Social cognition in temporal lobe epilepsy: A systematic review and meta-analysis

Objective: There is increasing evidence suggesting that social cognitive abilities are impaired in temporal lobe epilepsy (TLE), the most common form of focal epilepsies. Methods: In this meta-analysis, 31 studies investigating theory of mind (ToM) and facial emotion recognition performances of 1356 patients with TLE (351 postsurgery) and 859 healthy controls were included. Results: Patients with TLE had significant deficits in ToM (d = 0.73-0.89) and recognition of facial emotions. There were no significant differences in severity of social cognitive deficits between patients with TLE with or without medial temporal lobectomy. Earlier onset of seizures was associated with ToM impairment. Rightsided TLE was associated with more severe deficits in recognition of fear, sadness, and disgust. Conclusions: Social cognitive information processing is impaired in TLE, and the potential role of these deficits in functional impairment needs to be further investigated.