title: Increased limbic blood flow and total sleep deprivation in major depression with melancholia.
abstract: Single photon emission computed tomography (SPECT) with technetium-99m-d,l-hexamethyl-propylene amine oxime (99Tcm-HMPAO) was carried out in 20 melancholic patients before and after total sleep deprivation. Findings in 11 responders to total sleep deprivation (defined by > or = 40% improvement on the Hamilton Rating Scale for Depression) were compared with findings in nine nonresponders. On the basis of a semiquantitative evaluation of SPECT findings, responders showed relative hyperperfusion before sleep deprivation in the right anterior cingulate cortex and in the right and left fronto-orbital cortex and basal cingulate gyrus. Responders who showed > or = 50% improvement also showed hippocampal overactivation before sleep deprivation. It is possible that limbic overactivation may characterize depressed responders to total sleep deprivation as a distinct subtype. Another possibility is that the pattern of limbic hyperactivation reflects the increased number of bipolar patients in the responder group, with response to total sleep deprivation being only a covariate of this bipolar-unipolar distinction.
authors.affiliation: Department of Psychiatry, University of Erlangen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Ebert
authors.forename: H
authors.initials: H
authors.lastname: Feistel
authors.forename: A
authors.initials: A
authors.lastname: Barocka
authors.forename: W
authors.initials: W
authors.lastname: Kaschka
mesh_terms: D000328:Adult; D001931:Brain Mapping; D003866:Depressive Disorder / Q000000981:diagnostic imaging / Q000628:therapy*; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging / Q000628:therapy*; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging; D006179:Gyrus Cinguli / Q000098:blood supply / Q000000981:diagnostic imaging; D006624:Hippocampus / Q000098:blood supply / Q000000981:diagnostic imaging; D006801:Humans; D008032:Limbic System / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D012039:Regional Blood Flow; D012892:Sleep Deprivation / Q000000981:diagnostic imaging*; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
chemical_list: D019690:Technetium Tc 99m Exametazime