title: 5-HT1A receptor binding in temporal lobe epilepsy patients with and without major depression.
abstract: BACKGROUND
  Major depressive disorder (MDD) is the most common comorbid psychiatric condition associated with temporal lobe epilepsy (TLE). Preclinical and clinical studies suggest that 5-HT(1A) receptors play a role in the pathophysiology of both TLE and MDD. There is preliminary evidence for an association between decreased 5-HT(1A) receptor binding in limbic brain areas and affective symptoms in TLE patients. The objective of this study was to compare 5-HT(1A) receptor binding between TLE patients with and without MDD. For the first time, 5-HT(1A) receptor binding was measured in a sample large enough to permit sensitive comparisons between TLE patients with and without comorbid MDD diagnosed by clinical and structured psychiatric interviews.
  
  
  METHODS
  Thirty-seven epilepsy patients with temporal lobe foci confirmed by ictal video-electroencephalogram (EEG) monitoring were recruited from the Clinical Epilepsy Section, National Institute of Neurological Disorders and Stroke. We performed interictal positron emission tomography scanning, with [(18)F]FCWAY, a fluorinated derivative of WAY100635, on a GE Medical Systems (Waukesha, Wisconsin) Advance scanner with continuous EEG monitoring. The 5-HT(1A) receptor binding was estimated by partial volume-corrected [(18)F]FCWAY V/f(1) values.
  
  
  RESULTS
  In addition to decreased 5-HT(1A) receptor binding in the epileptic focus itself, comorbid MDD was associated with a significantly more pronounced reduction in 5-HT(1A) receptor binding in TLE patients, extending into non-lesional limbic brain areas outside the epileptic focus. Focus side and the presence of mesial temporal sclerosis were not associated with the presence of comorbid depression.
  
  
  CONCLUSIONS
  Reductions in 5-HT(1A) receptor binding might help elucidate the neurobiological mechanisms underlying the TLE-MDD comorbidity.
authors.affiliation: Department of Psychiatry, University Hospital, Culmannstrasse 8, Zürich, Switzerland. g.hasler@bluewin.ch
authors.forename: Gregor
authors.initials: G
authors.lastname: Hasler
authors.forename: Robert
authors.initials: R
authors.lastname: Bonwetsch
authors.forename: Giampiero
authors.initials: G
authors.lastname: Giovacchini
authors.forename: Maria T
authors.initials: MT
authors.lastname: Toczek
authors.forename: Anto
authors.initials: A
authors.lastname: Bagic
authors.forename: David A
authors.initials: DA
authors.lastname: Luckenbaugh
authors.forename: Wayne C
authors.initials: WC
authors.lastname: Drevets
authors.forename: William H
authors.initials: WH
authors.lastname: Theodore
mesh_terms: D000293:Adolescent; D000328:Adult; D003510:Cyclohexanes; D003865:Major Depressive Disorder / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism*; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010879:Piperazines; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D044282:Receptor, Serotonin, 5-HT1A / Q000378:metabolism*
chemical_list: D003510:Cyclohexanes; C493883:N-(2-(4-(2-methoxyphenyl)piperazino))-N-(2-pyridinyl) trans-4-fluorocyclohexanecarboxamide; D010879:Piperazines; D019275:Radiopharmaceuticals; D044282:Receptor, Serotonin, 5-HT1A