Social cognition after epilepsy surgery in temporal lobe epilepsy: A long-term follow-up

Abstract

BACKGROUND: Previous studies have suggested that social cognition abilities do not change following surgical treatment for temporal lobe epilepsy (TLE). However, the follow-up period in these studies was no longer than 14 months. The present study investigated the long-term effects of epilepsy surgery on social cognition, extending the follow-up period to an average of 12 years (range 7-15 years). METHODS: We assessed 24 patients with drug-resistant TLE (mean age = 37 +- 11 years; 14 males) who underwent temporal lobe resection. Social cognition was measured using the Emotion Recognition Test (ERT, measuring emotion recognition) and the Faux-Pas Test (FPT, measuring Theory of Mind). Linear mixed-effects models accounted for repeated measures. Baseline scores for both ERT and FPT were standardized as Z-scores. RESULTS: ERT scores remained stable over time (estimate = 0.01, p = 0.405), while FPT performance declined gradually (estimate = -0.04, p = 0.009). Later epilepsy onset predicted higher initial FPT scores (estimate = 0.02, p = 0.036) but faster decline (estimate = -0.01, p = 0.013). Epilepsy duration, side, IQ, sex, and depressive symptoms had no significant effect. CONCLUSION: While ERT appeared to remain stable over the extended period, FPT showed a gradual decline across the post-surgery follow-up independent of age. Later age at epilepsy onset was associated with steeper FPT deterioration. Our results extend previous findings, confirming stability in emotion recognition and suggesting decline in recognition of Faux-Pax after epilepsy surgery.