Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Objective: The aim of this study was to investigate differences in gray matter volume between patients with mesial temporal lobe epilepsy (MTLE) with and without depression using voxel-based morphometry. Method: We included 48 adults with refractory MTLE (31 women, 39.18 +/- 8.4 years) and 96 healthy controls (75 women, 37.11 +/- 8.9 years). For the psychiatric evaluation, the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Axis I, was used for the diagnosis of depression, and the Beck Depression Inventory, for the determination of symptom intensity. All patients underwent an MRI scan. Patients were separated into two groups: those with MTLE with depression (n = 24) and those with MILE without depression (n=24). We performed voxel-based morphometric analysis, comparing patients with controls using the t test. Results: The number of areas of gray matter volume loss was higher in patients with MTLE with depression than in those with MTLE without depression. Conclusions: The evidence of more widespread gray matter volume loss in patients with MTLE and depression calls our attention to the importance of timely recognition and treatment of depression in patients with MTLE and also to the bidirectional relationship between the two disorders and their frequent co-occurrence. (C) 2010 Elsevier Inc. All rights reserved.193422427Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [05/56578-4, 07/51280-2]