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A week later, those participants were called back for a follow-up session inside an MRI scanner, and viewed fearful, surprised, and neutral faces.

In the third study, we examined amygdala activity when subjects viewed fearful, happy and neutral facial expressions (Fig. 1, lower left).

No significant MTL activation was seen for viewing fearful faces.

There was left-sided amygdala activation on viewing fearful faces (p = 0.003) (Fig. 1A).

Neuroimaging studies of emotion processing examine the neural responses to viewing fearful, happy or neutral faces.

Both, left and right amygdala (p = 0.001) activations were observed on viewing fearful faces (Fig. 1B).

We report all significant activations within the amygdala, the hippocampus, and the parahippocampal structures for the contrast of viewing fearful compared to neutral faces.

In left TLE patients, we did not observe any significant correlation between preoperative fMRI activation on viewing fearful faces and postoperative change in anxiety or depression scores.

We found a positive correlation in right TLE patients between preoperative right amygdala activation on viewing fearful faces and postoperative increase in anxiety and depression scores.

Our findings corroborate previous studies showing asymmetric activations in response to viewing fearful stimuli in normal subjects and extend these findings to patients with refractory epilepsy.

Correlation of fMRI activation (viewing fearful contrasted by neutral faces) with preoperative anxiety/depression scores: In right TLE patients, there was a significant correlation between preoperative anxiety scores and fMRI activation associated with viewing fearful faces in left (p = 0.001) and right amygdala (p = 0.000) (Fig. 3A and Table 1c).