Department of Neurosciences and Behavior, University of Sao Paulo School of Medicine, Ribeirao Preto, Brazil.
Psychiatry Res. 2012 Feb 28;195(3):144-50. doi: 10.1016/j.psychres.2011.06.005. Epub 2011 Jul 8.
Psychiatric co-morbidities in epilepsy are common in patients with temporal lobe epilepsy (TLE). Pathological alterations in TLE are well characterised; however, neuropathologic data are relatively scale regarding the association between psychiatric diseases and epilepsy. Our objective was to evaluate the clinical data of 46 adult TLE patients with and without psychiatric co-morbidities and to correlate the data with hippocampal neuronal density and mossy fiber sprouting. Accordingly, patients were grouped as follows: TLE patients without history of psychiatric disorder (TLE, n=16), TLE patients with interictal psychosis (TLE+P, n=14), and TLE patients with major depression (TLE+D, n=16). Hippocampi from autopsies served as non-epileptic controls (n=10). TLE+P exhibited significantly diminished mossy fiber sprouting and decreased neuronal density in the entorhinal cortex when compared with TLE. TLE+P showed significantly poorer results in verbal memory tasks. TLE+D exhibited significantly increased mossy fiber sprouting length when compared with TLE and TLE+P. Further, a higher proportion of TLE+D and TLE+P presented secondarily generalised seizures than did TLE. Our results indicate that TLE patients with psychiatric disorders have distinct features when compared with TLE patients without psychiatric co-morbidities and that these changes may be involved in either the manifestation or the maintenance of psychiatric co-morbidities in epilepsy.
癫痫患者常伴有精神共病，颞叶癫痫（TLE）患者中更为常见。TLE 的病理改变已有明确特征；然而，与精神疾病和癫痫相关的神经病理学数据相对较少。我们的目的是评估 46 例伴有和不伴有精神共病的成年 TLE 患者的临床数据，并将这些数据与海马神经元密度和苔藓纤维发芽相关联。因此，患者分为以下几组：无精神障碍病史的 TLE 患者（TLE，n=16）、伴有癫痫发作间期精神病的 TLE 患者（TLE+P，n=14）和伴有重度抑郁症的 TLE 患者（TLE+D，n=16）。尸检海马作为非癫痫对照（n=10）。与 TLE 相比，TLE+P 表现出明显减少的苔藓纤维发芽和内嗅皮质神经元密度降低。TLE+P 在言语记忆任务中的表现明显较差。与 TLE 和 TLE+P 相比，TLE+D 表现出明显增加的苔藓纤维发芽长度。此外，TLE+D 和 TLE+P 中有更高比例的患者出现继发性全面性发作，而 TLE 患者则没有。我们的研究结果表明，与不伴有精神共病的 TLE 患者相比，伴有精神障碍的 TLE 患者具有明显的特征，这些变化可能与癫痫伴发精神障碍的表现或维持有关。
