Impaired performance on advanced Theory of Mind tasks in children with epilepsy is related to poor communication and increased attention problems

Lunn, Judith; Lewis, C. S.; Sherlock, Chris

doi:10.1016/j.yebeh.2014.11.010

Cited by 25 publications

(28 citation statements)

References 66 publications

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“…The inclusion criteria for patients were children with epilepsy (CWE) in mainstream education with presumed genetic or unknown etiology without identifiable structural or metabolic abnormalities. The research program's recruitment strategy has been previously described 9 . At recruitment to the research program a pediatric neurologist classified patients in accordance with the revised terminology proposed by the International League Against Epilepsy (ILAE) [2005][2006][2007][2008][2009].…”

Section: Participantsmentioning

confidence: 99%

“…Few studies have addressed the link between social perceptual skills and behavioural difficulties. Golouboff et al reported impaired fear recognition predicted behavioural problems in a subset of TLE patients, and perceptual theory of mind deficits were shown to correlate with social and attention problems in a heterogeneous patient group with below average IQ 9 . Overall, findings indicate a high degree of individual variability, and deficits not isolated to the social perceptual domain.…”

Section: Introductionmentioning

confidence: 99%

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Social attention in children with epilepsy

Lunn

Donovan

Litchfield

et al. 2017

Brain and Cognition

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Children with epilepsy may be vulnerable to impaired social attention given the increased risk of neurobehavioural comorbidities. Social attentional orienting and the potential modulatory role of attentional control on the perceptual processing of gaze and emotion cues have not been examined in childhood onset epilepsies. Social attention mechanisms were investigated in patients with epilepsy (n = 25) aged 8-18 years old and performance compared to healthy controls (n = 30). Dynamic gaze and emotion facial stimuli were integrated into an antisaccade eye-tracking paradigm. The time to orient attention and execute a horizontal saccade toward (prosaccade) or away (antisaccade) from a peripheral target measured processing speed of social signals under conditions of low or high attentional control. Patients with epilepsy had impaired processing speed compared to healthy controls under conditions of high attentional control only when gaze and emotions were combined meaningfully to signal motivational intent of approach (happy or anger with a direct gaze) or avoidance (fear or sad with an averted gaze). Group differences were larger in older adolescent patients. Analyses of the discrete gaze emotion combinations found independent effects of epilepsy-related, cognitive and behavioural problems. A delayed disengagement from fearful gaze was also found under low attentional control that was linked to epilepsy developmental factors and was similarly observed in patients with higher reported anxiety problems. Overall, findings indicate increased perceptual processing of developmentally relevant social motivations during increased cognitive control, and the possibility of a persistent fear-related attentional bias. This was not limited to patients with chronic epilepsy, lower IQ or reported behavioural problems and has implications for social and emotional development in individuals with childhood onset epilepsies beyond remission.

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Section: Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Social attention in children with epilepsy

Lunn

Donovan

Litchfield

et al. 2017

Brain and Cognition

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“…It is not surprising that we found a ToM-Q deficit in children with refractory epilepsy, as even children with "epilepsy only" (epilepsy at the benign end of the severity spectrum) have recently been shown to have a ToM deficit (Lew et al, 2015;Lunn et al, 2015). Controlling for VIQ did not eliminate this effect.…”

Section: Children With Refractory Epilepsy Have a Tom Deficitmentioning

confidence: 62%

“…Despite its developmental significance in everyday functioning, research on ToM in paediatric epilepsy patients is scarce. ToM is vulnerable even in children with "epilepsy only" and this cannot be explained by lower intelligence (Lew et al, 2015;Lunn et al, 2015). Furthermore, a later onset of epilepsy is associated with better ToM functioning, whereas antiepileptic drug use is not related to ToM functioning (Lew et al, 2015;Lunn et al, 2015).…”

Section: Theory Of Mind and Surgerymentioning

confidence: 99%

Epilepsy surgery in children: no further threat to theory of mind

Braams

Meekes

Nieuwenhuizen

et al. 2019

Epileptic Disorders

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Aims . To investigate whether theory of mind (ToM), an important requirement for adaptive social functioning, is different between children with pharmacologically refractory epilepsy who undergo epilepsy surgery and healthy control children, whether ToM is affected by epilepsy surgery in these children, and whether ToM is associated with demographic or epilepsy variables. Methods . The “ToM storybooks”, a psychometrically sound ToM instrument designed for children, was administered shortly before and 0.5, one and two years after surgery as part of a neuropsychological assessment. Fifteen patients (mean age: 7.1 years) completed the ToM storybooks before and at least twice after surgery. Two sex‐ and age‐matched healthy control children were included per patient. Linear mixed models were used to analyse differences between patients and controls. The association between ToM and demographic, epilepsy and surgical variables was explored. Results . Patients had lower ToM scores than healthy control children, even when corrected for verbal intelligence quotient (VIQ). Epilepsy surgery had neither a harmful nor a favourable effect on ToM. Later epilepsy onset and temporal origin of epilepsy were associated with higher (better) ToM scores relative to earlier epilepsy onset and extra‐temporal epilepsy (including hemispherotomy in one case). Children in whom the amygdala was resected had worse ToM scores. Conclusion . Children with refractory epilepsy have a ToM deficit that may not be accounted for by lower VIQ. Epilepsy surgery does not affect ToM functioning. Younger age at epilepsy onset is associated with poorer ToM, and temporal epilepsy with better ToM. Finally, the amygdala is implicated in ToM deficit. Patients and their parents should be educated about the possible consequences of epilepsy with regards to the development of social cognition and should be guided in order to help improve ToM.

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“…são os pioneiros na investigação da ToM na EBICT. Alguns poucos trabalhos investigaram esta função em crianças e adolescentes com outras síndromes epilépticas (Hu, Jiang, Hu, Ma, & Wang, 2016;Lunn, Lewis, & Sherlock, 2015). Investigar a ToM na epilepsia é fundamental, pois as dificuldades nessa função cognitiva estão relacionadas a prejuízos nas habilidades sociais, comunicação, atenção e aprendizagem (Giovagnoli, 2014;Lunn et al, 2015;Schenkel, Marlow-O'Connor, Moss, Sweeney, & Pavuluri, 2008).…”

Section: Funcionamento Executivo Na Ebictunclassified

Epilepsia Benigna da Infância com Paroxismos Centrotemporais - delineamento do perfil executivo

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Aos meus pais, Cida e Antonio, pelo amor incondicional e pelo apoio em todos os momentos da minha vida. Essa dissertação foi construída por vocês e para vocês. Por me ensinarem que, em tudo o que se fizer, tem que ter coração, garra, persistência e dedicação. Por me ensinarem (e me mostrarem!) o valor do amor e do trabalho. A vocês toda a minha gratidão e o meu amor, eternos.Aos meus irmãos, Marco, Andréa e Luciana, e aos meus primos, Renato, Patrícia e Vicenzo, pelo carinho e pelo cuidado.À minha irmã-amiga, Luciana, pelo amor e por se fazer presente sempre em minha vida, mesmo com a distância geográfica. Pelo modelo de mulher, força, garra e psicóloga. Por ser meu porto seguro, junto com o papai e com a mamãe.À minha amiga-irmã, Renata, pela parceria completa, pela presença em meus dias, por compartilhar tantos momentos comigo, profissionais e pessoais. Por ser minha irmã de alma e de vida. Pelos ensinamentos. Pela sintonia e reciprocidade.Ao meu namorado, Victor, pelo companheirismo e pelo cuidado. Pela presença tão confortante e pelo carinho. Por ter entendido nos momentos em que não pude estar presente, para realizar esse trabalho. Você é incrível ("e nunca deixe que digam o contrário!").Ao meu amado Fofinho, pela companhia incansável nas noites (e dias, e madrugadas...) de trabalho. Por me acompanhar há 13 anos em minhas jornadas de estudo, de trabalho e de vida, sempre pertinho de mim.Aos meus amigos, Mariana e Lucas, pelo apoio tão carinhoso e pelas conversas, que fizeram parte do meu crescimento. Pela doçura e pela compreensão, tão raros nesse mundo. À mestre, professora e amiga, Camila, pelos ensinamentos, desde os meus 17 anos, com tanta paixão e generosidade que transbordam -e transbordaram em mim! Obrigada por ter me apresentado a Neuropsicologia, a pesquisa, a estatística e, acima de tudo, o amor a tudo isso e aos pacientes. Amo vocês! AgradecimentosA todos os meus pacientes e clientes, em especial às crianças, adolescentes e pais que participaram desse trabalho. Sem vocês, nada disso seria possível. Vocês foram (e são!) a maior motivação de todo o meu esforço e dedicação, do início ao fim. O conhecimento vem, antes de tudo, do contato com vocês e das experiências que compartilhamos.À minha orientadora, Profa. Dra. Kette Dualibi Ramos Valente, pela orientação, dedicada e disponível, e pelos ensinamentos sempre sábios e valorosos. Essa dissertação é fruto de um trabalho árduo e constante, o qual sem a sra. não teria sido possível.À minha co-orientadora, Dra. Patrícia Rzezak, pelas oportunidades, pela disponibilidade, pelo conhecimento compartilhado e pelas inúmeras contribuições inteligentes.Às Profas. Dras. Marilisa Mantovani Guerreiro e Maria Augusta Montenegro, pela generosidade em compartilhar conosco alguns de seus pacientes e pela inspiração ao longo de todo o trabalho.À Mel e à Cecília Canalle, por toda a ajuda no recrutamento dos participantes para esse estudo.A todos os colegas pós-graduandos do Laboratório de Neurofisiologia, pelas vivências em comum, pelo compartilhamento de experiências ...

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Impaired performance on advanced Theory of Mind tasks in children with epilepsy is related to poor communication and increased attention problems

Cited by 25 publications

References 66 publications

Social attention in children with epilepsy

Social attention in children with epilepsy

Epilepsy surgery in children: no further threat to theory of mind

Epilepsia Benigna da Infância com Paroxismos Centrotemporais - delineamento do perfil executivo

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