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Hippocampal ¹H-MRSI correlates with severity of depression symptoms in temporal lobe epilepsy

From the Department of Neurology (F.G.G.), Columbia University, New York, NY; Department of Neurology (R.C.M., S.M.S., R.E.F., M.V.), University of Alabama at Birmingham; Department of Neurology (R.I.K.), New York University, New York, NY; GE Global Research Center (J.W.H.), Niskayuna, NY; The Brain Institute (B.M.M.), Miami Children's Hospital, Miami, FL.

Address correspondence and reprint requests to Dr. Frank G. Gilliam, The Neurological Institute, Columbia University, New York, NY 10032; e-mail: fgilliam{at}neruo.columbia.edu

Objective: To investigate the association of an indicator of hippocampal function with severity of depression symptoms in temporal lobe epilepsy.

Methods: We evaluated 31 patients with video/EEG-confirmed temporal lobe epilepsy using creatine/N-acetylaspartate ratio maps derived from a previously validated ¹H magnetic resonance spectroscopic imaging (¹H-MRSI) technique at 4.1 T. We also assessed depression symptoms, epilepsy-related factors, and self-perceived social and vocational disability. We used conservative nonparametric bivariate procedures to determine the correlation of severity of depression symptoms with imaging and clinical variables.

Results: The extent of hippocampal ¹H-MRSI abnormalities correlated with severity of depression (Spearman rho = 0.65, p value < 0.001), but other clinical factors did not.

Conclusion: The extent of hippocampal dysfunction is associated with depression symptoms in temporal lobe epilepsy and may be a more important factor than seizure frequency or degree of disability.

Supported by National Institutes of Health grants NS01794, NS033919, NS40808, NS047551, and a grant from the Epilepsy Foundation of America.

Disclosure: The authors report no conflicts of interest.

Received December 12, 2005. Accepted in final form October 9, 2006.

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