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Changes in regional cerebral blood flow abnormalities in late‐life depression following response to electroconvulsive therapy
Author(s) -
Awata Shuichi,
Konno Michiko,
Kawashima Ryuta,
Suzuki Kazumasa,
Sato Toshimitsu,
Matsuoka Hiro,
Fukuda Hiroshi,
Sato Mitsumoto
Publication year - 2002
Publication title -
psychiatry and clinical neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 74
eISSN - 1440-1819
pISSN - 1323-1316
DOI - 10.1046/j.1440-1819.2002.00927.x
Subject(s) - electroconvulsive therapy , cerebral blood flow , orbitofrontal cortex , psychology , depression (economics) , anterior cingulate cortex , cardiology , gyrus , medicine , anesthesia , psychiatry , prefrontal cortex , neuroscience , schizophrenia (object oriented programming) , cognition , economics , macroeconomics
The impact of electroconvulsive therapy (ECT) on the regional cerebral blood flow (rCBF) abnormalities in late‐life depression is still unknown and the clinical significance of these findings in late‐life depression has not been fully discussed. Using single photon emission computed tomography (SPECT) with 99m Tc‐hexamethylpropylene amine oxime ( 99m Tc‐HMPAO), we examined the changes of rCBF patterns in nine late‐life patients with major depressive episodes before and following response to ECT compared with nine age‐ and sex‐matched healthy volunteers. Statistical comparisons were made on both region‐of‐interest (ROI) and voxel‐by‐voxel bases. In ROI‐based analyses, a mean rCBF was significantly decreased in the patients before ECT compared with the control, significantly increased (normalized) in the patients 2 weeks after ECT compared with that before ECT, and still increased in the patients 12 weeks after ECT compared with that before ECT. In voxel‐by‐voxel analyses, a significant rCBF reduction was found in the bilateral pre‐ and subcallosal anterior cingulate cortex, the bilateral caudal orbitofrontal cortex, the right insular cortex and the right posterior middle frontal gyrus in patients before ECT compared with the control, and similar rCBF patterns were shown at 2 weeks and 12 weeks after ECT. We propose the hypothesis that a mean rCBF reduction may have a state‐related property while persistent anterior paralimbic hypoperfusion may have a trait‐like property, which relates to the relapse vulnerability as well as a tendency toward medication failure and illness chronicity in late‐life depression.