Brain single photon emission computed tomography findings in depressive pseudodementia patients.
BACKGROUND
Recently, there have been studies suggesting that depressive pseudodementia would include early-stage dementing disorder. Through the comparison of the 99mTc-HMPAO single photon emission computed tomography (SPECT) image of depressive pseudodementia subjects, healthy comparison subjects, depressed subjects free of cognitive impairment, and dementia of Alzheimer's type (DAT) subjects, we aimed to see part of pathophysiology of the depressive pseudodementia of elderly patients.


METHODS
Study subjects consisted of seven patients with depressive pseudodementia, seven healthy comparison subjects, seven patients with depression free of cognitive impairment, and eleven patients with DAT. Depression patients were diagnosed according to DSM-III-R. DAT patients were diagnosed by DSM III-R and NINCDS-ADRDA criteria of DAT. Other measures for assessment include Hamilton Rating Scale for Depression and Mini Mental State Exam. All underwent 99mTc-HMPAO SPECT scan. The images of each group were analyzed using statistical parametric mapping of Friston, which compares the images on voxel-by-voxel basis.


RESULTS
The results were as follows (1) The DAT group showed significant decreases of cerebral blood flow (CBF) in the right frontal, right temporal region, and both parietal regions as compared with control group (P < 0.05). (2) The depression group showed a significant decrease of CBF in the left frontal region as compared with control group (P < 0.05). (3) The depressive pseudodementia group showed significant decreases of CBF in both parietal regions as compared with control group (P < 0.05). (4) The depressive pseudodementia group showed significant decreases of CBF in the right temporal region and both parietal regions as compared with depression group (P < 0.05). (5) The DAT group showed significant decreases of CBF in the right temporal region, both frontal regions, and both parietal regions as compared with depressive pseudodementia group (P < 0.05).


CONCLUSIONS
The small number of subjects may make it difficult to generalize from our results. Because decreased CBF in depressive pseudodementia is found while the subjects were depressed, we cannot tell whether it is a state marker or a trait marker.


CONCLUSIONS
The depressive pseudodementia group showed decreased CBF in the temporo-parietal region, similar to that of the DAT group and different from that of the depression group.
Cho
Maeng Je
MJ
Department of Neuropsychiatry, Clinical Research Institute, Seoul National University College of Medicine and Hospital, 28 Yongon-dong, Chongno-gu, Seoul, 110-744 South Korea. mjcho@plaza.snu.ac.kr
Lyoo
In Kyoon
IK
Lee
Dong Woo
DW
Kwon
Jun Soo
JS
Lee
Jae Sung
JS
Lee
Dong Soo
DS
Jung
June Key
JK
Lee
Myung Chul
MC
D000368:Aged; D000544:Alzheimer Disease / Q000503:physiopathology; D001921:Brain / Q000098:blood supply / Q000503:physiopathology*; D003866:Depressive Disorder / Q000503:physiopathology*; D005162:Factitious Disorders / Q000503:physiopathology*; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply / Q000503:physiopathology; D006801:Humans; D008297:Male; D010296:Parietal Lobe / Q000098:blood supply / Q000503:physiopathology; D019690:Technetium Tc 99m Exametazime; D013702:Temporal Lobe / Q000098:blood supply / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon
D019690:Technetium Tc 99m Exametazime