Social Cognition in Temporal and Frontal Lobe Epilepsy: Systematic Review, Meta-analysis, and Clinical Recommendations

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

Theory of mind and facial emotion recognition in adults with temporal lobe epilepsy: A meta-analysis

“…The current study has important clinical implications. In terms of clinical practice recommendations, given the prevalence of ToM and FER impairments in adults with epilepsy ( 24 , 135 , 136 ), we encourage clinicians to be vigilant about indicators of social cognitive impairment in adult patients with TLE, and our results support inclusion of ToM and FER measures in routine neuropsychological testing in adult patients with TLE ( 137 ). Additional, given the diversity and complexity of current ToM and FER measures ( 21 , 138 , 139 ) and the fact that few ToM and FER measures have been adjusted and standardized specifically for patients with epilepsy ( 140 ), we propose the development of comprehensive, ecologically valid, and economically feasible standardized social cognitive assessment tools for patients with epilepsy.…”

Psychische Störungen bei Epilepsie

“…Eine aktuelle Metaanalyse kommt zu dem Ergebnis, dass sowohl Patienten mit Frontal-als auch mit Temporallappenepilepsien Schwierigkeiten in allen Aspekten sozialer Kognition aufweisen. Dabei schnitten die Personen mit Temporallappenepilepsie der rechten Seite schlechter ab (v. a. bei Theory-of-Mind-bezogenen Tests) als Personen mit linksseitigem epileptogenen Herd [33].…”

Adjunctive Treatment With Eslicarbazepine Acetate for Adults and Children With Focal-Onset Epilepsy: A Meta-Analysis

“…The recurrent episodes of seizures significantly threaten the health of people with epilepsy (5). Moreover, long-term recurrence of seizures despite of the use of multiple ASMs could adversely affect the quality of life and lead to the increased risk of affective disorders and neurocognitive dysfunction in people with epilepsy (6)(7)(8). Focal-onset epilepsy (FOE) is the most prevalent type of seizures and can pose a significant risk to individual health and impair quality of life, particularly when they are associated with impairment of awareness (9).…”