Abstracts

Empathy depends on frontotemporolimbic networks. Previous studies of empathy in patients with brain lesions suggest that cognitive components of empathy depend on frontal/executive functions while emotional components depend on temporal/limbic functions. Temporal lobe epilepsy (TLE) might influence empathy by affecting these regions. In this study of empathy in TLE patients awaiting temporal lobectomy (TL), we 1) describe patterns of empathy in this population compared to other groups and 2) show correlations and dissociations between empathic function and frontal/executive function., As part of a study of epilepsy surgery and social cognition, preoperative data from the first 20 subjects with TLE (13F/7M, 6 R TL/14 L TL, age 18-67) were reviewed. First-degree relatives rated subjects[apos] empathy using the Interpersonal Reactivity Index. This yielded two cognitive empathy scores (Perspective Taking [PT] and Fantasy [FS]) and two emotional empathy scores (Empathic Concern [EC] and Personal Distress [PD]). Subjects also had standard neuropsychological testing with multiple measures of frontal/executive function., 1) Compared to normal elderly controls, our subjects did worse on one cognitive (PT mean 16.8(SD 6.6) vs 24.5(6.4)) and both emotional empathy scores (EC 24.9(6.5) vs 29.5(2.6), PD 19.6(6.3) vs 15.0(6.2) [higher PD scores are worse]); they also performed worse than patients with Alzheimer disease (AD) on one emotional score (EC 25.0(6.5) vs 28.4(4.9)). They performed better than semantic dementia (SD) patients on all scores and better than frontotemporal dementia (FTD) patients on one cognitive score (FS 18.5(6.5) vs 14.8(6.2)) (P [lt] 0.05 for all comparisons; comparison groups from Rankin 2005 Cogn Behav Neurol.). In multivariate models, neither age, sex, seizure duration, laterality, nor presence of mesial temporal pathology correlated with IRI scores. Multivariate linear regressions show correlation of cognitive score FS with verbal abstract reasoning (R = 0.51, P = 0.025) but no correlation between emotional subscores and any measures of frontal/executive function., Subjects showed reduced emotional empathy relative to both normal elderly and AD patients; their average scores were not different from those of FTD patients. Their cognitive empathy scores were lower than those of normal elderly subjects but one cognitive score was higher than that of FTD patients. One cognitive subscore correlated with a common test of abstract reasoning while emotional empathy scores had no relationship to frontal/executive test scores.Together, these results suggest that our subjects[apos] reduced cognitive empathy may be related to broader frontal/executive dysfunction (likely multifactorial in origin). Thier emotional empathy, on the other hand, may be related to dysfunction of specific temporal structures. Further study of more subjects and of pre/postoperative changes in empathy will help to support or refute this contention., (Supported by NINDS K23 NS047100 to HEK.)