title: Association between major depressive symptoms in heart failure and impaired regional cerebral blood flow in the medial temporal region: a study using 99m Tc-HMPAO single photon emission computerized tomography (SPECT).
abstract: OBJECTIVE
  Depressive symptoms are frequently associated with heart failure (HF), but the brain mechanisms underlying such association are unclear. We hypothesized that the presence of major depressive disorder (MDD) emerging after the onset of HF would be associated with regional cerebral blood flow (rCBF) abnormalities in medial temporal regions previously implicated in primary MDD, namely the hippocampus and parahippocampal gyrus.
  
  
  METHODS
  Using 99mTc-SPECT, we measured rCBF in 17 elderly MDD-HF patients, 17 non-depressed HF patients, and 18 healthy controls, matched for demographic variables. Group differences were investigated with Statistical Parametric Mapping.
  
  
  RESULTS
  Significant rCBF reductions in MDD-HF patients relative to both non-depressed HF patients and healthy controls were detected in the left anterior parahippocampal gyrus and hippocampus (ANOVA, p=0.008 corrected for multiple comparisons) and the right posterior hippocampus and parahippocampal gyrus (p=0.005 corrected). In the overall HF group, there was a negative correlation between the severity of depressive symptoms and rCBF in the right posterior hippocampal/parahippocampal region (p=0.045 corrected).
  
  
  CONCLUSIONS
  These findings are consistent with the notion that the medial temporal region is vulnerable to brain perfusion deficits associated with HF, and provide evidence that such functional deficits may be specifically implicated in the pathophysiology of MDD associated with HF.
authors.affiliation: Department of Psychiatry, University of São Paulo Medical School, SP, Brazil. tania_alves@hotmail.com
authors.forename: Tânia C T F
authors.initials: TC
authors.lastname: Alves
authors.forename: Jairo
authors.initials: J
authors.lastname: Rays
authors.forename: Renério
authors.initials: R
authors.lastname: Fráguas
authors.forename: Mauricio
authors.initials: M
authors.lastname: Wajngarten
authors.forename: Renata M S
authors.initials: RM
authors.lastname: Telles
authors.forename: Fabio Luis De Souza
authors.initials: FL
authors.lastname: Duran
authors.forename: José C
authors.initials: JC
authors.lastname: Meneghetti
authors.forename: Cecil Chow
authors.initials: CC
authors.lastname: Robilotta
authors.forename: Silvana
authors.initials: S
authors.lastname: Prando
authors.forename: Cláudio Campi
authors.initials: CC
authors.lastname: De Castro
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Buchpiguel
authors.forename: Geraldo F
authors.initials: GF
authors.lastname: Busatto
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000503:physiopathology; D006624:Hippocampus / Q000098:blood supply* / Q000000981:diagnostic imaging; D006801:Humans; D016014:Linear Models; D008297:Male; D020534:Parahippocampal Gyrus / Q000098:blood supply* / Q000000981:diagnostic imaging; D015899:Tomography, Emission-Computed, Single-Photon