Regional cerebral blood flow changes in depression after electroconvulsive therapy.
A large number of studies have documented regional cerebral blood flow (rCBF) abnormalities in depression. A smaller yet significant number of studies have examined changes in rCBF before and after treatment. The findings, however, have been variable with regard to changes before and after electroconvulsive therapy (ECT). A consecutive series of patients (n=10) with drug-resistant major depressive episode according to DSM-IV with 17-item Hamilton Rating Scale for Depression (HRSD) scores greater than or equal to 14 gave their informed consent and were studied with technetium-99m ethyl cysteinate dimer single-photon emission computed tomography (99mTc-ECD SPECT) before and after a course of ECT. The results were analyzed with statistical parametric mapping version 99. No region showed significant positive correlations between rCBF patterns of changes and HRSD changes, but three clusters emerged as showing significant negative correlations. These regions corresponded with left frontopolar gyrus, left amygdala, globus pallidus and nucleus accumbens, and left superior temporal gyrus. It was speculated that ECT affected both the prefrontal cortex, commonly assumed to be involved in depression, and the amygdala, known to play a central role in the processing of emotional stimuli, through the limbic-cortical-striatal-pallidal-thalamic circuit.
Segawa
Kazuhisa
K
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.
Azuma
Hideki
H
Sato
Kiyoe
K
Yasuda
Toshinobu
T
Arahata
Keiko
K
Otsuki
Kazuyuki
K
Tohyama
Junko
J
Soma
Tsutomu
T
Iidaka
Tetsuya
T
Nakaaki
Shutaro
S
Furukawa
Toshi A
TA
D000328:Adult; D001479:Basal Ganglia / Q000098:blood supply; D001921:Brain / Q000098:blood supply*; D002560:Cerebrovascular Circulation / Q000502:physiology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000098:blood supply; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon