Quantitative regional cerebral blood flow measured by Tc-99m HMPAO SPECT in mood disorder

Abstract Depressed (n = 14) and remitted (n = 9) patients with mood disorder, patients with depressive disorder not otherwise specified (NOS; n = 10) and normal subjects (n = 8) underwent non-invasive and quantitative measurement of cerebral blood flow using HMPAO and SPECT in a resting state. The mean and regional cerebral blood flow (CBF) in twelve ROIs were compared among the four groups and correlations between CBF and the depressive symptoms were studied. The CBF was computed using graphical analysis on the SPECT console after a bolus injection of Tc-99m HMPAO and radionuclide angiography. The depressed group had significantly lower mCBF in the bilateral hemisphere and rCBF in all except one of the ROIs that the NOS and normal group. Significant negative correlations were found between the Hamilton scale for depression and rCBF in the bilateral lower frontal cortex after correcting for age in the mood disorder. Parallel analysis using both the quantitative and semiquantitative methods revealed that the former provided more global reduction of CBF in mood disorder. These results indicate that mean and regional CBF measured by this non-invasive method contributes to the objective evaluation of depressive symptoms. Negative correlations between HRSD and rCBF in the frontal regions indicate that frontal hypoactivity is closely related to depressive symptoms.

[1]  B L Miller,et al.  Reduction of cerebral blood flow in older depressed patients. , 1994, Archives of general psychiatry.

[2]  H. Fukuyama,et al.  SPECT with [99mTc]-d,l-Hexamethyl-Propylene Amine Oxime (HM-PAO) Compared with Regional Cerebral Blood Flow Measured by PET: Effects of Linearization , 1988, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[3]  M. Hamilton A RATING SCALE FOR DEPRESSION , 1960, Journal of neurology, neurosurgery, and psychiatry.

[4]  N. Alpert,et al.  A positron emission tomographic study of simple phobic symptom provocation. , 1995, Archives of general psychiatry.

[5]  J. Barrio,et al.  Quantifying local cerebral blood flow by N-isopropyl-p-[123I]iodoamphetamine (IMP) tomography. , 1982, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[6]  J R Moeller,et al.  Regional cerebral blood flow in mood disorders. I. Comparison of major depressives and normal controls at rest. , 1990, Archives of general psychiatry.

[7]  S. Pappatà,et al.  Left prefrontal glucose hypometabolism in the depressed state: a confirmation. , 1990, The American journal of psychiatry.

[8]  T. Higuchi,et al.  Regional cerebral blood flow in mood disorders , 1997 .

[9]  Klaus P. Ebmeier,et al.  State changes in brain activity shown by the uptake of 99mTc-exametazime with single photon emission tomography in major depression before and after treatment. , 1993, Journal of affective disorders.

[10]  J. Mendlewicz,et al.  Regional Cerebral Blood Flow in Patients with Affective Disorders , 1990, British Journal of Psychiatry.

[11]  M. Reivich,et al.  Brain function in psychiatric disorders. III. Regional cerebral blood flow in unmedicated schizophrenics. , 1983, Archives of general psychiatry.

[12]  L. DeLisi,et al.  Positron emission tomographic image measurement in schizophrenia and affective disorders , 1984, Annals of neurology.

[13]  Klaus P. Ebmeier,et al.  Single photon emission tomography with 99mTc-exametazime in major depression and the pattern of brain activity underlying the psychotic/neurotic continuum. , 1992, Journal of affective disorders.

[14]  Karl J. Friston,et al.  Cerebral responses to pain in patients with atypical facial pain measured by positron emission tomography. , 1994, Journal of neurology, neurosurgery, and psychiatry.

[15]  C S Patlak,et al.  Graphical Evaluation of Blood-to-Brain Transfer Constants from Multiple-Time Uptake Data , 1983, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[16]  W. Zung A SELF-RATING DEPRESSION SCALE. , 1965, Archives of general psychiatry.

[17]  H Matsuda,et al.  Quantitative cerebral blood flow measurements using N-isopropyl-(iodine 123) p-iodoamphetamine and single photon emission computed tomography with rotating gamma camera. , 1985, American journal of physiologic imaging.

[18]  J. Mazziotta,et al.  Reduction of prefrontal cortex glucose metabolism common to three types of depression. , 1989, Archives of general psychiatry.

[19]  M. Reivich,et al.  Brain function in psychiatric disorders. II. Regional cerebral blood flow in medicated unipolar depressives. , 1984, Archives of general psychiatry.

[20]  J R Moeller,et al.  Regional cerebral blood flow in mood disorders. II. Comparison of major depression and Alzheimer's disease. , 1993, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[21]  J C Mazziotta,et al.  Cerebral metabolic rates for glucose in mood disorders. Studies with positron emission tomography and fluorodeoxyglucose F 18. , 1985, Archives of general psychiatry.

[22]  H N Wagner,et al.  Paralimbic hypoperfusion in unipolar depression. , 1994, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[23]  Karl J. Friston,et al.  The anatomy of melancholia – focal abnormalities of cerebral blood flow in major depression , 1992, Psychological Medicine.

[24]  L. DeLisi,et al.  Anteroposterior gradients in cerebral glucose use in schizophrenia and affective disorders. , 1984, Archives of general psychiatry.

[25]  M. Yonekawa,et al.  Regional Cerebral Blood Flow in Depression , 1990, The Japanese journal of psychiatry and neurology.

[26]  R. Mathew,et al.  CEREBRAL BLOOD FLOW IN DEPRESSION , 1980, The Lancet.

[27]  Karl J. Friston,et al.  Dorsolateral prefrontal cortex dysfunction in the major psychoses; symptom or disease specificity? , 1993, Journal of neurology, neurosurgery, and psychiatry.

[28]  Karl J. Friston,et al.  Regional cerebral blood flow in depression measured by positron emission tomography: the relationship with clinical dimensions , 1993, Psychological Medicine.