Depressive disorders: focally altered cerebral perfusion measured with arterial spin-labeling MR imaging.
OBJECTIVE
To assess focal cerebral perfusion in patients with refractory depressive disorder (RDD), patients with nonrefractory depressive disorder (NDD), and healthy control subjects by using arterial spin-labeling (ASL) magnetic resonance (MR) imaging.


METHODS
This study was approved by the local ethical committee, and written informed consent was obtained from all participants. Twenty-four patients with RDD, 37 patients with NDD, and 42 healthy control subjects were included. From February 2006 to July 2007, all participants were imaged with a 3-T MR system. ASL and echo-planar images were subtracted and averaged to give perfusion-weighted images. Voxel-based analysis was performed. Region-of-interest analysis was applied to the bilateral hippocampi, thalami, and lentiform nuclei.


RESULTS
Patients with NDD showed reduced perfusion in the left prefrontal cortex versus control subjects and increased perfusion mainly in the limbic-striatal areas (P < .05). In contrast, patients with RDD had decreased perfusion predominantly in the bilateral frontal and bilateral thalamic regions (P < .05). Compared with patients with RDD, patients with NDD showed higher perfusion mainly in the limbic-striatal areas (P < .05). In region-of-interest analysis, the NDD group showed higher regional cerebral blood flow than both RDD and control groups in the left hippocampus (P = .045), right hippocampus (P = .001), and right lentiform nucleus (P = .049).


CONCLUSIONS
This study revealed alterations of regional perfusion in the brains of patients with RDD that differed from those in patients with NDD. These results are consistent with the concept that RDD is associated with decreased activity of the bilateral prefrontal areas; and NDD, with decreased activity of left frontal areas in conjunction with overactivity of the bilateral limbic system.
Lui
Su
S
Department of Radiology, Huaxi MR Research Center, State Key Laboratory of Biotherapy, West China Hospital, West China School of Clinical Medicine, Guo Xuexiang 37, Chengdu Sichuan 610041, China.
Parkes
Laura M
LM
Huang
Xiaoqi
X
Zou
Ke
K
Chan
Raymond C K
RC
Yang
Hong
H
Zou
Ling
L
Li
Dongming
D
Tang
Hehan
H
Zhang
Tijiang
T
Li
Xiuli
X
Wei
Yi
Y
Chen
Long
L
Sun
Xueli
X
Kemp
Graham J
GJ
Gong
Qi-Yong
QY
D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D001921:Brain / Q000098:blood supply / Q000503:physiopathology*; D002536:Cerebral Arteries / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D003866:Depressive Disorder / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013113:Spin Labels; D055815:Young Adult
D013113:Spin Labels