Department of Neurological Sciences, Rush University Medical Center, 1653 West Congress Parkway, Chicago, IL 60612, USA.
Epilepsy Behav. 2012 Jun;24(2):156-68. doi: 10.1016/j.yebeh.2012.01.007.
Depression is the most frequent psychiatric comorbidity in people with epilepsy (PWE) with lifetime prevalence rates ranging between 30 and 35%. Multifactorial variables play a pathogenic role in the high comorbid occurrence of these two disorders. These variables were critically examined during an international symposium held in Chicago in September 2010, the results of which are presented in two companion manuscripts. The first manuscript summarizes new epidemiologic data highlighting the bidirectional relation between depression and epilepsy and related methodological issues in studying this relationship. An examination of the neurobiologic aspects of primary mood disorders, mood disorders in PWE and pathogenic mechanisms of epilepsy derived from studies in animal models and humans is allowing a better understanding of the complex relation between the two conditions. In the first manuscript, we review data from animal models of epilepsy in which equivalent symptoms of depression and anxiety disorders develop and, conversely, animal models of depression in which the kindling process is facilitated. Data from structural and functional neuroimaging studies in humans provide a further understanding of potential common pathogenic mechanisms operant in depression and epilepsy that may explain their high comorbidity. The negative impact of depression on the control of seizure disorders has been documented in various studies. In this manuscript, these data are reviewed and potential mechanisms explaining this phenomenon are proposed.
抑郁症是癫痫患者（PWE）最常见的精神共病，终身患病率在 30%至 35%之间。多种因素在这两种疾病的高共病发生中起致病作用。这些变量在 2010 年 9 月在芝加哥举行的一次国际研讨会上进行了批判性检查，其结果在两篇相关的论文中呈现。第一篇论文总结了新的流行病学数据，强调了抑郁症和癫痫之间的双向关系以及研究这种关系的相关方法学问题。对原发性情绪障碍、PWE 中的情绪障碍和源自动物模型和人类的癫痫发病机制的神经生物学方面的检查，使人们能够更好地理解这两种情况之间的复杂关系。在第一篇论文中，我们回顾了癫痫动物模型中的数据，在这些模型中会出现类似的抑郁和焦虑障碍症状，反之亦然，在这些动物模型中，易化过程会促进抑郁的产生。来自人类结构和功能神经影像学研究的数据提供了对可能存在的、在抑郁和癫痫中起作用的共同发病机制的进一步理解，这可以解释它们的高共病性。在各种研究中都记录了抑郁症对癫痫发作控制的负面影响。在这篇论文中，我们回顾了这些数据，并提出了解释这种现象的潜在机制。
