# More Fixations in Static Facial Regions During Emotion Recognition Among TLE Patients With Severe Depression

## TL;DR

TLE patients with severe depression focus more on static facial areas like the nose during emotion recognition tasks compared to others.

## Contribution

Identifies abnormal fixation patterns in TLE patients with severe depression using eye-tracking during emotion recognition.

## Key findings

- TLE patients without depression had lower FPT scores and dynamic facial ER accuracy than healthy controls.
- Severely depressed TLE patients showed more fixations on the nose compared to those with no/mild/moderate depression.
- Eye-tracking reveals biobehavioral indicators useful for early monitoring of severe depression in TLE patients.

## Abstract

To explore the emotion recognition (ER) abilities among temporal lobe epilepsy (TLE) patients with different levels of depression.

This observational study was conducted during December 2021 and November 2022, including 71 healthy controls (HCs) and 93 TLE patients. Based on the scores of the Beck Depression Index, the patients were divided into four groups (no/mild/moderate/severe depression). All participants finished the Faux pas task (FPT), watched the dynamic facial expression task and recognized the emotion (anger, disgust, happiness, or sadness) with the recording of eye movements. The accuracy of ER was recorded. The percentage of fixation in interested areas (IA) and fixation counts in IA were selected and analyzed.

TLE patients without depression had significantly lower FPT scores (p = 0.001) and accuracy ratios of dynamic facial ER (p = 0.039) than HCs. Patients with severe depression had significantly more fixation percentages and fixation counts in the nose than patients with no/mild/moderate depression (p < 0.05).

The recording of eye movement provides more accurate and objective biobehavioral indicators for distinguishing TLE patients with severe depression, which has great practical significance for early monitoring and intervention.

Eye‐tracking data revealed distinct attentional patterns: TLE patients with severe depression exhibited abnormal fixation preferences, disproportionately focusing on static facial features (e.g., nose) rather than dynamic, emotionally informative regions (e.g., eyes and mouth).