Prognostic value of frontal functional neuroimaging in late-onset severe major depression.
BACKGROUND
There is growing evidence of a relationship between frontal neuroimaging and neuropsychological abnormalities and the physiopathology and course of late-onset major depression.


OBJECTIVE
To assess acute antidepressant response in late-onset major depression in relation to baseline frontal perfusion ratios.


METHODS
A 99mTc HMPAO single photon emission computed tomographic brain scan was performed in medication-free patients with late-onset major depression, who were then included in a 12-week antidepressant treatment regimen. Logistic regression was used to define a predictive model of non-remission.


RESULTS
A total of 47 patients completed the study, 34 of whom were classed as remitters and 13 as non-remitters. The variable left anterior fronto-cerebellar perfusion ratio had a global predictive power of 87%. Analysing this variable together with the baseline variables age of onset and duration of index episode, the predictive power of the model rose to 94%.


CONCLUSIONS
Our study suggests that a specific frontal functioning could predict the acute antidepressant response in late-onset severe major depression.
Navarro
Victor
V
Clinical Institute of Psychiatry and Psychology, Hospital Clinic, Barcelona, Spain. 30739vno@comb.es
Gastó
Cristóbal
C
Lomeña
Francisco
F
Torres
Xavier
X
Mateos
José J
JJ
Portella
María J
MJ
Masana
Guillem
G
Marcos
Teodoro
T
D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D002560:Cerebrovascular Circulation; D003866:Depressive Disorder / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D016896:Treatment Outcome
D000928:Antidepressive Agents; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime