Prefrontal cortex dysfunction and depression in atypical parkinsonian syndromes.
Depressive symptoms are common in patients with neurodegenerative disorders. Imaging studies suggest that a disruption of frontal-subcortical pathways may underlie depression associated with basal ganglia disease. This pilot study tested the hypothesis that frontal dysfunction contributes to depression associated with multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). Depressed patients with MSA (n = 11), PSP (n = 9), and age-matched controls (n = 25) underwent measures of cerebral glucose metabolism applying positron emission tomography with (18)F-fluorodeoxyglucose. Regional metabolism in the patient groups was compared to the normal subjects using the voxel-based statistical parametric mapping. Depressive symptom severity (Hamilton Depression Rating) and degree of locomotor disability (Hoehn & Yahr) were assessed in the patient groups. The association between prefrontal metabolism and the occurrence of depressive symptoms and the degree of locomotor disability was investigated. When compared to controls, MSA patients revealed significant metabolic decreases in bilateral frontal, parietal, and cerebellar cortex and in the left putamen. In PSP patients, significant hypometabolism was demonstrated in bilateral frontal cortex, right thalamus, and midbrain. Depression severity but not the patients' functional condition was significantly associated with dorsolateral prefrontal glucose metabolism in both patient groups. The findings of this pilot study support the hypothesis that depressive symptoms in MSA and PSP are associated with prefrontal dysfunction.
Herting
Birgit
B
Department of Neurology, Technische Universität Dresden, Germany. birgit.herting@mailbox.tu-dresden.de
Beuthien-Baumann
Bettina
B
Pöttrich
Katrin
K
Donix
Markus
M
Triemer
Antje
A
Lampe
Johannes B
JB
von Kummer
Rüdiger
R
Herholz
Karl
K
Reichmann
Heinz
H
Holthoff
Vjera A
VA
D000368:Aged; D001933:Brain Stem / Q000378:metabolism / Q000473:pathology; D002531:Cerebellum / Q000378:metabolism / Q000473:pathology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000209:etiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000453:epidemiology; D009483:Neuropsychological Tests; D010296:Parietal Lobe / Q000378:metabolism / Q000473:pathology; D020734:Parkinsonian Disorders / Q000453:epidemiology / Q000473:pathology* / Q000523:psychology*; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D017397:Prefrontal Cortex / Q000378:metabolism* / Q000473:pathology*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012720:Severity of Illness Index; D013788:Thalamus / Q000378:metabolism / Q000473:pathology; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18