Relative glucose metabolic rates in the elderly depressed patient (MRI/PET)

Abstract

Coregistered magnetic resonance (MRI) and positron electron tomography (PET) images of relative glucose metabolic rates (normalized to the whole brain) in an elderly depressed patient (upper panel) and in an age-matched control subject (lower panel). The PET scans were obtained at baseline, following one night of total sleep deprivation (post-TSD), after one night of recovery sleep, and (in the case of the patient) after one night of recovery sleep, and (in the case of the patient) after 2 weeks of paroxetine treatment. Glucose metabolism was lower in the patient than in the control. Sleep deprivation was administered to test its ability to accelerate the onset of paroxetine's antidepressant activity. Relative glucose metabolism was decreased after sleep deprivation (relative to baseline) in the superior and middle frontal gyrus (Brodman's areas 6, 7, and 10) and the right parietal cortex. Reductions in left frontal cortex and left cingulated metabolism (areas 24/32) were also observed after recovery sleep and after paroxetine treatment. The data are presented in detail in: Smith GS, Reynolds CF, Pollock B, et al. The cerebral glucose metabolic response to combined total sleep deprivation and antidepressant treatment in geriatric depression. Am J Psychiatry. 1999;156:683-689.