileptogenic effects in the host hippocampus, as evidenced by reductions in host interneuron loss, abnormal neurogenesis, and aberrant mossy fiber sprouting in the dentate gyrus (DG). Furthermore, axons from graft-derived interneurons made synapses on the dendrites of host excitatory neurons in the DG and the CA1 subfield of the hippocampus, implying an excellent graft–host synaptic integration. Remarkably, seizure-suppressing effects of grafts were significantly reduced when the activity of graft-derived interneurons was silenced by a designer drug while using donor hiPSC-MGE cells expressing designer receptors exclusively activated by designer drugs (DREADDs). These results implied the direct involvement of graft-derived interneurons in seizure control likely through enhanced inhibitory synaptic transmission. Collectively, the results support a patient-specific MGE cell grafting approach for treating TLE.
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Do mentalization skills affect the perception of stigma in patients with epilepsy? Epilepsy Behav 2018; 88:49-53. [PMID: 30241053 DOI: 10.1016/j.yebeh.2018.08.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/17/2018] [Accepted: 08/17/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE We aimed to study the relationship between the mentalizing ability and stigma in patients with epilepsy. METHODS Patients with epilepsy were administered the following battery of tests: Mini-International Neuropsychiatric Interview (MINI) form, Reading the Mind in the Eyes Test (Eyes Test), Stigma Scale of Epilepsy (SSE), Internalized Stigma of Mental Illness (ISMI) Scale, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). RESULTS Assessment of an association between the Eyes Test score, ISMI Scale total score, and subscale scores revealed a negative significant correlation of Eyes Test scores with approval of stereotypes, perceived discrimination, stigma resistance, and total score. Eyes Test score and BDI scores appears to be significant predictor of internalized stigma among the clinical variables that were studied. A positive significant correlation was detected between BDI score and alienation, perceived discrimination, and total score. CONCLUSION The presence of a correlation between the mentalization and stigma perception in our study demonstrates that these two concepts are connected and that this connection needs further study. In particular, mentalization-based therapy can have an effect on the reduction of the stigma perceptions and in this way can improve the course of the disease, potentially improving the patients' quality of life.
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Theory of Mind and social competence in children and adolescents with genetic generalised epilepsy (GGE): Relationships to epilepsy severity and anti-epileptic drugs. Seizure 2018; 60:96-104. [DOI: 10.1016/j.seizure.2018.06.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 06/13/2018] [Accepted: 06/15/2018] [Indexed: 11/19/2022] Open
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Fan Z, Feng X, Fan Z, Zhu X, Yin S. Immunotherapy by targeting of VGKC complex for seizure control and prevention of cognitive impairment in a mouse model of epilepsy. Mol Med Rep 2018; 18:169-178. [PMID: 29749462 PMCID: PMC6059666 DOI: 10.3892/mmr.2018.9004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 04/16/2018] [Indexed: 11/13/2022] Open
Abstract
Epilepsy is a type of refractory neurologic disorder mental disease, which is associated with cognitive impairments and memory dysfunction. However, the potential mechanisms of epilepsy are not well understood. Previous evidence has identified the voltage gated potassium channel complex (VGKC) as a target in various cohorts of patients with epilepsy. In the present study, the efficacy of an antibody against VGKC (anti-VGKC) for the treatment of epilepsy in mice was investigated. A mouse model of lithium-pilocarpine temporal lobe epilepsy was established and anti-VGKC treatment was administered for 30 days. Memory impairment, anxiety, visual attention, inhibitory control and neuronal loss were measured in the mouse model of lithium-pilocarpine temporal lobe epilepsy. The results revealed that epileptic mice treated with anti-VGKC were able to learn the task and presented attention impairment, even a tendency toward impulsivity and compulsivity. It was also exhibited that anti-VGKC treatment decreased neuronal loss in structures classically associated with attentional performance in hippocampus. Mice who received Anti-VGKC treatment had inhibited motor seizures and hippocampal damage as compared with control mice. In conclusion, these results indicated that anti-VGKC treatment may present benefits for improvements of the condition of motor attention impairment and cognitive competence, which suggests that VGKC may be a potential target for the treatment of epilepsy.
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Affiliation(s)
- Zhiliang Fan
- The Third Department of Neurology, Xingtai People's Hospital of Hebei Province, Xingtai, Hebei 054001, P.R. China
| | - Xiaojuan Feng
- Department of Ultrasound, Xingtai People's Hospital of Hebei Province, Xingtai, Hebei 054001, P.R. China
| | - Zhigang Fan
- Department of Ultrasound, Xingtai People's Hospital of Hebei Province, Xingtai, Hebei 054001, P.R. China
| | - Xingyuan Zhu
- The Third Department of Neurology, Xingtai People's Hospital of Hebei Province, Xingtai, Hebei 054001, P.R. China
| | - Shaohua Yin
- The Third Department of Neurology, Xingtai People's Hospital of Hebei Province, Xingtai, Hebei 054001, P.R. China
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Social cognitive dysfunction as a clinical marker: A systematic review of meta-analyses across 30 clinical conditions. Neurosci Biobehav Rev 2018; 84:92-99. [DOI: 10.1016/j.neubiorev.2017.11.014] [Citation(s) in RCA: 141] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 10/04/2017] [Accepted: 11/21/2017] [Indexed: 12/13/2022]
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Faedda N, Natalucci G, Calderoni D, Cerutti R, Verdecchia P, Guidetti V. Metacognition and Headache: Which Is the Role in Childhood and Adolescence? Front Neurol 2017; 8:650. [PMID: 29312108 PMCID: PMC5735075 DOI: 10.3389/fneur.2017.00650] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 11/17/2017] [Indexed: 11/30/2022] Open
Abstract
Headache, in particular migraine, is one of the most frequent neurological symptoms in children and adolescents and it affects about 60% of children and adolescents all over the world. Headache can affect several areas of child’s functioning, such as school, physical activities, peer, and family relationship. The global and severe burden of this disease requires a multidisciplinary strategy and an effective treatment addressed all of the patient’s needs and based on cutting-edge scientific research. In recent years, research has focused on cognitive factors specifically in functions called metacognitive processes. Metacognition can be defined as the knowledge, beliefs, and cognitive processes involved in monitoring, control, and assessment of cognition. Metacognition seems to be closely related to the ability of theory of mind, the ability to infer, and reason about the mental states of other people in order to predict and explain own behavior. Recent studies found a relationship between metacognitive skills and anxiety, depression, motivation, academic performance, human social interactions, and stress symptoms. This relationship is very interesting for headache treatment, because these factors are the most commonly reported triggers in this disorder and there is a high comorbidity with anxiety and depression in children and adolescents with headache. So, headache and these comorbidities, in particular anxiety and depression, may have in common persistent and maladaptive patterns of thinking which are related to maladaptive metacognitive beliefs. Further research should assess metacognitive processes of children and adolescents with headache in order to increase their ability to control their own cognitive processes and consequently monitor factors which may trigger the attacks.
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Affiliation(s)
- Noemi Faedda
- Department of Paediatric and Child and Adolescent Neuropsychiatry, Sapienza University of Rome, Rome, Italy
| | - Giulia Natalucci
- Department of Paediatric and Child and Adolescent Neuropsychiatry, Sapienza University of Rome, Rome, Italy
| | - Dario Calderoni
- Department of Paediatric and Child and Adolescent Neuropsychiatry, Sapienza University of Rome, Rome, Italy
| | - Rita Cerutti
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Paola Verdecchia
- Department of Paediatric and Child and Adolescent Neuropsychiatry, Sapienza University of Rome, Rome, Italy
| | - Vincenzo Guidetti
- Department of Paediatric and Child and Adolescent Neuropsychiatry, Sapienza University of Rome, Rome, Italy
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Facial emotion perception in patients with epilepsy: A systematic review with meta-analysis. Neurosci Biobehav Rev 2017; 83:212-225. [PMID: 29045812 DOI: 10.1016/j.neubiorev.2017.10.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 10/13/2017] [Accepted: 10/13/2017] [Indexed: 11/21/2022]
Abstract
Facial emotion perception is a fundamental social competency relying on a specialised, yet distributed, neural network. This review aimed to determine whether patients with epilepsy have facial emotion perception accuracy impairments overall, or for a subset of emotions (anger, disgust, happiness, sadness, fear, and surprise), and the relationship to epilepsy type, demographic/treatment variables, and brain organisation. Database searches used PRISMA guidelines with strict inclusion/exclusion criteria. Thirty included studies assessed patients with temporal lobe (TLE; n=709), frontocentral (FCE; n=22), and genetic generalised (GGE; n=48) epilepsy. Large deficits emerged in patients with epilepsy compared to controls (n=746; Hedges' g=0.908-1.076). Patients with TLE were significantly impaired on all emotions except surprise; patients with GGE were significantly impaired in anger, disgust, and fear perception. Meta-regression of patients with TLE revealed younger age at testing was associated with lower accuracy. This review provides evidence for marked global deficits of emotion perception in epilepsy, with differential emotion-specific impairment patterns in patients with TLE and GGE.
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Ryan NP, Catroppa C, Beare R, Silk TJ, Hearps SJ, Beauchamp MH, Yeates KO, Anderson VA. Uncovering the neuroanatomical correlates of cognitive, affective and conative theory of mind in paediatric traumatic brain injury: a neural systems perspective. Soc Cogn Affect Neurosci 2017; 12:1414-1427. [PMID: 28505355 PMCID: PMC5629820 DOI: 10.1093/scan/nsx066] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 04/17/2017] [Accepted: 04/23/2017] [Indexed: 12/14/2022] Open
Abstract
Deficits in theory of mind (ToM) are common after neurological insult acquired in the first and second decade of life, however the contribution of large-scale neural networks to ToM deficits in children with brain injury is unclear. Using paediatric traumatic brain injury (TBI) as a model, this study investigated the sub-acute effect of paediatric traumatic brain injury on grey-matter volume of three large-scale, domain-general brain networks (the Default Mode Network, DMN; the Central Executive Network, CEN; and the Salience Network, SN), as well as two domain-specific neural networks implicated in social-affective processes (the Cerebro-Cerebellar Mentalizing Network, CCMN and the Mirror Neuron/Empathy Network, MNEN). We also evaluated prospective structure-function relationships between these large-scale neural networks and cognitive, affective and conative ToM. 3D T1- weighted magnetic resonance imaging sequences were acquired sub-acutely in 137 children [TBI: n = 103; typically developing (TD) children: n = 34]. All children were assessed on measures of ToM at 24-months post-injury. Children with severe TBI showed sub-acute volumetric reductions in the CCMN, SN, MNEN, CEN and DMN, as well as reduced grey-matter volumes of several hub regions of these neural networks. Volumetric reductions in the CCMN and several of its hub regions, including the cerebellum, predicted poorer cognitive ToM. In contrast, poorer affective and conative ToM were predicted by volumetric reductions in the SN and MNEN, respectively. Overall, results suggest that cognitive, affective and conative ToM may be prospectively predicted by individual differences in structure of different neural systems-the CCMN, SN and MNEN, respectively. The prospective relationship between cerebellar volume and cognitive ToM outcomes is a novel finding in our paediatric brain injury sample and suggests that the cerebellum may play a role in the neural networks important for ToM. These findings are discussed in relation to neurocognitive models of ToM. We conclude that detection of sub-acute volumetric abnormalities of large-scale neural networks and their hub regions may aid in the early identification of children at risk for chronic social-cognitive impairment.
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Affiliation(s)
- Nicholas P. Ryan
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia
- Department of Psychology, Royal Children’s Hospital, Parkville, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Cathy Catroppa
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia
- Department of Psychology, Royal Children’s Hospital, Parkville, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Richard Beare
- Developmental Imaging, Murdoch Childrens Research Institute, Parkville, VIC, Australia
| | - Timothy J. Silk
- Developmental Imaging, Murdoch Childrens Research Institute, Parkville, VIC, Australia
- Department of Pediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Stephen J. Hearps
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia
| | - Miriam H. Beauchamp
- Department of Psychology, University of Montreal, Montreal, QC, Canada
- Ste-Justine Research Center, Montreal, QC, Canada
| | - Keith O. Yeates
- Hotchkiss Brain Institute, Alberta Children’s Hospital Research Institute, and Department of Psychology, The University of Calgary, Calgary, AB, Canada
| | - Vicki A. Anderson
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia
- Department of Psychology, Royal Children’s Hospital, Parkville, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
- Department of Pediatrics, University of Melbourne, Parkville, VIC, Australia
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Richard AE, Scheffer IE, Wilson SJ. Features of the broader autism phenotype in people with epilepsy support shared mechanisms between epilepsy and autism spectrum disorder. Neurosci Biobehav Rev 2017; 75:203-233. [DOI: 10.1016/j.neubiorev.2016.12.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 12/15/2016] [Accepted: 12/20/2016] [Indexed: 12/29/2022]
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