Department of Psychology, Chung Shan Medical University, Taichung, Taiwan.
Department of Neurology, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan.
Epilepsy Behav. 2022 Jan;126:108462. doi: 10.1016/j.yebeh.2021.108462. Epub 2021 Dec 9.
No studies have examined the relationship between the intensity of facial emotion expression and theory of mind (ToM) ability in people with epilepsy. This study aimed to explore facial emotion recognition in a group of patients with frontal (FLE) or temporal lobe epilepsy (TLE) and its relationship with the intensities of perceived facial emotion expressions, ToM, and social functioning.
Twenty-six patients with FLE or TLE and 30 matched controls were included in the study. All participants completed the facial emotion recognition test, Faux Pas Recognition (FPR) test measuring advanced ToM, Symptom Checklist-90-Revised, Social and Occupational Functioning Scale for Epilepsy (SOFSE), and background neuropsychological tests.
The patient group was significantly worse than the control group in recognizing facial expressions of negative emotions, particularly for medium-intensity facial expression of fear. There was no significant difference between the groups in recognizing high-intensity fear facial expressions. The scores of FPR (overall and affective ToMs) in the patient group were significantly lower than those in the control group. Additionally, the facial emotion recognition was significantly associated with the total score of FPR, and the FPR total score remarkably correlated with the Communication subscale score of the SOFSE.
Patients with FLE or TLE had impaired ability to recognize medium-intensity facial expressions of fear. Moreover, patients' ToM deficit significantly correlated not only with their emotion recognition problem but also with their social-communicative competence. Nevertheless, we also found that increasing the intensity of expression can improve the accuracy of emotion recognition in patients with epilepsy. These findings may provide considerations for further longitudinal studies and interventions on the social difficulties of people with epilepsy.
目前尚无研究探讨癫痫患者的面部表情情绪强度与心理理论（Theory of Mind，ToM）能力之间的关系。本研究旨在探索额叶（frontal，FLE）或颞叶（temporal lobe，TLE）癫痫患者的面部情绪识别能力及其与感知面部表情情绪强度、ToM 能力和社会功能的关系。
本研究纳入 26 例 FLE 或 TLE 患者和 30 名匹配的对照组参与者。所有参与者均完成了面部情绪识别测试、错误察觉测试（Faux Pas Recognition，FPR），以评估高级 ToM 能力、症状清单-90 修订版（Symptom Checklist-90-Revised，SCL-90-R）、癫痫社会和职业功能量表（Social and Occupational Functioning Scale for Epilepsy，SOFSE）和背景神经心理学测试。
与对照组相比，患者组在识别负性面部表情，尤其是中等强度的恐惧面部表情方面的能力显著更差。两组在识别高强度恐惧面部表情方面无显著差异。患者组的 FPR（整体和情感 ToM）评分显著低于对照组。此外，面部情绪识别与 FPR 的总分显著相关，而 FPR 总分与 SOFSE 的交流分量表得分显著相关。
FLE 或 TLE 患者的中等强度恐惧面部表情识别能力受损。此外，患者的 ToM 缺陷不仅与他们的情绪识别问题显著相关，而且与他们的社交沟通能力显著相关。然而，我们还发现，增加表情的强度可以提高癫痫患者情绪识别的准确性。这些发现可能为进一步研究癫痫患者的社会困难和干预措施提供参考。
