Correlation between cerebral blood flow and items of the Hamilton Rating Scale for Depression in antidepressant-naive patients.
BACKGROUND
The purpose of this study was to correlate the basal cerebral blood flow (CBF) in patients with major depressive disorder (MDD) with the score for each of the 21 questions in the Hamilton Rating Scale for Depression (HRSD), in order to determine the cerebral regions associated with each item.


METHODS
Fourteen antidepressant-naive patients with unipolar depression (DSM-IV criteria for MDD) participated in this study with a HRSD score of >/=20 points. CBF images obtained by SPECT were analyzed by SPM99 software. The significant correlation threshold for a priori regions (frontocortical and limbic regions) was a Z value of at least 2.25 and clusters formed by more than 10 voxels.


RESULTS
Items 1, 6, 11 and 20 were positively correlated with right medial frontal gyrus; item 7 was negatively correlated with bilateral medial frontal gyrus. Items 2 and 10 were positively correlated with right anterior and medial cingulate, respectively. Item 5 was negatively correlated with the left amygdala. Item 9 was negatively correlated with bilateral insula, and item 16 with right insula. Items 12 and 14 were positively correlated with right and left precentral frontal gyrus, respectively.


CONCLUSIONS
The small sample size and only out-patients included in the study.


CONCLUSIONS
The frontal cortex plays an important role in the expression of MDD symptoms. Not all the symptoms evaluated correlated with one single structure, which may explain the diverse results reported in the literature. These preliminary results support the necessity of further analyses by symptoms that could provide more specific information on the pathophysiology of MDD.
Graff-Guerrero
Ariel
A
Instituto Nacional de Psiquiatría Ramón de la Fuente, Dirección de Servicios Clínicos, Calz. México-Xochimilco 101, Col. San Lorenzo Huipulco, Del. Tlalpan 14370, México D.F., Mexico. agraff@imp.edu.mx
González-Olvera
Jorge
J
Mendoza-Espinosa
Yazmín
Y
Vaugier
Víctor
V
García-Reyna
Juan Carlos
JC
D000328:Adult; D000679:Amygdala / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging; D002540:Cerebral Cortex / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D003545:Cysteine / Q000031:analogs & derivatives*; D003866:Depressive Disorder / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D007839:Functional Laterality / Q000502:physiology; D006179:Gyrus Cinguli / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008032:Limbic System / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D015609:Organotechnetium Compounds; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D012039:Regional Blood Flow / Q000502:physiology; D015899:Tomography, Emission-Computed, Single-Photon / Q000706:statistics & numerical data
D015609:Organotechnetium Compounds; C059659:technetium Tc 99m bicisate; D003545:Cysteine