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BRIEF RESEARCH REPORT article

Front. Syst. Neurosci.
Volume 18 - 2024 | doi: 10.3389/fnsys.2024.1491791
This article is part of the Research Topic Asymmetry in the Central Nervous System: Functional Implications - Volume II View all 7 articles

Exploring the Role of Epileptic Focus Lateralization on Facial Emotion Recognition in the Spectrum of Mesial Temporal Lobe Epilepsy

Provisionally accepted
Fabio Iannaccone Fabio Iannaccone 1Chiara Pizzanelli Chiara Pizzanelli 1*Francesca Lorenzini Francesca Lorenzini 1Francesco Turco Francesco Turco 1Chiara Milano Chiara Milano 1Claudia Scarpitta Claudia Scarpitta 1Luca Tommasini Luca Tommasini 1Gloria Tognoni Gloria Tognoni 1Riccardo Morganti Riccardo Morganti 2Enrica Bonanni Enrica Bonanni 1Gabriele Siciliano Gabriele Siciliano 1
  • 1 Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
  • 2 Department of Clinical and Experimental Medicine, Section of Statistics, University of Pisa, Pisa, Italy

The final, formatted version of the article will be published soon.

    Introduction: evidence increasingly shows that facial emotion recognition (FER) is impaired in refractory mesial temporal lobe epilepsy (rMTLE), especially in patients with a right focus. This study explores FER in both mild (mMTLE) and refractory forms, examining the influence of epileptic focus lateralization on FER. Methods: 50 MTLE patients, categorized by epilepsy severity and focus lateralization, were compared with healthy controls. FER was assessed using the Ekman Faces Test (EFT), which evaluates recognition of six basic emotions, alongside a battery of cognitive and mood tests.Results: mMTLE patients showed selective deficits in recognizing fear and anger, while rMTLE patients displayed broader deficits, affecting all emotions except surprise. Patients with a right focus underperformed across all negative emotions, whereas those with a left focus showed deficits mainly in fear and anger. Analysis indicated that early epilepsy onset was associated with poorer FER in rightfocused patients; febrile seizures and mesial temporal sclerosis significantly impacted FER in leftfocused patients. Conclusions: MTLE affects circuits of FER even in mild subjects, although to a lesser extent than in refractory ones. Earlier onset of MTLE could disrupt the development of FER, possibly interfering during a critical phase of maturation of its circuits, when the focus is right. Conversely, left MTLE may cause less damage to FER circuits, requiring additional factors such as a history of febrile seizures and/or mesial temporal sclerosis for significant impact. Clinically, refractory and right-sided MTLE might be viewed as risk factors of FER deficits.

    Keywords: Epilepsy, Mesial temporal lobe epilepsy, facial emotion recognition, asymmetry, social cognition, Age at epilepsy onset, mesial temporal sclerosis, febrile seizures

    Received: 05 Sep 2024; Accepted: 10 Dec 2024.

    Copyright: © 2024 Iannaccone, Pizzanelli, Lorenzini, Turco, Milano, Scarpitta, Tommasini, Tognoni, Morganti, Bonanni and Siciliano. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Chiara Pizzanelli, Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy

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