5-HT1A receptor binding in temporal lobe epilepsy patients with and without major depression

Biol Psychiatry. 2007 Dec 1;62(11):1258-64. doi: 10.1016/j.biopsych.2007.02.015. Epub 2007 Jun 22.


Background: Major depressive disorder (MDD) is the most common comorbid psychiatric condition associated with temporal lobe epilepsy (TLE). Preclinical and clinical studies suggest that 5-HT(1A) receptors play a role in the pathophysiology of both TLE and MDD. There is preliminary evidence for an association between decreased 5-HT(1A) receptor binding in limbic brain areas and affective symptoms in TLE patients. The objective of this study was to compare 5-HT(1A) receptor binding between TLE patients with and without MDD. For the first time, 5-HT(1A) receptor binding was measured in a sample large enough to permit sensitive comparisons between TLE patients with and without comorbid MDD diagnosed by clinical and structured psychiatric interviews.

Methods: Thirty-seven epilepsy patients with temporal lobe foci confirmed by ictal video-electroencephalogram (EEG) monitoring were recruited from the Clinical Epilepsy Section, National Institute of Neurological Disorders and Stroke. We performed interictal positron emission tomography scanning, with [(18)F]FCWAY, a fluorinated derivative of WAY100635, on a GE Medical Systems (Waukesha, Wisconsin) Advance scanner with continuous EEG monitoring. The 5-HT(1A) receptor binding was estimated by partial volume-corrected [(18)F]FCWAY V/f(1) values.

Results: In addition to decreased 5-HT(1A) receptor binding in the epileptic focus itself, comorbid MDD was associated with a significantly more pronounced reduction in 5-HT(1A) receptor binding in TLE patients, extending into non-lesional limbic brain areas outside the epileptic focus. Focus side and the presence of mesial temporal sclerosis were not associated with the presence of comorbid depression.

Conclusions: Reductions in 5-HT(1A) receptor binding might help elucidate the neurobiological mechanisms underlying the TLE-MDD comorbidity.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adolescent
  • Adult
  • Cyclohexanes
  • Depressive Disorder, Major / complications*
  • Depressive Disorder, Major / diagnostic imaging
  • Depressive Disorder, Major / metabolism*
  • Electroencephalography
  • Epilepsy, Temporal Lobe / complications*
  • Epilepsy, Temporal Lobe / diagnostic imaging
  • Epilepsy, Temporal Lobe / metabolism*
  • Female
  • Functional Laterality / physiology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Piperazines
  • Positron-Emission Tomography
  • Radiopharmaceuticals
  • Receptor, Serotonin, 5-HT1A / metabolism*


  • Cyclohexanes
  • N-(2-(4-(2-methoxyphenyl)piperazino))-N-(2-pyridinyl) trans-4-fluorocyclohexanecarboxamide
  • Piperazines
  • Radiopharmaceuticals
  • Receptor, Serotonin, 5-HT1A