Abstract
Social behaviour of healthy humans and its neural correlates have been extensively studied in social neuroscience and neuroeconomics. Whereas it is well established that several types of epilepsies, such as frontal lobe epilepsy, lead to social cognitive impairments, experimental evidence on how these translate into behavioural symptoms is scarce. Furthermore, it is unclear whether social cognitive or behavioural disturbances have an impact on therapy adherence, which is critical for effective disease management, but generally low in these patients. In order to investigate the relationship between social cognition, social behaviour, and therapy adherence in patients with frontal lobe epilepsies (FLE), we designed a study combining conventional neuropsychological with behavioural economic and functional magnetic resonance imaging (fMRI) methodology. Fifteen patients and 15 healthy controls played a prisoners' dilemma game (an established game to operationalize social behaviour) while undergoing fMRI. Additionally, social cognitive, basic neuropsychological variables, and therapy adherence were assessed. Our results implicate that social behaviour is indeed affected and can be quantified using neuroeconomic methods in patients with FLE. Impaired social behaviour in these patients might be a consequence of altered brain activation in the medial prefrontal cortex and play a role in low therapy adherence. Finally, this study serves as an example of how to integrate neuroeconomic methods in neurology.
Highlights
Social cognition is a term used for several high-level cognitive functions that determine human behaviour in a social context
Crucial parts of this brain network reside in the frontal cortex such as the ventromedial frontal/orbitofrontal cortex and the anterior cingulate cortex [5]. These discoveries have led to the adoption of economic methodology to study behaviour in neurology [6], but to the best of our knowledge, no such study has focused on the behaviour of patients with epilepsy
One of the goals of this study was to find out whether deficits in social cognition in frontal lobe epilepsies (FLE) patients could lead to differences in social behaviour that can be operationalized
Summary
Social cognition is a term used for several high-level cognitive functions that determine human behaviour in a social context. In neuroeconomics—the science of studying research questions in economics through the application of neuroscientific methods and theories—pro-social behaviours, such as trust or cooperation, have been extensively studied for decades, mainly through game paradigms, such as the trust game or the prisoners’ dilemma game [4]. Using this approach, several brain areas were found to play a role in prosocial behaviour of healthy humans. These discoveries have led to the adoption of economic methodology to study behaviour in neurology [6], but to the best of our knowledge, no such study has focused on the behaviour of patients with epilepsy
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