Dados do Trabalho

Título

Independent effects of major depressive disorder and pharmacoresponse on amygadalar T2 signal in temporal lobe epilepsy

Introdução

Temporal lobe epilepsy (TLE) is frequently associated with psychiatric comorbidities, particularly major depressive disorder (MDD). As the amygdala plays an important role in both disorders and T2 signal changes might translate gliotic dysfunction, the measure of T2 signal changes in TLE and MDD might help to better understand the coexistence of these diseases.

Objetivo

To measure amygdalar T2 signal in TLE patients according to pharmacoresponse and presence of MDD.

Método

We included 119 individuals: MDD*responsive (n=10), MDD*AED-resistant (n=19), no-MDD*responsive (n=12), no-MDD*EAD-resistant (n=17), MDD-only (n=26) and controls (n=35). Using Aftervoxel (http://www.bergo.eng.br/academic/aftervoxel/), we performed, for each amygdala, relaxometry in T2 coronal multi-echo images (two slices of 3-mm thick) acquired at a 3T MRI scanner. MDD diagnosis followed DSM-V criteria. We performed generalized linear model with log link function, including MDD and pharmacoresponse as main effects and MDD*pharmacoresponse interaction. We set p<0.05 as significant.

Resultados

There was an independent effect of MDD and pharmacoresponse in the ipsilateral T2 signal (both p<0.001). We found increased ipsilateral T2-signal in MDD*responsive, MDD*AED-resistant, no-MDD*responsive and no-MDD*resistant compared to controls (all p<0.004); in MDD*AED-resistant (p<0.001) compared to no-MDD*responsive; in MDD*responsive, MDD*AED-resistant and no-MDD*AED-resistant compared to MDD-only (all p<0.001). For the contralateral amygdala, there was an effect of pharmacoresponse (p<0.001), but no effect of MDD (p=0.53) nor pharmacoresponse*MDD. We found increased T2-signal in responsive and AED-resistant patients compared to controls (p<0.01), regardless presence of MDD.

Conclusão

Our data suggest a bilateral effect of pharmacoresponse and only ipsilateral effect of MDD in increased T2 signal in the amygdala of TLE patients.

Palavras-chave

major depressive disorder, temporal lobe epilepsy, amygdala