Research Article| Volume 142, 109191, May 2023

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Revisiting emotion recognition in different types of temporal lobe epilepsy: The influence of facial expression intensity

  • C. Nineuil
    Univ. Lille, ULR 4072 - PSITEC - Psychologie : Interactions Temps Émotions Cognition, F-59000 Lille, France
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  • M. Houot
    Centre of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière Hospital, Paris, France

    Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France

    Clinical Investigation Centre, Institut du Cerveau et de la Moelle épinière (ICM), Pitié-Salpêtrière Hospital, Paris, France
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  • D. Dellacherie
    Univ. Lille, ULR 4072 - PSITEC - Psychologie : Interactions Temps Émotions Cognition, F-59000 Lille, France

    CHU Lille, Department of Pediatric Neurology, F-59000 Lille, France
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  • M. Méré
    Epilepsy Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
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  • M. Denos
    Rehabilitation Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
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  • S. Dupont
    Epilepsy Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France

    Centre de Recherche de l’Institut du Cerveau Et de La Moelle Épinière (ICM), UMPC-UMR 7225 CNRS-UMRS 975 Inserm, Paris, France
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  • S. Samson
    Corresponding author at: Université de Lille, Domaine Universitaire du Pont de Bois, Laboratoire PSITEC (ULR 4072), Rue du Barreau BP 60149 59653 Villeneuve d'Ascq Cedex, France.
    Univ. Lille, ULR 4072 - PSITEC - Psychologie : Interactions Temps Émotions Cognition, F-59000 Lille, France

    Epilepsy Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France

    Centre de Recherche de l’Institut du Cerveau Et de La Moelle Épinière (ICM), UMPC-UMR 7225 CNRS-UMRS 975 Inserm, Paris, France
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      • Emotional facial recognition is not globally impaired in TLE.
      • TLE patients show deficits in recognizing facial expressions of fear and disgust.
      • Localization of epilepsy focus plays a role in recognizing specific expressions.
      • Sensitivity to emotional intensity varies with epilepsy localization and emotion.


      Temporal lobe epilepsy (TLE) can induce various difficulties in recognizing emotional facial expressions (EFE), particularly for negative valence emotions. However, these difficulties have not been systematically examined according to the localization of the epileptic focus. For this purpose, we used a forced-choice recognition task in which faces expressing fear, sadness, anger, disgust, surprise, or happiness were presented in different intensity levels from moderate to high intensity. The first objective of our study was to evaluate the impact of emotional intensity on the recognition of different categories of EFE in TLE patients compared to control participants. The second objective was to assess the effect of localization of epileptic focus on the recognition of EFE in patients with medial temporal lobe epilepsy (MTLE) associated or not with hippocampal sclerosis (HS), or lateral temporal lobe epilepsy (LTLE). The results showed that the 272 TLE patients and the 68 control participants were not differently affected by the intensity of EFE. However, we obtained group differences within the clinical population when we took into account the localization of the temporal lobe epileptic focus. As predicted, TLE patients were impaired in recognizing fear and disgust relative to controls. Moreover, the scores of these patients varied according to the localization of the epileptic focus, but not according to the cerebral lateralization of TLE. The facial expression of fear was less well recognized by MTLE patients, with or without HS, and the expression of disgust was less well recognized by LTLE as well as MTLE without HS patients. Moreover, emotional intensity modulated differently the recognition of disgust and surprise of the three patient groups underlying the relevance of using moderate emotional intensity to distinguish the effect of epileptic focus localization. These findings should be taken into account for interpreting the emotional behaviors and deserve to be further investigated before considering TLE surgical treatment or social cognition interventions in TLE patients.



      TLE (Temporal lobe epilepsy), EFE (Emotional facial expressions), MTLE (Medial temporal lobe epilepsy), HS (Hippocampal sclerosis), LTLE (Lateral temporal lobe epilepsy), ASMs (Anti-seizure medications)
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