Lunn, Judith Fiona and Donovan, Tim and Litchfield, Damien and Lewis, Charles Neville and Davies, Robert Aye Imanol and Crawford, Trevor Jeremy (2017) Social attention in children with epilepsy. Brain and Cognition, 113. pp. 76-84. ISSN 0278-2626
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Abstract
Children with epilepsy may be vulnerable to impaired social attention given the increased risk of neu- robehavioural comorbidities. Social attentional orienting and the potential modulatory role of attentional control on the perceptual processing of gaze and emotion cues have not been examined in childhood onset epilepsies. Social attention mechanisms were investigated in patients with epilepsy (n = 25) aged 8–18 years old and performance compared to healthy controls (n = 30). Dynamic gaze and emotion facial stimuli were integrated into an antisaccade eye-tracking paradigm. The time to orient attention and exe- cute a horizontal saccade toward (prosaccade) or away (antisaccade) from a peripheral target measured processing speed of social signals under conditions of low or high attentional control. Patients with epi- lepsy had impaired processing speed compared to healthy controls under conditions of high attentional control only when gaze and emotions were combined meaningfully to signal motivational intent of approach (happy or anger with a direct gaze) or avoidance (fear or sad with an averted gaze). Group dif- ferences were larger in older adolescent patients. Analyses of the discrete gaze emotion combinations found independent effects of epilepsy-related, cognitive and behavioural problems. A delayed disengage- ment from fearful gaze was also found under low attentional control that was linked to epilepsy devel- opmental factors and was similarly observed in patients with higher reported anxiety problems. Overall, findings indicate increased perceptual processing of developmentally relevant social motivations during increased cognitive control, and the possibility of a persistent fear-related attentional bias. This was not limited to patients with chronic epilepsy, lower IQ or reported behavioural problems and has implica- tions for social and emotional development in individuals with childhood onset epilepsies beyond remission.