Abstract
Mesial temporal lobe epilepsy (MTLE) can be associated with emotion recognition impairment that can be particularly severe in patients with early onset seizures (1–3). Whereas, there is growing evidence that memory and language can improve in seizure-free patients after anterior temporal lobectomy (ATL) (4), the effects of surgery on emotional processing are still unknown. We used functional magnetic resonance imaging (fMRI) to investigate short-term reorganization of networks engaged in facial emotion recognition in MTLE patients. Behavioral and fMRI data were collected from six patients before and after ATL. During the fMRI scan, patients were asked to make a gender decision on fearful and neutral faces. Behavioral data demonstrated that two patients with early onset right MTLE were impaired in fear recognition while fMRI results showed they lacked specific activations for fearful faces. Post-ATL behavioral data showed improved emotion recognition ability, while fMRI demonstrated the recruitment of a functional network for fearful face processing. Our results suggest that ATL elicited brain plasticity mechanisms allowing behavioral and fMRI improvement in emotion recognition.
Highlights
Mesial temporal lobe epilepsy (MTLE) is a drug-resistant epilepsy characterized by hippocampal sclerosis as well as by damage to the amygdala complex [5]
This study concerns the functional bases of emotion recognition in a group of patients with MTLE, examined both before, and 6 months after temporal lobectomy
The present results show that the functional network for processing faces is not significantly affected either by epilepsy or temporal lobectomy
Summary
Mesial temporal lobe epilepsy (MTLE) is a drug-resistant epilepsy characterized by hippocampal sclerosis as well as by damage to the amygdala complex [5]. The mesial temporal lobe structures are major components of a complex system involved in both memory and emotional functions. Relatively little is known about the effect of surgery on cognitive functions, there is increasing evidence that functional compensation and reorganization can occur after epilepsy surgery [4]. The nature of the cognitive impairment in subjects with MTLE depends on the laterality of the damage: left-sided MTLE is generally characterized by material-specific verbal memory deficits, whereas right-sided MTLE is associated with deficits in spatial memory [7, 8], identification of famous faces [9], and recognition of emotion from facial expression [1, 3, 10]
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