['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.', '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 MTLE without depression (n = 24). We performed voxel-based morphometric analysis, comparing patients with controls using the t test.', 'The number of areas of gray matter volume loss was higher in patients with MTLE with depression than in those with MTLE without depression.'] Are neuroimaging changes in mesial temporal lobe epilepsy magnified in the presence of depression?