Cerebral Metabolism and Personality in Patients with Epilepsy of the Temporal Lobe

Abstract

Extratension and introversion are stable personality styles in adult subjects. Mental functioning of the former is especially influenced by the emotions and of the latter by ideation. The aim of the present work is to analyze, using positron emission tomography with [18F]fluorodeoxyglucose (18FDG-PET), possible differences in cerebral metabolism in patients with intractable temporal lobe epilepsy (TLE) in relation to different personality styles assessed with the Rorschach test.Twenty-eight drug-resistant TLE patients with complex partial seizures were assessed by means of FDG-PET and the Rorschach test. According to location of the epileptogenic area in the dominant hemisphere and the personality style of the subject, a table of contingencies was drawn up (χ² and contingency coefficient). Finally, an analysis was made of the personality changes in patients that had received neurosurgical treatment.The results show a clear differentiation with FDG-PET as regards location of the temporal lobe affected. In 80% of subjects personality style coincided with a cerebral metabolic pattern: introversives had predominant hypometabolism in the left hemisphere and extratensives in the right. The tendency toward introversion or extratension in ambitents showed this metabolic pattern only in 38% of subjects, with 54% presenting the opposite pattern. The Rorschach test was carried out for a second time after surgical temporal resection (n = 13), and it was observed that some patients maintained their personality style while others modified it.These results suggest the existence of different hemispheric metabolic patterns in the personality styles assessed by the Rorschach test in TLE patients.