Abstract
Regional cerebral blood flow (rCBF) studies of major depression have yielded variable results. The present study employed a longitudinal observation method to measure rCBF every 3 months during treatment. Thirteen patients with major depressive disorder underwent single-photon emission computed tomography (SPECT) with 99mTc-HMPAO three times over a 6-month period. rCBF was analyzed with the Statistical Parametric Mapping. The findings were compared to scans from 14 normal control subjects. Depression symptoms were rated using the Hamilton Rating Scale for Depression. At baseline, the main regions with lower rCBF compared to controls were the middle and inferior frontal gyri, superior temporal gyrus, and cingulate cortex. Three months later, despite significant improvement of depressive symptoms, decreased rCBF was observed in the same regions, but to lesser extent. At 6 months, depressive symptoms showed continued improvement, and rCBF in the superior temporal gyrus increased up to control levels, but rCBF in the temporal pole, cingulate, and inferior frontal gyrus remained low. The results of the present study suggest that there might be time- and state-dependent differences in rCBF recovery in patients with major depression.
Highlights
Altered brain activity in patients with mood disorders can be reflected in changes in regional cerebral blood flow
We found that regional cerebral blood flow (rCBF) values in the superior temporal gyrus, cingulate, and inferior frontal gyrus were consistently lower in patients with major depression compared to controls throughout the 6-month treatment period (Table 2)
Our results showed increased blood flow in the superior and middle frontal gyri and middle temporal gyrus and decreased blood flow in the superior temporal gyrus at 3 months, as well as decreased blood flow in the temporal pole including the amygdala at 6 months after initiation of treatment for major depressive disorder
Summary
Altered brain activity in patients with mood disorders can be reflected in changes in regional cerebral blood flow (rCBF). Many studies have reported rCBF measured by single-photon emission computed tomography (SPECT) in patients with major depression, but comparisons of rCBF with healthy controls and during the course of treatment are inconsistent [1]-[6]. The inconsistent results of previous studies may partly be owing to the heterogeneous etiology of depression and personal and treatment conditions. They could be owing to measurements being taken too early in the course of treatment. We prospectively followed patients during their treatment course for 6 months and measured rCBF (as a ratio to blood flow in the cerebellum) using SPECT every 3 months. Our goal was to delineate altered brain function in patients with major depression during exacerbation periods and the alleviation of depressive symptoms following pharmacological treatment
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