title: Alterations of rCBF and mitochondrial dysfunction in major depressive disorder: a case report.
abstract: OBJECTIVE
  A mitochondrial disease might be considered when depressive disorder is associated with diabetes mellitus or other symptoms commonly found in mitochondrial disease. Scattered regional cerebral blood flow (rCBF) decreases and increases have been reported in depressive and mitochondrial disorders. A 61-year-old male patient with early adult onset of depressive disorder and a slowly developing multiorgan syndrome including diabetes mellitus was investigated.
  
  
  METHODS
  99mTc-HMPAO rCBF SPECT and muscle biopsy to assess mitochondrial functions were performed in the patient.
  
  
  RESULTS
  Alterations of rCBF were found in the patient, with the most pronounced decreases in the left dorsolateral frontal and inferior parietal lobes, and the most pronounced increases in the bilateral superior parietal lobes. Muscle biopsy revealed myopathy and decrease of mitochondrial adenosine triphosphate production rates (MAPRs).
  
  
  CONCLUSIONS
  The MAPRs decreases support the suspicion of mitochondrial dysfunction in the patient. A subgroup of depressed patients may have mitochondrial dysfunctions.
authors.affiliation: NEUROTEC Department, Division of Psychiatry, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden. agardner@swipnet.se
authors.forename: A
authors.initials: A
authors.lastname: Gardner
authors.forename: M
authors.initials: M
authors.lastname: Pagani
authors.forename: R
authors.initials: R
authors.lastname: Wibom
authors.forename: I
authors.initials: I
authors.lastname: Nennesmo
authors.forename: H
authors.initials: H
authors.lastname: Jacobsson
authors.forename: T
authors.initials: T
authors.lastname: Hällström
mesh_terms: D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging; D003865:Major Depressive Disorder / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D048909:Diabetes Complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D017240:Mitochondrial Myopathies / Q000150:complications* / Q000175:diagnosis; D019275:Radiopharmaceuticals; D012039:Regional Blood Flow; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime