Impaired social cognition in patients with interictal epileptiform discharges in the frontal lobe.
BACKGROUND
Patients with epilepsy frequently experience cognitive impairments, including impairments in social cognition. However, there is a lack of direct examinations of the affective and cognitive aspects of social cognition in such patients. The neural correlates remain to be identified. The present study was designed to examine the degree of impairments in different aspects of social cognition including empathy, emotion recognition, and Theory of Mind (ToM) in patients with epilepsy. In addition, we further explored factors related to the impairments, highlighting the specific importance of the frontal region.


MATERIALS AND METHODS
After 24-hour EEG monitoring, 53 patients with epilepsy were administered a neuropsychological battery of tests for basic intelligence assessment and then were tested with the Interpersonal Reactive Index, the "Yoni" task, the Emotion Recognition Test, the Reading the Mind in the Eyes test, and other neuropsychological tests. The clinical variables potentially affecting the ability to accomplish these tests were taken into account. We divided the patients into those having frontal lobe interictal epileptiform discharges (group with frontal IEDs) and those with seizures originating outside the frontal or temporal lobes (group with extrafrontal IEDs). Sixty healthy individuals served as controls.


RESULTS
The group with frontal IEDs achieved the most severe deficits in emotion recognition, ToM, and cognitive empathy, while affective empathy was intact. Moreover, the performance scores of empathy in the group with frontal IEDs were selectively correlated with their executive function scores, which are believed to be associated with orbitofrontal functioning. In contrast, patients with epilepsies not originating from the frontal or temporal lobes may also be at risk of impairments in social cognition, albeit to a lesser extent.


CONCLUSIONS
The preliminary findings suggest that patients with epilepsy, especially those having frontal lobe interictal epileptiform discharges, have associated general social cognition deficits. At the clinical level, these results are in line with previous findings regarding social cognition and the importance of the prefrontal area in the integration of cognition and affect. At the theoretical level, our findings also provide evidence for the functional independence of cognitive from affective aspects of empathy.
['Hu|Ying|Y|', 'Jiang|Yubao|Y|', 'Hu|Panpan|P|', 'Ma|Huijuan|H|', 'Wang|Kai|K|']
D000293:Adolescent D000328:Adult D002648:Child D002681:China D003071:Cognition D060825:Cognitive Dysfunction D004644:Emotions D004645:Empathy D004827:Epilepsy D056344:Executive Function D005145:Face D005260:Female D005625:Frontal Lobe D006801:Humans D008297:Male D009483:Neuropsychological Tests D012919:Social Behavior D013702:Temporal Lobe D056345:Theory of Mind D055815:Young Adult
Social cognition Frontal lobe Epilepsy Empathy Theory of Mind Comorbidities