Dissociation between affective and cognitive empathy in patients with idiopathic generalized epilepsy

Abstract

Objective To explore different aspects of empathy in patients with idiopathic generalized epilepsy and to study the effect of epileptiform discharges from different areas of the brain on empathy. Methods One hundred and fifty healthy controls and 62 patients with idiopathic generalized epilepsy were administered with a neuropsychological battery for basic cognitive assessment and an empathy scale after 24-hour electroencephalography monitoring. Results Compared with healthy controls, patients with epilepsy obtained significantly lower total scores and the cognitive empathy scores including perspective-taking and fantasy subscale of the Interpersonal Reactivity Index-China (46.39±9.74 vs 50.99±9.97, t=-2.893, P=0.004; 23.31±7.10 vs 27.24±6.22, t=-3.974, P=0.000; 10.18±4.21 vs 11.84±3.67, t=-2.838, P=0.005; 13.13±4.46 vs 15.40±3.84, t=-3.698, P=0.000, respectively). In contrast, the individuals with epilepsy did not score significantly different on the affective empathy, empathic concern and personal distress (P＞0.05, respectively). Patients with frontal epileptiform discharges suffered the most on the total empathy scores, cognitive empathy and perspective-taking subscale when compared with other three groups of individuals (P 0.05, respectively). No correlation was found between the empathy ability and other cognitive neuropsychological tests. Conclusions Patients with idiopathic generalized epilepsy is not associated with a general empathy deficit, but rather with a dissociated pattern combining impaired cognitive empathy and preserved affective one, which leads to a double-dissociation, supports the notion that affective and cognitive empathies are two distinct abilities. The activation of epileptiform discharges from the frontal lobe is a key factor that could diminish the empathy ability. Key words: Epilepsy; Cognition; Empathy; Electroencephalography