Nuclei‐Specific Amygdala Enlargement Is Linked to Psychiatric Comorbidities in Drug‐Resistant Focal Epilepsy

ABSTRACT Objective Amygdala enlargement has been the subject of controversial studies regarding its significance in terms of pathogenicity both in epilepsy and in psychiatric comorbidities such as anxiety, depression, and post‐traumatic stress disorder. However, no causal link has been established i...

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Main Authors: Hélène Mourre, Julia Makhalova, Lisa Soncin, Elodie Garnier, Hugo Dary, Arnaud Le Troter, Roy A. M. Haast, Benoit Testud, Marie Arthuis, Samuel Medina Villalon, Stanislas Lagarde, Francesca Pizzo, Christian Bénar, Jean‐Philippe Ranjeva, Maxime Guye, Fabrice Bartolomei
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:Annals of Clinical and Translational Neurology
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Online Access:https://doi.org/10.1002/acn3.70071
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author Hélène Mourre
Julia Makhalova
Lisa Soncin
Elodie Garnier
Hugo Dary
Arnaud Le Troter
Roy A. M. Haast
Benoit Testud
Marie Arthuis
Samuel Medina Villalon
Stanislas Lagarde
Francesca Pizzo
Christian Bénar
Jean‐Philippe Ranjeva
Maxime Guye
Fabrice Bartolomei
author_facet Hélène Mourre
Julia Makhalova
Lisa Soncin
Elodie Garnier
Hugo Dary
Arnaud Le Troter
Roy A. M. Haast
Benoit Testud
Marie Arthuis
Samuel Medina Villalon
Stanislas Lagarde
Francesca Pizzo
Christian Bénar
Jean‐Philippe Ranjeva
Maxime Guye
Fabrice Bartolomei
author_sort Hélène Mourre
collection DOAJ
description ABSTRACT Objective Amygdala enlargement has been the subject of controversial studies regarding its significance in terms of pathogenicity both in epilepsy and in psychiatric comorbidities such as anxiety, depression, and post‐traumatic stress disorder. However, no causal link has been established in either direction, and the role of distinct amygdala nuclei remains unknown. We investigated volumetric changes of the amygdala and its nine main nuclei and their associations with psychiatric comorbidities in patients with drug‐resistant focal epilepsy. Methods Eighty‐seven adult patients with drug‐resistant focal epilepsy, available 7 T MRI, and completed standardized psychiatric assessments were included. Whole amygdala and nuclei volumes were quantified and compared to healthy controls. Correlations between the amygdala or nuclei volumes and psychiatric scores were analyzed, as well as the prevalence and severity of each comorbidity depending on the presence of enlargement. Results Amygdala enlargement was present in 41% of patients, with bilateral enlargement observed in 30% of these cases, while atrophy was noted in 2%. Bilateral enlargement correlated with higher posttraumatic stress disorder and depression scores. Central nucleus enlargement was associated with a greater prevalence of depression and more severe anxiety. Bilateral enlargement of distinct nuclei in the basolateral group was linked to more severe depression or posttraumatic stress disorder. Interpretation These findings suggest that bilateral amygdala enlargement, particularly in specific nuclei, may serve as a morphological marker of psychiatric comorbidities in epilepsy. Further research is needed to explore the specific roles of amygdala nuclei in psycho‐epileptogenesis.
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spelling doaj-art-40dfd70c94884aceae381348b9ffbd3d2025-08-20T02:37:14ZengWileyAnnals of Clinical and Translational Neurology2328-95032025-07-011271395140710.1002/acn3.70071Nuclei‐Specific Amygdala Enlargement Is Linked to Psychiatric Comorbidities in Drug‐Resistant Focal EpilepsyHélène Mourre0Julia Makhalova1Lisa Soncin2Elodie Garnier3Hugo Dary4Arnaud Le Troter5Roy A. M. Haast6Benoit Testud7Marie Arthuis8Samuel Medina Villalon9Stanislas Lagarde10Francesca Pizzo11Christian Bénar12Jean‐Philippe Ranjeva13Maxime Guye14Fabrice Bartolomei15APHM, Timone Hospital Epileptology and Cerebral Rhythmology Marseille FranceAPHM, Timone Hospital Epileptology and Cerebral Rhythmology Marseille FranceAPHM, Timone Hospital Epileptology and Cerebral Rhythmology Marseille FranceAix Marseille Univ, INSERM, INS Inst Neurosci Syst Marseille FranceAix Marseille Univ, CNRS CRMBM Marseille FranceAix Marseille Univ, CNRS CRMBM Marseille FranceAix Marseille Univ, CNRS CRMBM Marseille FranceAix Marseille Univ, CNRS CRMBM Marseille FranceAPHM, Timone Hospital Epileptology and Cerebral Rhythmology Marseille FranceAPHM, Timone Hospital Epileptology and Cerebral Rhythmology Marseille FranceAPHM, Timone Hospital Epileptology and Cerebral Rhythmology Marseille FranceAPHM, Timone Hospital Epileptology and Cerebral Rhythmology Marseille FranceAix Marseille Univ, INSERM, INS Inst Neurosci Syst Marseille FranceAix Marseille Univ, CNRS CRMBM Marseille FranceAix Marseille Univ, CNRS CRMBM Marseille FranceAPHM, Timone Hospital Epileptology and Cerebral Rhythmology Marseille FranceABSTRACT Objective Amygdala enlargement has been the subject of controversial studies regarding its significance in terms of pathogenicity both in epilepsy and in psychiatric comorbidities such as anxiety, depression, and post‐traumatic stress disorder. However, no causal link has been established in either direction, and the role of distinct amygdala nuclei remains unknown. We investigated volumetric changes of the amygdala and its nine main nuclei and their associations with psychiatric comorbidities in patients with drug‐resistant focal epilepsy. Methods Eighty‐seven adult patients with drug‐resistant focal epilepsy, available 7 T MRI, and completed standardized psychiatric assessments were included. Whole amygdala and nuclei volumes were quantified and compared to healthy controls. Correlations between the amygdala or nuclei volumes and psychiatric scores were analyzed, as well as the prevalence and severity of each comorbidity depending on the presence of enlargement. Results Amygdala enlargement was present in 41% of patients, with bilateral enlargement observed in 30% of these cases, while atrophy was noted in 2%. Bilateral enlargement correlated with higher posttraumatic stress disorder and depression scores. Central nucleus enlargement was associated with a greater prevalence of depression and more severe anxiety. Bilateral enlargement of distinct nuclei in the basolateral group was linked to more severe depression or posttraumatic stress disorder. Interpretation These findings suggest that bilateral amygdala enlargement, particularly in specific nuclei, may serve as a morphological marker of psychiatric comorbidities in epilepsy. Further research is needed to explore the specific roles of amygdala nuclei in psycho‐epileptogenesis.https://doi.org/10.1002/acn3.70071amygdalaepilepsypsychiatric comorbidities
spellingShingle Hélène Mourre
Julia Makhalova
Lisa Soncin
Elodie Garnier
Hugo Dary
Arnaud Le Troter
Roy A. M. Haast
Benoit Testud
Marie Arthuis
Samuel Medina Villalon
Stanislas Lagarde
Francesca Pizzo
Christian Bénar
Jean‐Philippe Ranjeva
Maxime Guye
Fabrice Bartolomei
Nuclei‐Specific Amygdala Enlargement Is Linked to Psychiatric Comorbidities in Drug‐Resistant Focal Epilepsy
Annals of Clinical and Translational Neurology
amygdala
epilepsy
psychiatric comorbidities
title Nuclei‐Specific Amygdala Enlargement Is Linked to Psychiatric Comorbidities in Drug‐Resistant Focal Epilepsy
title_full Nuclei‐Specific Amygdala Enlargement Is Linked to Psychiatric Comorbidities in Drug‐Resistant Focal Epilepsy
title_fullStr Nuclei‐Specific Amygdala Enlargement Is Linked to Psychiatric Comorbidities in Drug‐Resistant Focal Epilepsy
title_full_unstemmed Nuclei‐Specific Amygdala Enlargement Is Linked to Psychiatric Comorbidities in Drug‐Resistant Focal Epilepsy
title_short Nuclei‐Specific Amygdala Enlargement Is Linked to Psychiatric Comorbidities in Drug‐Resistant Focal Epilepsy
title_sort nuclei specific amygdala enlargement is linked to psychiatric comorbidities in drug resistant focal epilepsy
topic amygdala
epilepsy
psychiatric comorbidities
url https://doi.org/10.1002/acn3.70071
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