title: Alterations in functional connectivity between the hippocampus and prefrontal cortex as a correlate of depressive symptoms in temporal lobe epilepsy.
abstract: Depression is a common comorbidity in temporal lobe epilepsy (TLE) that is thought to have a neurobiological basis. This study investigated the functional connectivity (FC) of medial temporal networks in depression symptomatology of TLE and the relative contribution of structural versus FC measures. Volumetric MRI and functional connectivity MRI (fcMRI) were performed on nineteen patients with TLE and 20 controls. The hippocampi and amygdalae were selected as seeds, and five prefrontal and five cingulate regions of interest (ROIs) were selected as targets. Low-frequency blood-oxygen-level-dependent signals were isolated from fcMRI data, and ROIs with synchronous signal fluctuations with the seeds were identified. Depressive symptoms were measured by the Beck Depression Inventory-II. The patients with TLE showed greater ipsilateral hippocampal atrophy (HA) and reduced FC between the ipsilateral hippocampus and the ventral posterior cingulate cortex (vPCC). Neither HA nor hippocampal-vPCC FC asymmetry was a robust contributor to depressive symptoms. Rather, hippocampal-anterior prefrontal FC was a stronger contributor to depressive symptoms in left TLE (LTLE). Conversely, right amygdala FC was correlated with depressive symptoms in both patient groups, with a positive and negative correlation in LTLE and right TLE (RTLE), respectively. Frontolimbic network dysfunction is a strong contributor to levels of depressive symptoms in TLE and a better contributor than HA in LTLE. In addition, the right amygdala may play a role in depression symptomatology regardless of the side of the epileptogenic focus. These findings may inform the treatment of depressive symptoms in TLE and inspire future research to help guide surgical planning.
authors.affiliation: University of California San Diego Multimodal Imaging Laboratory, 8950 Villa La Jolla Dr., Suite C101, La Jolla, CA 92037, USA; Department of Psychiatry, University of California, San Diego, CA, USA. Electronic address: nkemmotsu@ucsd.edu.
authors.forename: Nobuko
authors.initials: N
authors.lastname: Kemmotsu
authors.forename: N Erkut
authors.initials: NE
authors.lastname: Kucukboyaci
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Cheng
authors.forename: Holly M
authors.initials: HM
authors.lastname: Girard
authors.forename: Evelyn S
authors.initials: ES
authors.lastname: Tecoma
authors.forename: Vicente J
authors.initials: VJ
authors.lastname: Iragui
authors.forename: Carrie R
authors.initials: CR
authors.lastname: McDonald
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003863:Depression / Q000209:etiology / Q000473:pathology; D004833:Epilepsy, Temporal Lobe / Q000150:complications / Q000473:pathology*; D005260:Female; D007839:Functional Laterality; D006624:Hippocampus / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000098:blood supply / Q000502:physiology*; D010100:Oxygen / Q000097:blood; D017397:Prefrontal Cortex / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology*
chemical_list: D010100:Oxygen
keywords: Amygdala; Asymmetry; Comorbidities; Depression; Functional connectivity; Hippocampus; Temporal lobe epilepsy