Changes in regional cerebral blood flow on recovery from depression—comparison of vascular depression and non-vascular depression

Abstract

Cerebrovascular or vascular change is frequent in elderly patients with depression. The concept of vascular depression (VD) has been a topic of interest in neuropsychiatry. During the last decade, functional neuroimaging studies have reported that recovery from depression was associated with increased regional cerebral blood flow (rCBF) in specific regions. However, the majority of studies have been confined to depression without cerebrovascular changes. Therefore, this study was undertaken to examine changes in rCBF on recovery from vascular depression. We measured rCBF in nine patients with ‘vascular depression’ and 11 patients with ‘non-vascular depression’ using 123I-IMP single photon emission computed tomography (SPECT) during illness and after recovery. The results showed that VD has significantly lower mean rCBF than non-VD during both depressed and remitted state, localized to the left anterior frontal region. This suggested that persisting left frontal hypoperfusion may lead to longer duration or higher frequency of relapse. Both VD and non-VD showed significantly higher mean rCBF in remitted state than in depressed state, especially left anterior temporal rCBF correlated with recovery from depression. This suggested that left temporal activity might be a state or episode-dependent marker for both VD and non-VD