title: Low frequency rTMS as an add-on antidepressive strategy: heterogeneous impact on 99mTc-HMPAO and 18 F-FDG uptake as measured simultaneously with the double isotope SPECT technique. Pilot study.
abstract: Single photon emission computed tomography (SPECT) and positron emission tomography (PET) are examination procedures that have shown that repetitive transcranial magnetic stimulation (rTMS) is biologically active. The aim of the present study was to investigate the patterns of regional cerebral 18F-fluorodeoxyglucose (18F-FDG) uptake and regional 99mTc-hexamethylpropyleneamine oxime (99mTc-HMPAO) uptake simultaneously during a series of therapeutic rTMS at low frequency. Four drug-resistant depressed patients underwent 10 rTMS as an add-on measure over 14 days. One day before and one day after TMS, simultaneous measurements of 18F-FDG, representing regional cerebral metabolic rate (rCMR), and 99mTc-HMPAO, representing regional cerebral blood flow (rCBF), were carried out. A conventional double head SPECT camera with 511 keV collimators was used. Statistically significant simultaneous overall changes of rCBF and rCMR were found in the upper prefrontal regions bilaterally in terms of increased uptake rates and in the left gyrus frontalis inferior in terms of decreased uptake rates of both isotopes compared to controls. Although this method improves our understanding of rTMS mechanism, there are limitations due to the lower resolution provided. Therapeutic rTMS seems to influence distinct, cortical regions affecting rCBF and rCMR.
authors.affiliation: Department of Nuclear Medicine, Hospital of Feldkirch, 6800 Feldkirch, Austria. William.Peschina@lkhf.at
authors.forename: W
authors.initials: W
authors.lastname: Peschina
authors.forename: A
authors.initials: A
authors.lastname: Conca
authors.forename: P
authors.initials: P
authors.lastname: König
authors.forename: H
authors.initials: H
authors.lastname: Fritzsche
authors.forename: W
authors.initials: W
authors.lastname: Beraus
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism*; D001931:Brain Mapping / Q000379:methods*; D015283:Citalopram / Q000627:therapeutic use; D003866:Depressive Disorder / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D007839:Functional Laterality; D006801:Humans; D008280:Magnetics; D008297:Male; D008376:Maprotiline / Q000627:therapeutic use; D010865:Pilot Projects; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012016:Reference Values; D019690:Technetium Tc 99m Exametazime / Q000493:pharmacokinetics*; D014018:Tissue Distribution; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014196:Trazodone / Q000627:therapeutic use
chemical_list: D000928:Antidepressive Agents; D019275:Radiopharmaceuticals; D015283:Citalopram; D019788:Fluorodeoxyglucose F18; D008376:Maprotiline; D019690:Technetium Tc 99m Exametazime; D014196:Trazodone