title: Temporal lobe epilepsy and affective disorders: the role of the subgenual anterior cingulate cortex.
abstract: OBJECTIVE
  Reduced deactivation within the default mode network (DMN) is common in individuals with primary affective disorders relative to healthy volunteers (HVs). It is unknown whether similar network abnormalities are present in temporal lobe epilepsy (TLE) patients with a history of affective psychopathology.
  
  
  METHODS
  17 TLE patients with a lifetime affective diagnosis, 31 TLE patients with no formal psychiatric history and 30 HVs were included. We used a visuo-spatial 'n-back' paradigm to compare working memory (WM) network activation between these groups. Post hoc analyses included voxel-based morphometry and diffusion tensor imaging. The Beck Depression Inventory-Fast Screen and Beck Anxiety Inventory were completed on the day of scanning.
  
  
  RESULTS
  Each group activated the fronto-parietal WM networks and deactivated the typical DMN in response to increasing task demands. Group comparison revealed that TLE patients with lifetime affective morbidity showed significantly greater deactivation in subgenual anterior cingulate cortex (sACC) than either the TLE-only or the HVs (p<0.001). This effect persisted after covarying for current psychotropic medication and severity of current depressive/anxiety symptoms (all p<0.001). Correlational analysis revealed that this finding was not driven by differences in task performance. There were no significant differences in grey matter volume or structural connectivity between the TLE groups.
  
  
  CONCLUSIONS
  Our results provide novel evidence suggesting that affective psychopathology in TLE has a neurobiological correlate, and in this context the sACC performs differently compared with network activity in primary affective disorders.
authors.affiliation: Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK MRC Cognition and Brain Science Unit, Cambridge, UK.
authors.forename: J
authors.initials: J
authors.lastname: Stretton
authors.affiliation: Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK Clinical Psychopharmacology Unit, University College London, London, UK.
authors.forename: R A
authors.initials: RA
authors.lastname: Pope
authors.affiliation: Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK.
authors.forename: G P
authors.initials: GP
authors.lastname: Winston
authors.affiliation: Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK.
authors.forename: M K
authors.initials: MK
authors.lastname: Sidhu
authors.affiliation: Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Symms
authors.affiliation: Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK.
authors.forename: J S
authors.initials: JS
authors.lastname: Duncan
authors.affiliation: Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Koepp
authors.affiliation: Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK.
authors.forename: P J
authors.initials: PJ
authors.lastname: Thompson
authors.affiliation: Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Foong
mesh_terms: D000293:Adolescent; D000328:Adult; D016880:Anisotropy; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000503:physiopathology; D003863:Depression / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D056324:Diffusion Tensor Imaging; D004833:Epilepsy, Temporal Lobe / Q000150:complications / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D059907:Functional Neuroimaging; D066128:Gray Matter / Q000473:pathology; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006624:Hippocampus / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology*; D009434:Neural Pathways / Q000473:pathology / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance / Q000502:physiology; D055815:Young Adult
keywords: EPILEPSY; FUNCTIONAL IMAGING; LIMBIC SYSTEM; MEMORY; PSYCHIATRY