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    Depression in temporal lobe epilepsy surgery patients: An FDG-PET study

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    Author
    Salzberg, M; Taher, T; Davie, M; Carne, R; Hicks, RJ; Cook, M; Murphy, M; Vinton, A; O'Brien, TJ
    Date
    2006-12-01
    Source Title
    EPILEPSIA
    Publisher
    WILEY
    University of Melbourne Author/s
    Salzberg, Michael; Carne, Ross; Hicks, Rodney; Cook, Mark; Murphy, Michael; O'Brien, Terence; DAVIE, MICHAEL; TAHER, TAUFIK RAKHMAN; VINTON, ANITA
    Affiliation
    Medicine - Royal Melbourne Hospital
    Metadata
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    Document Type
    Journal Article
    Citations
    Salzberg, M., Taher, T., Davie, M., Carne, R., Hicks, R. J., Cook, M., Murphy, M., Vinton, A. & O'Brien, T. J. (2006). Depression in temporal lobe epilepsy surgery patients: An FDG-PET study. EPILEPSIA, 47 (12), pp.2125-2130. https://doi.org/10.1111/j.1528-1167.2006.00860.x.
    Access Status
    This item is currently not available from this repository
    URI
    http://hdl.handle.net/11343/26453
    DOI
    10.1111/j.1528-1167.2006.00860.x
    Description

    C1 - Journal Articles Refereed

    Abstract
    PURPOSE: Depression is common in temporal lobe epilepsy (TLE) and after temporal lobectomy, and its etiology is obscure. In nonepileptic depression (including depression associated with other neurologic disorders), a consistent PET imaging finding is frontal lobe hypometabolism. Many TLE patients have hypometabolism involving frontal regions. Thus in data available from routine clinical assessments in an epilepsy surgery unit, we tested the hypothesis that the pattern of hypometabolism, particularly in the frontal lobe, may be associated with the depression seen in patients with TLE and TLE surgery. METHODS: We studied 23 medically refractory TLE patients who underwent anterior temporal lobectomy and who had preoperative FDG-PET scanning. All patients had pre- and postoperative psychiatric assessment. By using statistical parametric mapping (SPM-99), patterns of hypometabolism were compared between patients who had a preoperative history of depression (n=9) versus those who did not (n=14) and between those in whom postoperative depression developed (n=13) versus those in whom it did not (n=10). A significant region of hypometabolism was set at p<0.001 for a cluster of >or=20 contiguous voxels. RESULTS: Patients with a history of depression at any time preoperatively showed focal hypometabolism in ipsilateral orbitofrontal cortex compared with those who did not (t=4.64; p<0.001). Patients in whom depression developed postoperatively also showed hypometabolism in the ipsilateral orbitofrontal region (t=5.10; p<0.001). CONCLUSIONS: Although this study is methodologically limited, and other explanations merit consideration, orbitofrontal cortex dysfunction, already implicated in the pathophysiology of nonepileptic depression, may also be relevant to the depression of TLE and temporal lobectomy.
    Keywords
    Central Nervous System ; Psychiatry ; Nervous System and Disorders

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