Baxendale Sallie A, Thompson Pamela J, Duncan John S
Department of Clinical and Experimental Epilepsy, Institute of Neurology, London, UK.
Seizure. 2005 Sep;14(6):435-8. doi: 10.1016/j.seizure.2005.07.003.
Hippocampal sclerosis (HS) is one of the most common pathologies in medically intractable temporal lobe intractable epilepsy. Significant hippocampal volume loss has also been found in patients with chronic depression. Depression is common in chronic epilepsy populations, but the effects of this comorbidity on hippocampal volume are unknown. We examined the hippocampal volumes of 87 patients (n=31 right hippocampal sclerosis, RHS; n=56 left hippocampal sclerosis, LHS). Each subject completed the Hospital Anxiety and Depression Scale (HADS). In the group as a whole, 13 subjects (15%) recorded moderate or severe levels of depression. Depression was more common in the LHS group with 1 in 5 scoring in the moderate or severe range on the HADS (n=11). Depression scores were not significantly correlated with quantitative measures of hippocampal volume in the LHS group. However, higher degrees of hippocampal symmetry were associated with higher levels of depression in the RHS group. This suggests that the left hippocampus may be smaller in depressed patients with RHS, although our numbers were too small to confirm this statistically. Our results suggest that the depression may influence left hippocampal volume in patients with right hippocampal sclerosis. We conclude that the neuroradiological characteristics of patients with epilepsy and chronic depression deserve further examination.
海马硬化（HS）是药物难治性颞叶癫痫最常见的病理表现之一。在慢性抑郁症患者中也发现了明显的海马体积丢失。抑郁症在慢性癫痫患者群体中很常见，但这种共病对海马体积的影响尚不清楚。我们检查了87例患者的海马体积（n = 31例右侧海马硬化，RHS；n = 56例左侧海马硬化，LHS）。每位受试者都完成了医院焦虑抑郁量表（HADS）。在整个研究组中，13名受试者（15%）记录有中度或重度抑郁水平。抑郁症在LHS组中更为常见，五分之一的患者在HADS上得分在中度或重度范围内（n = 11）。在LHS组中，抑郁评分与海马体积的定量测量没有显著相关性。然而，在RHS组中，较高程度的海马对称性与较高水平的抑郁相关。这表明，尽管我们的样本量太小，无法从统计学上证实这一点，但在患有RHS的抑郁症患者中，左侧海马可能较小。我们的结果表明，抑郁症可能会影响右侧海马硬化患者的左侧海马体积。我们得出结论，癫痫和慢性抑郁症患者的神经放射学特征值得进一步研究。
