Department of Neurology, Thomas Jefferson University, United States; Department of Neurosurgery, Thomas Jefferson University, United States.
Brain Cogn. 2013 Nov;83(2):171-82. doi: 10.1016/j.bandc.2013.08.001. Epub 2013 Sep 11.
The amygdala has been described as a structure affected by mesial temporal lobe epilepsy (MTLE). Indeed, it is suggested that amygdala abnormalities are related to the co-morbid depression and anxiety reported in MTLE. In this context, we investigated the relation between functional connectivity (FC) emerging from this structure in fMRI and depression and anxiety levels reported in MTLE patients. We focused on resting-state BOLD activity and evaluated whether FC differences emerge from each of three amygdala subdivisions (laterobasal, centromedial and superficial) in left and right MTLE groups, compared with healthy controls. Results revealed significant differences between patient groups and controls. Specifically, the left MTLE group showed abnormal FC for the left-sided seeds only. Furthermore, regardless of the seed, we observed more reliable differences between the right MTLE group and controls. Further analysis of these results revealed correlations between these impaired connectivities and psychiatric symptoms in both MTLE groups. Opposite relations, however, were highlighted: the more depressed or anxious the right MTLE patients, the closer their FC values approached controls; whereas the less anxious the left MTLE patients, the closer their FC values were normative. These results highlight how MTLE alter FC emerging from the limbic system. Overall, our data demonstrate that right TLE has a more maladaptive impact on emotion-related networks, in ways specific to the amygdala region, and the emotion symptom involved, than left TLE.
杏仁核被描述为受内侧颞叶癫痫（MTLE）影响的结构。事实上，有人认为杏仁核异常与 MTLE 患者报告的共病性抑郁和焦虑有关。在这种情况下，我们研究了 fMRI 中该结构出现的功能连接（FC）与 MTLE 患者报告的抑郁和焦虑水平之间的关系。我们专注于静息状态的 BOLD 活动，并评估了与健康对照组相比，左、右 MTLE 组的三个杏仁核亚区（基底外侧、中央内侧和浅层）中的每一个是否出现 FC 差异。结果显示患者组与对照组之间存在显著差异。具体来说，左 MTLE 组仅表现出左侧种子的异常 FC。此外，无论种子如何，我们都观察到右 MTLE 组与对照组之间的差异更可靠。对这些结果的进一步分析表明，这些受损的连通性与两个 MTLE 组的精神症状之间存在相关性。然而，突出了相反的关系：右 MTLE 患者越抑郁或焦虑，其 FC 值越接近对照组；而左 MTLE 患者越不焦虑，其 FC 值越接近正常。这些结果强调了 MTLE 如何改变边缘系统出现的 FC。总体而言，我们的数据表明，右 TLE 对与情绪相关的网络产生了更适应不良的影响，其方式特定于杏仁核区域以及涉及的情绪症状，而左 TLE 则不同。
