Comparison of migraine and epilepsy patients with HEALTHY controls regarding theory of mind, emotional and facial recognition, alexithymia, depression, anxiety, and executive functions

Comparison of migraine and epilepsy patients with healthy controls regarding theory of mind, emotional and facial recognition, alexithymia, depression, anxiety, and executive functions. Objective: The objective of this study is to compare Migraine and Epilepsy patients with each other and with healthy controls regarding the theory of mind, alexithymia, functions of social cognition and neurocognition such as facial emotional recognition, anxiety, and depression and to examine which of these factors are closely interrelated. Material and Method: 40 Migraine (18 without aura and 22 with aura), and 35 Epilepsy (5 focal, 30 idiopathic generalized) patients, 31 healthy control group whose ages and educations have been matched patients groups included in this study. The Patient and Healthy control groups have only consisted of female participants. First, social-demographic data form and then, Hospital Anxiety and Depression Scale, and Toronto Alexithymia Scale were given to the patient groups and healthy control group. For the assessment of theory of mind, Dokuz Eylül Theory of Mind Scale (DEZTÖ), the assessment of facial recognition Benton facial recognition test, and the Ekman face recognition battery have been used. The Executive functions have assessed with Wisconsin Card Sorting Test (WCST) and Stroop test. Findings: Theory of mind skills of Epilepsy and Migraine patients are similar to each other and their first-degree false belief and DEZTÖ total scores are lower than the healthy controls. Patients with migraine showed better performance than patients with Epilepsy in recognition of disgusted faces. The facial recognition skills of the patients with migraine are better than that of patients with Epilepsy and in both groups of patients, their skills of facial recognition are impaired compared with healthy controls. Patients with epilepsy show more alexithymic features compared with the healthy controls. According to the Stroop test, executive functions of epilepsy patients are impaired compared with migraine patients and healthy controls. WCST category scores of Migraine and Epilepsy patients significantly worse than healthy control group scores. Impairment of executive function scores of Migraine patients are associated to the impairment of theory of mind, but it is not to Epilepsy patients. While the increase in alexithymia scores in migraine patients are associated to the impairment of theory of mind, there is no relationship in epilepsy patients. While the increase in anxiety and depression scores in both diseases are not associated to the imprairment of theory of mind and executive functions, but they associated to the increased alexithymia scores. Our findings showed that Benton score was predicted by the patient group, Ekman Happy and Stroop5Time; DEZTÖ Total scores were predicted by Ekman Sad, Ekman Neutral and HAD total in patients with epilepsy, and by WCST Category and Ekman Neutral in patients with migraine; Ekman Disgusted scores were predicted by WCST Category and Ekman Sad in patients with epilepsy, and by Strrop5Error in patients with migraine. Conclusion: This cross-sectional, prospective and controlled is the first study we can see in the Turkish and English literature in which patients with Epilepsy and Migraine were compared in terms theory of mind, emotion and face recognition, alexithymia, depression and anxiety levels and executive functions and related factors were investigated. It has been shown that in patients with Epilepsy and Migraine, the impairment of social cognition stems not from the impairment of emotional recognition but from the impairment of the theory of mind; the impairment of the executive functions is associated to the impairment of the theory of mind in Migraine patients; and in the both diseases, the impairment of the executive functions is associated to the impairment of emotional recognition. Key Words: Epilepsy, Migraine, Social Cognition, Alexithymia