Regional cerebral glucose metabolism in patients with secondary depressive episodes after fatal pancreatic cancer diagnosis.
BACKGROUND
Secondary depression is common in the clinical oncology setting after pancreatic cancer diagnosis, following which the patients have to face the fact that they have a cancer with an extremely poor prognosis. However, the specific pathophysiology remains unclear. The present study examined the regional cerebral glucose metabolism using F18-fluorodeoxyglucose (F18-FDG) positron emission tomography (PET) in antidepressant-naïve pancreatic cancer patients with a depressive episode after their cancer diagnosis and before their cancer treatment.


METHODS
Regional cerebral glucose metabolism in pancreatic cancer patients without any antidepressant medication after the cancer diagnosis was measured with F18-FDG PET. A depressive episode after the cancer diagnosis was defined as including major and minor depressive episodes, and was diagnosed using the Diagnostic and Statistical Manual, Fourth Edition (DSM-IV). The prefrontal and limbic regions were the primary regions-of-interest, and an uncorrected value of p<0.005 was used as significant.


RESULTS
Six of 21 pancreatic cancer patients were diagnosed as having a depressive episode. Significantly higher glucose metabolism in depressed patients was found in the subgenual anterior cingulate cortex (sACC) (uncorrected p=0.002).


CONCLUSIONS
There was a small number of subjects, and there were no healthy controls.


CONCLUSIONS
The higher metabolism in the sACC may be associated with the pathophysiology of secondary depressive episodes in patients following pancreatic cancer diagnosis.
Inagaki
Masatoshi
M
Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwanoha 6-5-1, Kashiwa, Chiba 277-8577, Japan.
Yoshikawa
Eisho
E
Kobayakawa
Makoto
M
Matsuoka
Yutaka
Y
Sugawara
Yuriko
Y
Nakano
Tomohito
T
Akizuki
Nobuya
N
Fujimori
Maiko
M
Akechi
Tatsuo
T
Kinoshita
Taira
T
Furuse
Junji
J
Murakami
Koji
K
Uchitomi
Yosuke
Y
D000275:Adjustment Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004734:Energy Metabolism / Q000502:physiology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008032:Limbic System / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000523:psychology*; D049268:Positron-Emission Tomography; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology; D011379:Prognosis
D001786:Blood Glucose; D019788:Fluorodeoxyglucose F18