Abstracts

Rationale: Social cognition involves perceiving, processing, and using information appropriately to interact in our social world. The social brain is a complex network including the medial prefrontal cortex, anterior cingulate cortex, temporoparietal junction, superior temporal sulcus, and temporal poles. Because seizures can disrupt specific brain regions and networks, focal epilepsy syndromes provide an opportunity to examine the potential neural mechanisms of various social cognitive functions. In addition to potentially assisting with seizure localization, understanding the underlying mechanisms can help preserve these functions in patients who undergo resective surgery and optimize social functioning following treatment. Perceived social functioning has been shown to contribute to overall quality of life. The goal of this study was to examine performance on more objective measures of social functioning and the relations between these social cognition tasks and quality of life (QOL). Methods: Participants were epilepsy patients who underwent continuous EEG monitoring and neuropsychological evaluation to determine if they were appropriate candidates for resective surgery. Localization data were provided by the patients' neurosurgeon and epileptologists. Patients with bilateral or nonlateralizing seizures were excluded from the study, as were patients with IQ scores below 70. The final sample included 42 patients, 23 with a left-sided seizure focus and 19 with a right-sided focus. Patients ranged in age from 19 to 69 years (M = 36.17, SD = 14.34). The ACS Social Cognition subtests and Quality of Life in Epilepsy (QOLIE-31) were administered as part of the comprehensive neuropsychological battery. Results: Patients with right hemisphere (RH) seizure focus performed significantly below standardized means on measures of affect recognition [M = 8.16, SD = 2.65, t(18) = -3.03, p = .007], emotional prosody recognition [M = 5.28, SD = 3.36, t(17) = -5.97, p < .001], and overall social perception [M = 8.11, SD = 2.97, t(17) = -2.70, p = .015]. Scores for the RH group were significantly below the left hemisphere (LH) group for affect recognition [t(38) = 2.32, p = .026] and overall social perception [t(36) = 2.18, p = .036]. LH patients [M = 7.71, SD = 4.89, t(20) = -2.14, p = .045] also had some difficulty with emotional prosody perception. RH patients reported significantly better overall QOL [t(30) = -2.196, p = .036], subjective cognitive functioning [t(30) = -2.77, p = .009], and perceived social functioning [t(30) = -2.59, p = .015] than those with a left-sided focus. Conclusions: Findings were consistent with previous research showing that LH seizures are associated with poorer QOL compared to those with RH pathology. Despite showing more significant social cognitive deficits, RH patients reported better perceived social functioning and overall QOL, indicating that they may have less insight into their behavior and functioning, possibly related to a form of anosagnosia, which has been associated with right hemisphere dysfunction. Additional implications and directions for future research will be discussed.