Foreword for inaugural issue of Acta Epilepsy

Social cognition is the ability to identify, perceive, and interpret social information. It is an important skill for successful interpersonal functioning. Although social cognition is known to be impaired in several neurological and psychiatric conditions, its functional integrity in epilepsy is less well established. The aim of this review was to characterize the impairment of social cognition in domains of emotion recognition (ER) and theory of mind (ToM) in patients with epilepsy. An electronic search was conducted to identify clinical studies investigating social cognition in epilepsy populations, yielding 42 studies to be included in this review. Meta-analysis of the literature demonstrated that (1) ER and ToM are impaired in both patients with temporal lobe epilepsy and patients with epilepsy not originating within the temporal lobe; (2) in patients with temporal lobe epilepsy and extratemporal lobe epilepsy, there are no significant differences in the median effect size between ER and ToM. The social interaction difficulties observed in some patients with epilepsy may, at least in part, be due to an impaired ability to correctly process and interpret emotional expression and mental states of others. Establishing a clear understanding of the mechanisms underlying impaired social cognition in patients with epilepsy will help improve their clinical management and characterize the phenotypes of epilepsy, and at a broader level, reduce the disease burden in society.