Zmiany aktywności mózgu w spoczynku u pacjentów z padaczką skroniową i towarzyszącą depresją: analiza wielu badań

OBJECTIVE: To compare the differences in functional brain activity between patients with temporal lobe epilepsy comorbid with depressive disorder (TLE-D) and those with temporal lobe epilepsy without depressive disorder (TLE-ND) via a meta‑analysis of resting‑state functional magnetic resonance imaging (rs-fMRI) studies, and to explore the functional brain activity features associated with depressive symptoms. METHODS: Systematic searches were conducted in PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data from database inception to September 2026 to identify cross-sectional studies comparing rs-fMRI-derived differences in functional brain activity between patients with temporal lobe epilepsy comorbid with depressive disorder (TLE-D) and those without depressive disorder (TLE-ND). Eligible rs-fMRI metrics included regional brain activity indices and functional connectivity indices. A meta-analysis of studies reporting regional brain activity indices was performed using anisotropic effect-size signed differential mapping (AES-SDM). Due to their limited number, studies reporting functional connectivity indices were only described narratively. Study selection and data extraction were then completed, and a voxel-based meta-analysis of the included studies was performed with AES-SDM. RESULTS: A total of six studies yielding nine datasets met the inclusion criteria, involving 100 patients with TLE-D and 108 patients with TLE-ND. Meta-analysis showed that, compared with the TLE-ND group, the TLE-D group had significantly increased spontaneous brain activity in the right precuneus, right angular gyrus, right superior frontal gyrus, left middle frontal gyrus, and left cerebellum (analyzed via AES-SDM with an initial exploratory threshold of uncorrected voxel-level P < 0.005 and cluster size ≥10 voxels, and validated by leave-one-out sensitivity analysis). No brain regions with significantly decreased spontaneous brain activity were detected. CONCLUSION: These exploratory findings suggest that, compared with patients with TLE-ND, patients with TLE-D show distinct patterns of functional brain activity in multiple key nodes of the default mode network, including the precuneus and angular gyrus, as well as in prefrontal-related regions. These differences may provide preliminary neuroimaging evidence for understanding the neural mechanisms underlying depressive symptoms associated with temporal lobe epilepsy.