DEPRESSION IS ASSOCIATED WITH 18 FDG-PET ABNORMALITIES IN A LARGE EPILEPSY OUTPATIENT SAMPLE
Abstract number :
B.04
Submission category :
Year :
2002
Submission ID :
3448
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Kelly M. Brown, Hrayr P. Attarian, A. James Fessler, Victoria J. Vahle, Jewell Carter, Frank Gilliam. Department of Neurology, Washington University Medical Center, St. Louis, MO
RATIONALE: Depression is a common comorbid condition in patients with epilepsy, and substantially contributes to disability and poor health outcomes. However, the association of depression with brain dysfunction in epilepsy (versus social and vocational disability) is not definitively established. The purpose of this study was to evaluate the relationship between depressive symptoms and brain dysfunction based on 18 Fluorodeoxyglucose positron emission tomography (18 FDG-PET) in persons with epilepsy.
METHODS: We prospectively evaluated 200 consecutive patients in our epilepsy clinic for depression. All patients gave consent through a document approved by our IRB. The Beck Depression Inventory (BDI) was used to assess depressive symptoms. Sixty-two of these patients had 18 FDG-PET scans as part of their clinical evaluation. This subset consisted of our study sample. Standard (47 slice) 18 FDG-PET imaging with a mathematical attenuation correction was performed. Scores and demographic data were stored and independent t-test and ANOVA analyses were performed in a using SPSS. All analyses controlled for age, gender, and seizure frequency.
RESULTS: Of the 62 evaluated patients with 18 FDG-PET, 55 had abnormal and 7 had normal scans. The mean BDI score was 9.7 (s.d. 8.5) in the group with abnormal 18 FDG-PET scans and 1.8 (s.d. 2.6) in the group with normal scans (p=0.01). Fifty-two 18 FDG-PET scans had abnormalities involving the temporal lobes. Patients with right temporal lobe abnormalities (N=28) had a mean BDI score of 11.6 (s.d. 9.2). This value was significantly higher than the mean BDI score of 6.6 (s.d. 5.8) in patients with left temporal lobe abnormalities (N=24, p=0.02).
CONCLUSIONS: After controlling for gender, age and seizure frequency, depressive symptoms were significantly more severe in pateints with 18 FDG-PET abnormalities than patients with normal 18 FDG-PET. Also, right temporal lobe dysfunction was associated with worse depressive symptoms than left temporal lobe dysfunction, based on 18 FDG-PET hypometabolism. These findings suggest that cerebral dysfunction is a contributing cause of depression in epilepsy, and also that further research is needed to more fully understand the complex interactions of brain dysfunction, depression, and seizures.
[Supported by: NIH Grant NS01794-01, NIH Grant NS40808 and a grant from Glaxo SmithKline.]