Regional cerebral glucose utilization in patients with a range of severities of unipolar depression.
BACKGROUND
Patients with unipolar depression are most often reported to have decreased regional cerebral glucose metabolism (rCMRglu) in dorsal prefrontal and anterior cingulate cortices compared with healthy control subjects, often correlating inversely with severity of depression.


METHODS
We measured rCMRglu with fluorine-18 deoxyglucose positron emission tomography (PET) in 38 medication-free patients with unipolar depression and 37 healthy control subjects performing an auditory continuous performance task to further investigate potential prefrontal and anterior paralimbic rCMRglu abnormalities in patients attending to this task.


RESULTS
Compared with control subjects, the subgroup of patients with Hamilton depression scores of 22 or greater demonstrated decreased absolute rCMRglu in right prefrontal cortex and paralimbic/amygdala regions as well as bilaterally in the insula and temporoparietal cortex (right > left); they also exhibited increased normalized metabolic activity bilaterally in the cerebellum, lingula/cuneus, and brain stem. Severity of depression negatively correlated with absolute rCMRglu in almost the entire extent of the right cingulate cortex as well as bilaterally in prefrontal cortex, insula, basal ganglia, and temporoparietal cortex (right > left).


CONCLUSIONS
Areas of frontal, cingulate, insula, and temporal cortex appear hypometabolic in association with different components of the severity and course of illness in treatment-resistant unipolar depression.
Kimbrell
Tim A
TA
North Little Rock VA Medical Center (TAKi), North Little Rock, Arkansas, USA.
Ketter
Terence A
TA
George
Mark S
MS
Little
John T
JT
Benson
Brenda E
BE
Willis
Mark W
MW
Herscovitch
Peter
P
Post
Robert M
RM
D000328:Adult; D000368:Aged; D001479:Basal Ganglia / Q000378:metabolism; D001921:Brain / Q000378:metabolism*; D001933:Brain Stem / Q000378:metabolism; D002531:Cerebellum / Q000378:metabolism; D002540:Cerebral Cortex / Q000378:metabolism; D003866:Depressive Disorder / Q000175:diagnosis / Q000378:metabolism*; D004338:Drug Combinations; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006179:Gyrus Cinguli / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010296:Parietal Lobe / Q000378:metabolism; D017397:Prefrontal Cortex / Q000378:metabolism; D011244:Pregnadienediols; D011569:Psychiatric Status Rating Scales; D019275:Radiopharmaceuticals; D012720:Severity of Illness Index; D013702:Temporal Lobe / Q000378:metabolism; D014055:Tomography, Emission-Computed; D014508:Urea
D004338:Drug Combinations; D011244:Pregnadienediols; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D014508:Urea; C041052:fluodexan; D005947:Glucose