August 10, 2022

Delayed Diagnosis of Functional Seizures Associated With Abnormal Processing of Face Emotions

Article published by NeurologyLive

Increased posterior cingulate cortex activation to sad faces in the long-delay diagnostic group were associated with worse symptoms of depression, as expressed by Beck Depression Inventory scores.

By assessing emotion processing circuits, recently published findings in Epilepsy & Behavior showed that diagnostic delays for functional seizures (FS) are associated with functional MRI (fMRI) changes in the insula and cingulate regions of the brain. Both are implicated in mood control, self-referencing, and other emotion-relevant processes.

In addition to completing several assessments related to symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), and quality of life, patients also underwent fMRI at 3T with emotional faces task (EFT). Here, they indicated “male” or “female” via button press while implicitly processing happy, sad, fearful, and neutral faces. Findings showed that those with long-delay diagnosis (l-DD) had significantly greater fMRI activation than short-delay diagnosis (s-DD) to sad faces in the bilateral posterior cingulate cortex (PCC; 403 mm3= 4.66; peak MNI coordinates at x = –2, y = –43, z = 18) and to neutral faces in the right anterior insula (AI; 384 mm3= 5.04; peak MNI coordinates at x = 32, y = 20, z = –12).