Previous research has found that youth with epilepsy are at risk for poorer social and relational outcomes. Although this is not true of everyone with epilepsy, many children and adolescents with this neurodevelopmental disorder report having a hard time making and maintaining friendships. Perhaps related to this, youth with epilepsy often also struggle to interpret others’ emotions: they tend to be less accurate than youth without epilepsy on emotion recognition tasks, where people are asked to identify the intended emotion in facial or vocal expressions. Why might this be? Some researchers have suggested that the brains of youth with epilepsy may respond differently to emotional faces, compared to youth without epilepsy. Could something similar be happening with emotional voices?
To answer this question, the current study recruited youth who had been diagnosed with intractable epilepsy (meaning they still experienced seizures despite taking medication to prevent them), and some who had not. Participants were asked to listen to recordings of emotional voices (e.g., angry voices, fearful voices, etc.) while they were in an MRI scanner. After each recording, participants were asked to indicate what emotion they thought was being expressed. We examined how accurate they were at determining the intended emotion in each recording, and how their brains responded to the different types of voices.
We found that youth with epilepsy were less accurate than youth without epilepsy on this vocal emotion recognition task—especially at younger ages. In addition, we found six regions of the brain that responded differently to the emotional voices in youth with vs. without epilepsy. Activation patterns in these areas (including regions like the right temporo-parietal junction, the right hippocampus, and the right medial prefrontal cortex) could actually predict whether any given participant had been diagnosed with epilepsy or not. Interestingly, many of these six regions are often found to be involved in ‘mentalizing tasks’, where participants are asked to make judgments about others’ emotions, thoughts, and beliefs. Our findings suggest that these brain areas might be responding differently when trying to interpret others’ emotions (based on their tone of voice) in youth with epilepsy. We don’t yet know whether these different patterns of activation are actually related to emotion recognition accuracy, or to social difficulties; they could simply reflect an alternative “strategy” when processing vocal emotional cues. Although more research is needed to determine this, our findings contribute to our understanding of how neurodiverse brains process social and emotional information.