Temporal lobe epilepsy, depression, and hippocampal volume
Open Access
- 7 May 2009
- Vol. 50 (5), 1067-1071
- https://doi.org/10.1111/j.1528-1167.2008.01883.x
Abstract
Objective: To evaluate the relationship between hippocampal volume loss, depression, and epilepsy. Background: There is a significantly increased incidence of depression and suicide in patients with epilepsy. Both epilepsy and depression are associated with reduced hippocampal volumes, but it is uncertain whether patients with both conditions have greater atrophy than those with epilepsy alone. Previous studies used depression measures strongly weighted to current state, and did not necessarily assess the influence of chronic major depressive disorder (“trait”), which could have a greater impact on hippocampal volume. Methods: Fifty‐five epilepsy patients with complex partial seizures (CPS) confirmed by electroencephalography (EEG) had three‐dimensional (3D)‐spoiled gradient recall (SPGR) acquisition magnetic resonance imaging (MRI) scans for hippocampal volumetric analysis. Depression screening was performed with the Beck Depression Inventory (BDI, 51 patients) and with the structured clinical inventory for DSM‐IV (SCID, 34 patients). For the BDI, a score above 10 was considered mild to moderate, above 20 moderate to severe, and above 30 severe depression. MRI and clinical analysis were performed blinded to other data. Statistical analysis was performed with Systat using Student’s t test and analysis of variance (ANOVA). Results: There was a significant interaction between depression detected on SCID, side of focus, and left hippocampal volume. Patients with a diagnosis of depression and a right temporal seizure focus had significantly lower left hippocampal volume. A similar trend for an effect of depression on right hippocampal volume in patients with a right temporal focus did not reach statistical significance. Conclusions: Our results suggest that patients with right temporal lobe epilepsy and depression have hippocampal atrophy that cannot be explained by epilepsy alone.Keywords
This publication has 37 references indexed in Scilit:
- Contextual Fear Conditioning in Humans: Cortical-Hippocampal and Amygdala ContributionsJournal of Neuroscience, 2008
- Neuropsychiatric morbidity in focal epilepsyThe British Journal of Psychiatry, 2008
- Major depression in temporal lobe epilepsy with hippocampal sclerosis: clinical and imaging correlatesJournal of Neurology, Neurosurgery & Psychiatry, 2007
- Depression in Temporal Lobe Epilepsy Surgery Patients: An FDG‐PET StudyEpilepsia, 2006
- Facial Emotion Recognition after Curative Nondominant Temporal Lobectomy in Patients with Mesial Temporal SclerosisEpilepsia, 2006
- Clinical Assessment of Axis I Psychiatric Morbidity in Chronic Epilepsy: A Multicenter InvestigationThe Journal of Neuropsychiatry and Clinical Neurosciences, 2005
- MR-based in vivo hippocampal volumetrics: 2. Findings in neuropsychiatric disordersMolecular Psychiatry, 2004
- Depression in Intractable Partial Epilepsy Varies by Laterality of Focus and SurgeryEpilepsia, 2003
- Hippocampal sclerosis is a progressive disorder: A longitudinal volumetric MRI studyAnnals of Neurology, 2003
- Major depression is a risk factor for seizures in older adultsAnnals of Neurology, 2000