title: Effect of sleep deprivation on brain metabolism of depressed patients.
abstract: OBJECTIVE
  Sleep deprivation is a rapid, nonpharmacologic antidepressant intervention that is effective for a subset of depressed patients. The objective of this study was to identify which brain structures' activity differentiates responders from nonresponders and to study how metabolism in these brain regions changes with mood.
  
  
  METHODS
  Regional cerebral glucose metabolism was assessed by positron emission tomography (PET) with [18F]deoxyglucose (FDG) before and after total sleep deprivation in 15 unmedicated awake patients with unipolar major depression and 15 normal control subjects, who did the continuous performance test during FDG uptake.
  
  
  RESULTS
  After sleep deprivation, four patients showed a 40% or more improvement on the Hamilton Rating Scale for Depression. Before sleep deprivation the depressed responders had a significantly higher cingulate cortex metabolic rate than the depressed nonresponders, and this normalized after sleep deprivation. The normal control subjects and nonresponding depressed patients showed no change in cingulate metabolic rate after sleep deprivation.
  
  
  CONCLUSIONS
  Overactivation of the limbic system as assessed by PET scans may characterize a subset of depressed patients. Normalization of activity with sleep deprivation is associated with a decrease in depression.
authors.affiliation: Department of Psychiatry and Human Behavior, College of Medicine, University of California, Irvine 92717.
authors.forename: J C
authors.initials: JC
authors.lastname: Wu
authors.forename: J C
authors.initials: JC
authors.lastname: Gillin
authors.forename: M S
authors.initials: MS
authors.lastname: Buchsbaum
authors.forename: T
authors.initials: T
authors.lastname: Hershey
authors.forename: J C
authors.initials: JC
authors.lastname: Johnson
authors.forename: W E
authors.initials: WE
authors.lastname: Bunney
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000502:physiology; D003847:Deoxyglucose / Q000031:analogs & derivatives; D003866:Depressive Disorder / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008032:Limbic System / Q000000981:diagnostic imaging / Q000378:metabolism; D008297:Male; D011569:Psychiatric Status Rating Scales; D012892:Sleep Deprivation; D014055:Tomography, Emission-Computed
chemical_list: D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose; D005947:Glucose