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

Abstract

BackgroundMounting 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.MethodsA 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.ResultsThe 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.ConclusionsResults 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.

Navigating Social Waters: Understanding Theory-of-Mind Challenges in Patients with Mesial Temporal Lobe Epilepsy

“…Seizures and structural abnormalities in this area may disrupt the intricate connections required for ToM, impairing the ability to interpret social nuances and recognize the emotions and intentions of others. The literature points to the presence of difficulties with processing social information, recognizing facial expressions, detecting gaze direction, social perception, and ToM [ 10 , 11 , 12 , 13 , 14 ].…”