Abstract
The medial temporal lobes (mTL) are thought to enhance visual processing of fearful faces, yet the underlying mechanisms remain underspecified. To fill this gap, we recorded and compared event-related potentials (ERPs) and stimulus-induced gamma-band activity (GBA) from 36 patients with left- or right-hemispheric antero-medial temporal lobe resections including the amygdala (lTLR/rTLR) and 18 healthy controls. Only rTLR patients were found to lack fear-neutral differentiation in early P1 amplitudes (~100 ms) and exhibited heightened GBA for neutral faces over ipsi-resectional occipito-temporal areas (95-300 ms). lTLR patients showed strongest emotion differentiation in ERP components beyond the P1. Therefore, the right mTL, potentially particularly the amygdala, appears to support rapid attentional shifts toward fear and to coordinate fear-neutral differentiation in GBA. Conversely, the left mTL seems to down-regulate fear responses. These results reveal complementary, lateralized, and time-specific roles of the medial temporal lobes in fear processing, thereby refining models of emotional vision.