Cerebral Metabolism and Depression in Patients With Complex Partial Seizures

Bromfield, Edward B; Altshuler, Lori L.; Leiderman, Deborah B.; Balish, Marshall; Ketter, Terence A.; Devinsky, Orrin; Post, Robert M.; Theodore, William H.

doi:10.1001/archneur.1992.00530300049010

Cited by 171 publications

(95 citation statements)

References 42 publications

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“…In another study, a trend was noted for increased left amygdalar, but not hippocampal, metabolism to correlate with increased depression in TLE (21). Finally, there are data linking bilateral inferior frontal hypometabolism to depression in left TLE (63). Together, these studies support volumetric research by (1) implicating medial temporal and frontal lobe regions in mood disorders, and (2) suggesting a stronger correlation between depression and left-sided pathology in patients with TLE.…”

Section: Petmentioning

confidence: 73%

The use of neuroimaging to study behavior in patients with epilepsy

McDonald¹

2008

Epilepsy & Behavior

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Structural and functional neuroimaging continue to play an increasing role in the presurgical evaluation of patients with epilepsy. In addition to their value for localizing the epileptogenic zone and eloquent cortex, neuroimaging is contributing to our understanding of mood comorbidity in epilepsy. Although the vast majority of research has focused on patients with temporal lobe epilepsy (TLE), neuroimaging studies of patients with frontal lobe epilepsy (FLE) and primary generalized epilepsy are increasing in number. In this review, structural and functional imaging modalities that have received considerable research attention in recent years are reviewed, along with an assessment of their strengths and limitations for understanding behavior in epilepsy. In addition, advances in multimodal imaging are discussed along with their potential application to the presurgical evaluation of patients with seizure disorders.

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Section: Petmentioning

confidence: 73%

The use of neuroimaging to study behavior in patients with epilepsy

McDonald¹

2008

Epilepsy & Behavior

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“…Indeed, Bremner et al (1997) found that depressed patients who were 6 weeks into a course of antidepressant treatment exhibited decreases in glucose metabolic rates in the orbitofrontal cortex and thalamus after a tryptophan-depletion-induced acute relapse compared to patients without depressive symptoms. A comparable pattern of abnormality in the orbitofrontal cortical region is seen in refractory depressed patients (Mayberg et al, 1997) and in patients with depression associated with neurological disorders (Bromfield et al, 1992;Mayberg et al, 1990Mayberg et al, , 1992. Mayberg et al (1999) suggested that mood provocation in patients with acute and remitted depression resulted in rCBF decrease in the medial orbitofrontal cortex BA 10/11, which was absent in healthy controls.…”

Section: Orbitofrontal Cortex In Mdd With Bpd Compared To Mddmentioning

confidence: 84%

Positron Emission Tomography of Regional Brain Metabolic Responses to a Serotonergic Challenge in Major Depressive Disorder with and without Borderline Personality Disorder

Oquendo

Krunic

Parsey

et al. 2005

Neuropsychopharmacol

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Previous neuroimaging studies of major depression have not controlled for the presence of personality disorders characterized by impulsive aggressive behavior, such as borderline personality disorder (BPD). Using positron emission tomography (PET), we studied regional glucose uptake in response to fenfluramine (FEN) in depressed subjects with BPD (n ¼ 11) and depressed patients without Cluster B Axis II disorders (n ¼ 8). Subjects were scanned while medication-free after a single blind placebo administration and after FEN on a second day. Brain responses were measured by PET imaging of [ 18 F]fluorodeoxyglucose (FDG) and serial prolactin levels. Scans were compared at a voxel level using statistical parametric mapping. Correlations of changes in relative regional cerebral uptake (rCMRglu) with clinical measures were assessed. Depressed borderline patients had greater relative activity in parietotemporal cortical regions (BA 40, BA 22, and BA 42) before and after FEN activation compared to those without BPD. They also had less relative uptake in the anterior cingulate cortex (BA 32) at baseline compared to depressed patients without BPD and FEN abolished this difference. Impulsivity was positively correlated with rCMRglu in superior and middle frontal cortex (BA 6 and 44). Hostility was positively correlated with rCMRglu in temporal cortical regions (BA 21 and 22). In conclusions, borderline pathology in the context of a Major Depressive Disorder is associated with altered activity in parietotemporal and anterior cingulate cortical regions. Controlling for the presence of BPD in future imaging studies of mood disorders may elucidate similarities and differences in regional serotonergic function in these two often comorbid disorders.

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“…In patients with temporal lobe epilepsy, serotonergic receptor binding in the limbic area is decreased [12], while in patients with affective disorder, the efficacy of selective serotonergic reuptake inhibitors (SSRIs) is associated with the activation of regional metabolic rate in the limbic area [13,14]. Increased risk of depression is highly correlated with the cerebral structural and metabolic abnormalities in epilepsy [15,16], while significant reduction in hippocampal volume is observed in major depression [11,17]. Furthermore, not only do seizures and epilepsy increase the risk of major depressive episodes, but the reverse also holds true -depression and suicide attempt significantly increase the risk for future incidence of unprovoked seizures and development of epilepsy [10,18].…”

Section: Introductionmentioning

confidence: 99%

Depressive behavior and selective downregulation of serotonin receptor expression after early-life seizures: Reversal by environmental enrichment

Koh

Magid

Chung

et al. 2007

Epilepsy & Behavior

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Depression is the most common psychiatric comorbidity in epilepsy. To better understand the contribution of seizures versus environment to depression in epilepsy, we investigated differential gene expression using microarray and quantitative RT-PCR, and depressive behavior, in the Porsolt forced swim test in juvenile rats reared in different environments after kainic acid (KA)-induced seizures. We selected for genes significantly down-regulated by KA seizures and upregulated by environmental enrichment. This common gene selection process yielded one known gene involved in mood and affect: serotonin receptor 5B. The changes in serotonin receptor gene expression were paralleled by decreased mobility in the forced swim tests; depressive behavior exhibited after seizures was no longer evident in rats reared in environmental enrichment. Our results suggest that seizures lead to increased susceptibility to depression through transcriptional regulation while environment, in turn, can interact with gene expression to influence the behavioral outcome of epilepsy.

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Cerebral Metabolism and Depression in Patients With Complex Partial Seizures

Cited by 171 publications

References 42 publications

The use of neuroimaging to study behavior in patients with epilepsy

The use of neuroimaging to study behavior in patients with epilepsy

Positron Emission Tomography of Regional Brain Metabolic Responses to a Serotonergic Challenge in Major Depressive Disorder with and without Borderline Personality Disorder

Depressive behavior and selective downregulation of serotonin receptor expression after early-life seizures: Reversal by environmental enrichment

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