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Regional cerebral blood flow abnormalities in late‐life depression:Relation to refractoriness and chronification
Author(s) -
AWATA SHUICHI,
ITO HIROSHI,
KONNO MICHIKO,
ONO SHUICHI,
KAWASHIMA RYUTA,
FUKUDA HIROSHI,
SATO AND MITSUMOTO
Publication year - 1998
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 - 10.1111/j.1440-1819.1998.tb00980.x
Subject(s) - anterior cingulate cortex , cerebral blood flow , prefrontal cortex , gyrus , caudate nucleus , psychology , hippocampus , neuroscience , cingulate cortex , medicine , cardiology , central nervous system , cognition
We examined patterns of regional cerebral blood flow (rCBF) abnormalities in 18 patients with major depressive disorder in late life using single photon emission computed tomography (SPECT) and ( 99m Tc‐hexamethyl‐propylenamine oxime ( 99m Tc‐HMPAO). Compared with 13 age‐matched controls, relative rCBF was significantly decreased bilaterally in the anterior cingulate gyrus, the prefrontal cortex, the temporal cortex, the parietal cortex, the hippocampus and the caudate nucleus. However, it was not correlated with the severity of depression or global cognitive dysfunction. In 10 patients with a prolonged depressive episode or prolonged residual symptoms (the refractory subgroup), robust and extensive decreases in rCBF were found compared with controls and the rCBF decreased significantly in the anterior cingulate gyrus and the prefrontal cortex compared with that in the non‐refractory subgroup. In the non‐refractory subgroup, rCBF decreased significandy in the caudate nucleus and tended to decrease in the anterior cingulate gyrus compared with controls. These findings indicate that dysfunction of the limbic system, the cerebral association cortex and the caudate nucleus may be implicated in late‐life depression and that robust and extensive hypoperfusion, especially in the anterior cingulate and the prefrontal regions, may relate to refractoriness or chronification of depression.