Brain Imaging Correlates and Executive Impairments in Individuals with Epilepsy and Comorbid Major Depression (PD3.005)

Objective: To compare gray matter (GM) volumes, white matter fiber tract integrity, and executive functioning (e.g., reasoning) between individuals with epileptic seizures with and without a major depressive disorder. Background Research demonstrated that the structural integrity of white matter tracts connecting temporal and frontal lobes were related to cognitive and emotion processing. Structural integrity of the hippocampus and amygdala have also been related to cognitive impairment and emotional regulation difficulties. Individuals with depression are often found to have greater cognitive impairment compared to individuals who are not depressed. Design/Methods: Thirty-two patients (mean age of 39.6 years; 17 males) with intractable epilepsy (21 with temporal lobe epilepsy, 5 with GTC, 6 with extra-temporal lobe seizure foci) underwent neuroimaging and neuropsychological assessment. The Mini International Neuropsychiatric Inventory and clinical interview were used to define major depression. Fractional anisotropy [FA] was computed for white matter tracts using TrackVis by manual tracings. GM volumes were quantified with voxel-based morphometry. Results: Thirty-three patients met Diagnostic and Statistical Manual of Mental Disorders-IV criteria for major depression. MANOVA indicated that depressed patients performed significantly poorer on tests of unstructured problem solving (F[1,28]=8.6,p Conclusions: Individuals with epilepsy with comorbid major depression have reduced gray and white matter integrity and perform poorer on tests of executive functioning compared to individuals with epilepsy without depression. Greater impairment in executive functions in individuals with epilepsy and major depression appears partly attributable to reduced structural brain integrity. Disclosure: Dr. Dulay has nothing to disclose. Dr. Havins has nothing to disclose. Dr. Agbayani has nothing to disclose. Dr. Travis Seidl has nothing to disclose. Dr. Karmonik has nothing to disclose. Dr. Xue has nothing to disclose. Dr. Verma has received personal compensation for activities with UCB Pharma and GlaxoSmithKline, Inc. as a speaker and/or consultant. Dr. Verma has received research support from Pfizer, Inc., UCB Pharma, and GlaxoSmithKline, Inc. Dr. Kawai has nothing to disclose. Dr. Grossman has nothing to disclose.