Institute of Neurology, Department of Clinical and Experimental Epilepsy, University College London, Queen Square, London SL9 0RJ, UK; Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, 12 Queen Square, London WC1N 3BG, UK.
Institute of Neurology, Department of Clinical and Experimental Epilepsy, University College London, Queen Square, London SL9 0RJ, UK; Institute of Child Health, University College London, London WC1N 1EH, UK.
Epilepsy Res. 2014 Mar;108(3):517-25. doi: 10.1016/j.eplepsyres.2013.12.003. Epub 2013 Dec 27.
To investigate cerebral grey matter (GM) volumetric abnormalities in temporal lobe epilepsy (TLE) patients who develop de novo depression following TLE surgery using voxel-based morphometry (VBM).
We retrospectively examined pre-surgical grey matter (GM) volumes in 30 patients with TLE due to unilateral left-sided hippocampal sclerosis using 1.5-T MRI scan, which were segmented with optimised VBM parameters and normalised to a sample template using DARTEL, with SPM8 software. Voxel-wise GM differences between patients that developed de novo post-surgical depression (n=5) were compared with patients with no pre- or postoperative psychiatric diagnoses (n=25), using independent samples t-tests with age, gender and secondary generalised tonic-clonic seizures (SGTCS) as covariates (p<.001, unc).
Reduced preoperative bilateral GM in orbitofrontal cortices (OFC) and ipsilateral cingulate gyrus and thalamus were significantly associated with the development of de novo depression within 4 years postoperatively. Further analyses revealed no differences in seizure freedom (ILAE 1 vs 2-6) or postoperative memory decline between the groups.
Although the development of postoperative de novo depression following TLE surgery is likely to be multi-factorial, our results suggest that bilateral OFC and ipsilateral cingulate gyrus and thalamic atrophy in left-sided TLE patients may play a modulatory role. Abnormalities in these areas have also been implicated in primary mood disorders. Prospective neuroimaging studies with larger cohorts are warranted to replicate these results, and further elucidate the neural correlates of de novo depression.
使用基于体素的形态测量学（VBM）研究颞叶癫痫（TLE）患者在 TLE 手术后新发性抑郁的脑灰质（GM）体积异常。
我们回顾性地检查了 30 例单侧左侧海马硬化所致 TLE 患者的术前 GM 体积，这些患者使用 1.5-T MRI 扫描，使用优化的 VBM 参数进行分割，并使用 DARTEL 将其归一化为样本模板，使用 SPM8 软件。使用独立样本 t 检验，将新发性手术后抑郁（n=5）患者的 GM 体积与无术前或术后精神科诊断（n=25）的患者进行比较，将年龄、性别和继发性全面强直阵挛发作（SGTCS）作为协变量（p<.001，未校正）。
术前双侧眶额皮质（OFC）和同侧扣带回和丘脑的 GM 减少与术后 4 年内新发性抑郁的发展显著相关。进一步的分析表明，两组之间的无癫痫发作自由（ILAE 1 与 2-6）或术后记忆下降无差异。
尽管 TLE 手术后新发性抑郁的发生可能是多因素的，但我们的结果表明，左侧 TLE 患者双侧 OFC 和同侧扣带回和丘脑萎缩可能起调节作用。这些区域的异常也与原发性情绪障碍有关。需要进行前瞻性神经影像学研究，以复制这些结果，并进一步阐明新发性抑郁的神经相关性。
