Intrinsic Brain Activity in Temporal Lobe Epilepsy With and Without Depression: Insights From EEG Microstates

Background: Depression is the most common psychiatric comorbidity of temporal lobe epilepsy (TLE). In the recent years, studies have focused on the common pathogenesis of TLE and depression. However, few of the studies focused on the dynamic characteristics of TLE with depression. We tested the hypotheses that there exist abnormalities in microstates in patients with TLE with depression.Methods: Participants were classified into patients with TLE with depression (PDS) (n = 19) and patients with TLE without depression (nPDS) (n = 19) based upon the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). Microstate analysis was applied based on 256-channel electroencephalography (EEG) to detect the dynamic changes in whole brain. The coverage (proportion of time spent in each state), frequency of occurrence, and duration (average time of each state) were calculated.Results: Patients with PDS showed a shorter mean microstate duration with higher mean occurrence per second compared to patients with nPDS. There was no difference between the two groups in the coverage of microstate A–D.Conclusion: This is the first study to present the temporal fluctuations of EEG topography in comorbid depression in TLE using EEG microstate analysis. The temporal characteristics of the four canonical EEG microstates were significantly altered in patients with TLE suffer from comorbid depression.

Depression, diabetes, their comorbidity and all-cause and cause-specific mortality: a prospective cohort study

Aims/hypothesis: To investigate the risk of all-cause and cause-specific mortality among participants with neither, one, or both of diabetes and depression in a large prospective cohort study in the United Kingdom. Methods: Our study population included 499,830 UK Biobank participants without schizophrenia and bipolar disorder at baseline. Type 1 or type 2 diabetes and depression were identified using self-reported diagnoses, prescribed medication and hospital records. Mortality was identified from death records using the primary cause of death to define cause-specific mortality. We performed Cox proportional hazards models to estimate the risk of all-cause mortality and mortality due to cancer, circulatory disease and causes of death other than circulatory disease or cancer among participants with either depression (n=41,791) or diabetes alone (n=22,677) and with comorbid diabetes and depression (n=3,597), compared to the group with neither condition (n=431,765) adjusting for sociodemographic and lifestyle factors, comorbidities, and history of CVD or cancer. We investigated for interaction between diabetes and depression. Results: During a median of 6.8 (IQR: 6.1 - 7.5) years of follow-up, there were 13,724 deaths (cancer (n=7,976), circulatory disease (n=2,827), and other causes (n=2,921)). Adjusted hazard ratios of all-cause mortality and mortality due to cancer, circulatory disease and other causes were highest among people with comorbid depression and diabetes (HRs 2.16, 95% CI 1.94 - 2.42; 1.62, 95% CI 1.35 - 1.93; 2.22 95% CI 1.80 - 2.73 and 3.60, 95% CI 2.93 - 4.42, respectively). Among those with comorbid diabetes and depression, the risks of all-cause, cancer and other mortality exceeded the sum of the risks due to diabetes and depression alone. Conclusions/interpretation: We confirmed the negative impact of depression and diabetes on mortality outcomes, and also identified that comorbid depression and diabetes had synergistic effects on all-cause mortality which was largely driven by deaths due to cancer and causes other than circulatory disease and cancer.

Depressive Symptoms Account for Loss of Positive Attention Bias in ADHD Patients: An Eye-Tracking Study

Objectives: Depression and ADHD often co-occur and are both characterized by altered attentional processing. Differences and overlap in the profile of attention to emotional information may help explain the co-occurence. We examined negative attention bias in ADHD as neurocognitive marker for comorbid depression. Methods: Patients with depression ( n = 63), ADHD ( n = 43), ADHD and depression ( n = 25), and non-psychiatric controls ( n = 68) were compared on attention allocation toward emotional faces. The following eye-tracking indices were used: gaze duration, number of revisits, and location and duration of first fixation. Results: Controls revisited the happy faces more than the other facial expressions. Both the depression and the comorbid group showed significantly less revisits of the happy faces compared to the ADHD and the control group. Interestingly, after controlling for depressive symptoms, the groups no longer differed on the number of revisits. Conclusion: ADHD patients show a relative positive attention bias, while negative attention bias in ADHD likely indicates (sub)clinical comorbid depression.

The Association Between Post-Traumatic Stress and Depressive Symptoms Among Older Puerto Ricans in Boston: How Does Loneliness Matter?

Objectives To examine the association between post-traumatic stress and depression and whether such an association differs by level of loneliness among older Puerto Ricans. Methods Data were collected from 304 Puerto Ricans aged 60 and above living in the Greater Boston area who responded to questionnaires. We used ordinary least squares regression to examine the association between post-traumatic stress, loneliness, and depressive symptoms. Results Post-traumatic stress was significantly associated with higher levels of depression. The association between post-traumatic stress and depression was stronger for those experiencing a higher degree of loneliness. Discussion In working with older Puerto Ricans experiencing post-traumatic stress, it is important for mental health professionals to incorporate the assessment of loneliness and to prevent and reduce comorbid depression by addressing loneliness through improving social skills, enhancing social support, and reducing maladaptive social cognition.

Do Hippocampal Neurons Really Count for Comorbid Depression in Patients With Mesial Temporal Lobe Epilepsy and Hippocampal Sclerosis? A Histopathological Study

Depression is the most frequent psychiatric comorbidity seen in mesial temporal lobe epilepsy (MTLE) patients with hippocampal sclerosis (HS). Moreover, the HS is the most frequent pathological hallmark in MTLE-HS. Although there is a well-documented hippocampal volumetric reduction in imaging studies of patients with major depressive disorder, in epilepsy with comorbid depression, the true role of the hippocampus is not entirely understood. This study aimed to verify if patients with unilateral MTLE-HS and the co-occurrence of depression have differences in neuronal density of the hippocampal sectors CA1–CA4. For this purpose, we used a histopathological approach. This was a pioneering study with patients having both clinical disorders. However, we found no difference in hippocampal neuronal density when depression co-occurs in patients with epilepsy. In this series, CA1 had the lowest counting in both groups, and HS ILAE Type 1 was the most prevalent. More studies using histological assessments are needed to clarify the physiopathology of depression in MTLE-HS.