AUTHOR=Nogueira Mateus Henrique , Pimentel da Silva Luciana Ramalho , Vasques Moreira José Carlos , Rezende Thiago Junqueira Ribeiro de , Zanão Tamires Araújo , Campos Brunno Machado de , Yasuda Clarissa Lin , Cendes Fernando 

TITLE=Major Depressive Disorder Associated With Reduced Cortical Thickness in Women With Temporal Lobe Epilepsy

JOURNAL=Frontiers in Neurology

VOLUME=10

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2019.01398

DOI=10.3389/fneur.2019.01398

ISSN=1664-2295

ABSTRACT=<p><bold>Background:</bold> Major Depressive Disorder (MDD) is highly prevalent in patients with mesial temporal lobe epilepsy (MTLE), especially in women, carrying significant morbidity. This study aimed to investigate the cortical thickness (CT) abnormalities associated with MDD in women with MTLE and hippocampal atrophy (HA). Also, we investigated the impact of MDD upon the volumes of the hippocampus and amygdala in these patients.</p><p><bold>Methods:</bold> We included 50 women with MTLE and HA (20 left, LMTLE; 30 right, RMTLE), 41 healthy women in the control group, and 15 women with MDD without epilepsy. MTLE patients were subdivided into three groups: <italic>MTLE-without-MDD</italic> (23 MTLE patients without MDD), <italic>MTLE-mild-MDD</italic> (nine MTLE patients with mild symptoms of MDD), and <italic>MTLE-severe-MDD</italic> (18 MTLE patients with moderate to severe symptoms of MDD). The five groups were balanced for age (<italic>p</italic> = 0.56). All participants had high-resolution 3D T1-weighted images in a 3T scanner. We used FreeSurfer 6.0 for volumetry and CT parcellation. All participants were submitted to a clinical psychological evaluation through the Structured Clinical Interview for DSM-IV (SCID-IV) and completed the Beck Depression Inventory (BDI-II).</p><p><bold>Results:</bold> We identified a smaller ipsilateral amygdala volume (<italic>p</italic> = 0.04) in the <italic>MTLE-severe-MDD</italic> group when compared to the control group. Our results presented a reduced ipsilateral lateral orbitofrontal cortex (<italic>p</italic> = 0.02) in the <italic>MTLE-severe-MDD</italic> in comparison to the <italic>MTLE-mild-MDD</italic> group. We also identified a thinner ipsilateral fusiform gyrus (<italic>p</italic> &lt; 0.01) in the <italic>MTLE-severe-MDD</italic> compared to both <italic>MTLE-without-MDD</italic> and control groups. A reduced CT of the contralateral superior frontal gyrus (<italic>p</italic> = 0.02) was observed in the <italic>MTLE-severe-MDD</italic> in comparison to the <italic>MTLE-mild-MDD</italic> group.</p><p><bold>Conclusions:</bold> The identification of areas with reduced CT and atrophy of the ipsilateral amygdala in women with MTLE and MDD suggest that the cortical thinning in the network of the paralimbic system is related to the co-occurrence and intensity of depressive symptoms in this group.</p>