Abstracts

Rationale: Effective social interaction depends in part on the ability to accurately interpret certain aspects of non-verbal communication. For instance, facial expression can drastically change the intended meaning of a statement in a conversation. Multiple lines of evidence suggest that specific networks spanning the frontal and temporal lobes of the brain support this type of non-verbal communication. Coincidentally, these regions are frequently implicated as the cause of focal epilepsy. Deficits in memory, language, and psychiatric function in patients with focal epilepsy have been closely investigated. In contrast, only a handful of investigators have addressed problems with non-verbal communication in these patients. Our hypothesis is that patients with refractory temporal and frontal lobe epilepsy have difficulties with perception of certain aspects of non-verbal communication. Methods: To test our hypothesis, we administered a video based neuropsychological instrument called The Awareness of Social Inference Test (TASIT) which evaluates certain aspects of non-verbal communication to a cohort of 19 patients with medically refractory localization-related epilepsy. We compared the results to a published cohort of normal subjects using a one-sample t-test. Results: Patients with epilepsy had difficulty with emotional recognition compared normal controls (mean of 18.1 compared to mean of 24.86; p<0.001). Patients with epilepsy scored lower for recognition of sarcasm compared to normal controls (mean of 42.3 compared to a mean of 54.1; p<0.001). Patients with epilepsy had difficulty with differentiating insincere responses from sarcastic responses (mean 43.7 compared to a mean of 55.6; p<0.001). Conclusions: Our findings support the idea that focal epilepsy is associated with deficits in perception of non-verbal communication. The etiology of social cognitive disturbances in patients with epilepsy may be due to underlying neuropathology, due to ongoing seizure activity itself, or secondary to relative social isolation of patients with epilepsy. Further planned work includes addition of neuropsychological instruments which measure general intellectual function and obtaining an original control group. Strategies that improve non-verbal communication may improve the quality of life of patients with focal epilepsies.