Institution: | 1. Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK;2. Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK
Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland;3. Faculty of Medicine, Imperial College London, London, UK;4. Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK
Department of Neurosurgery, Carl Gustav Carus University Hospitals, Dresden, Germany;5. Invicro, London, UK |
Abstract: | Objective Affective disorders are frequent comorbidities of temporal lobe epilepsy (TLE). The endogenous opioid system has been implicated in both epilepsy and affective disorders, and may play a significant role in their bidirectional relationship. In this cross-sectional study, we investigated the association between μ-opioid receptor binding and affective disorders in patients with TLE. Methods Nine patients with TLE and depression/anxiety underwent 11C-carfentanil positron emission tomography (CFN PET) and neuropsychiatric assessment, including the Hospital Anxiety and Depression Scale and the Positive and Negative Affect Schedule. The normalized CFN PET scans were compared with those of 26 age-matched healthy controls. Correlation analyses with affective symptoms were performed by region of interest-based analysis focusing on the limbic circuit and orbitofrontal cortex. Results We observed widely reduced CFN binding potential (BP) in bilateral frontal lobes and striata in patients with TLE compared to healthy controls. In the TLE group, more severe anxiety and negative affect were associated with decreased CFN BP in the posterior cingulate gyrus. Significance In patients with TLE, interictally reduced binding in the opioid system was associated with higher levels of anxiety and negative affect. We speculate that seizure-related agonist-driven desensitization and downregulation of opioid receptors could be a potential underlying pathomechanism. |