Understanding Social Cognition May Be Critical in Treating Epilepsy

Susan Kreimer for Medscape

January 17, 2022

The report covered in this summary was published in medRxiv.org as a preprint and has not yet been peer reviewed.

Key Takeaway

  • Identifying the nature and magnitude of social cognitive impairments in people with epilepsy has both theoretical and clinical implications, including the potential to inform guidelines for clinical assessment and psychosocial intervention.

Why This Matters

  • People with epilepsy demonstrate impairments in social cognition that negatively impact quality of life, employability, and other cognitive functions.

  • Despite the increasing volume of studies investigating social cognition in epilepsy over recent years, research into the predictors of social cognitive impairment in this population remains lacking.

  • Specifically, the extent to which social cognitive difficulties are caused by medication, psychological, and social factors (for example, fear of seizures, perceived stigma, discrimination, lack of social support), recurrent seizures, or the underlying epileptogenic brain lesion, remains unclear.

  • To the authors' knowledge, this is the first review to comprehensively examine the four major domains of social cognition: emotion recognition, theory of mind, empathy, and social behavior, among patients with temporal and frontal lobe epilepsy.

Study Design

  • The authors reviewed papers from 1990-2021 and examined them for inclusion in the research.

  • After the deduplication process, they conducted a systematic review and meta-analysis of 44 and 40 articles, respectively, involving 113 people with frontal lobe epilepsy and 1482 people with temporal lobe epilepsy.

Key Results

  • The results indicated that although patients with frontal or temporal lobe epilepsy have difficulties in all aspects of social cognition relative to nonclinical controls, the effect sizes were larger for theory of mind (g = 0.95), than for emotion recognition (g = 0.69) among the temporal lobe epilepsy group.

  • The frontal lobe epilepsy group exhibited significantly greater impairment in emotion recognition compared with those who had temporal lobe epilepsy.

  • In addition, people with right temporal lobe epilepsy (g = 1.10) performed more poorly than those with a left-sided (g = 0.90) seizure focus, specifically in the theory of mind domain.

  • The data point to a potentially important difference in the severity of deficits within the emotion recognition and theory-of-mind abilities depending on the lateralization of seizure side.

Limitations

  • Due to the small number of studies and participants, the results need to be interpreted cautiously.

Study Disclosures

  • The authors have declared no competing interest.

This is a summary of a preprint research study, "Social Cognition in Temporal and Frontal Lobe Epilepsy: Systematic review, Meta-analysis, and Clinical Recommendations," by Maryam Ziaei from Norwegian University of Science and Technology, Trondheim, Norway, and University of Queensland, Brisbane, Australia, and colleagues, provided to you by Medscape. This study has not yet been peer reviewed. The full text of the study can be found on medRxiv.org.

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