Abstracts

Rationale: Socio-perceptive competencies integrate and attribute meaning to non verbal cues delivered by human environment. In adults, cerebral functional imaging studies have shown that the temporal cortex is involved in this type of information processing (face identity, gaze direction, emotional expression, voice identity, phrastic and emotional prosody). These data suggest that temporal cortex damage is likely to be associated with abnormal socio-perceptive development. Methods: To uncover the relationships between temporal cortex and visuo-and auditivo- social competencies during abnormal and normal development and to study possible differences between visual and auditory post-lesional plasticity we prospectively studied 39 children with unilateral temporal lobe epilepsy (TLE) and 9 age-matched control groups (72 healthy children), using tasks that allow evaluation of visuo- and auditory-perceptual processing of cues delivered by faces and voices. We analyzed deficits taking into account the localization of ictal and interictal EEG activity, the age at onset and the duration of the epilepsy and the data provided by cerebral neuroimaging (MRI). We also investigated correlations between socio-perceptual deficits and rest metabolism at FDG-PET (see abstract on SPeDeTEC II study by Chassoux et al.)Results: Socio-perceptual deficits have been evidenced in 62% of the 39 children with TLE. We didn’t find any relationship between the side of the epilepsy and the type of the eventual deficit. We showed that developmental deficits can be dissociated: one socio-perceptual modality impaired and not the other (visual versus auditory and vice versa) and can even be specific to a cue (for example, impairment in face identity with preserved emotional expression). Moreover, those deficits can be observed without any deficit in visual or auditory episodic memory, low level visual processing or speech perception. Conclusions: The lack of deficit lateralization (despite an early functional asymmetry during normal development) suggests a poor rescuing by the contralateral hemisphere. It also shows a close developmental dependency between the two hemispheres. Persistence of those deficits despite many years of “good” stimulation by the environment suggests poor neuro-fonctional plasticity for those competencies. Research programme funded by: CNRS, LFCE, FFRE, Fondation Wyeth, ARETNE. Acknowledgements: Philippe Kahane and Lorella Minoti (Grenoble); Edouard Hirsch and Maria-Paola Valenti (Strasbourg); Marie Bourgeois and Christian Sainte-Rose (Paris, Necker); Philippe Ryvlin, and Karine Ostrowsky (Lyon); Francine Chassoux (Paris, Sainte Anne); Dominique Parrain (Rouen); The multicentric network for epilepsy surgery in children.