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Study of association between atrophy of limbic structures, depression and mesial temporal lobe epilepsy

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Author(s):
Greize Collin
Total Authors: 1
Document type: Master's Dissertation
Press: Campinas, SP.
Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
Defense date:
Examining board members:
Fernando Cendes; Antônio Lúcio Teixeira; Marcondes Cavalcante Franca Junior
Advisor: Fernando Cendes
Abstract

Depression has been one of the most commonly related mental disorders associated with MTLE, reaching approximately 20% to 55% of the cases, whereas its prevalence is 9% in the general population. Since the aspects that interact in the association MTLE-depression are still quite fragmented, the physiopathology of depression in MTLE is not fully understood. This study has the aim of investigating the association of volumetric differences of amygdala, hippocampus and thalamus in MTLE and depressed patients, as well as correlating these with each patient's clinical data (such as seizure frequency and intensity of depressive symptoms). Magnetic Resonance images were acquired in 4 groups of 20 patients each: group ED - patients with MTLE and depression; group E - patients with MTLE; group D - patients with depression; and group C - healthy controls. The segmentation of amygdala, hippocampus and thalamus was performed using DISPLAY software, according to protocols validated by our group. We evaluated the asymmetry index (AI), which represents the ratio between the smallest and the largest side of each structure. The diagnosis for depressive disorder was performed in accordance with DSM-IV criteria obtained through the SCID-I applied by a trained professional. To measure the intensity of depressive symptoms we used Beck Depression Inventory (BDI), and SYSTAT 9®, ANOVA, Student's t-test and Spearman correlation for statistical analysis. 80 women with mean age of 40 years (SD=9.4) were analyzed. We compared the mean absolute volumes of RA (t=5.552, p=0.002) and LA (t=14.571, p<0.0001) between groups, and observed there was a significant difference between groups C and E related to RA (p=0.004) and LA (p<0.0001). Regarding groups D and E, there was a significant difference only in AE (p<0.0001), and groups E and ED in AD (p=0.004) and AE (p<0.0001). There was neither significant difference between RH (F= 0.461, p=0.711) and LH (F=2.329, p=0.081) mean volumes nor RT (F=0.786, p=0.505) and LT (F=0.492, p=0.689) between groups. In relation to HAI (t=9.793, p<0.0001), only the groups C and E (p=0.001), C and ED (p=0.001), D and E (p=0.004) and D and ED (p=0.003) presented a significant asymmetry. Concerning TAI (t=2.483, p=0.067), we found significant difference only between groups E and ED (p=0.039) and we did not find difference of AAI between any groups. We observed a positive correlation between BDI scores and seizure frequency (rs=0.481), in which the average monthly seizure frequency was higher (t=-2.245, p=0.031) for the ED group (7.45±2.85) than E group (3.05±2.85). It is concluded that there was no significant relationship between the degree of atrophy of limbic structures and the presence of mood disorder in patients with MTLE. However, our results indicate that seizure frequency is related to severity of depressive symptoms in patients with MTLE (AU)

FAPESP's process: 10/03129-6 - Study of association between atrophy of limbic structures, depression and mesial temporal lobe epilepsy
Grantee:Greize Collin
Support Opportunities: Scholarships in Brazil - Master