Depressive mood in pre-dialytic chronic kidney disease: Statistical parametric mapping analysis of Tc-99m ECD brain SPECT.
The purpose of this study was to investigate depression-related regions in pre-dialytic patients with chronic kidney disease (CKD) patients. Participants comprised 33 patients with stage 4 and 5 CKD (age, 55 [42-63]) and 32 healthy volunteers (age, 53.5 [49.5-57]). Depressed mood was assessed in the patients, and both groups underwent Tc-99m-labeled ethylcysteinate dimer (Tc-99m ECD) single photon emission computed tomograpy (SPECT). Statistical parametric mapping identified 18 areas of hypoperfusion in the patients in comparison with the normal controls. The largest clusters were areas including left precentral gyrus, right superior and middle temporal gyrus, both cerebellar posterior lobes, both inferior frontal gyrus, right superior and middle frontal gyrus, right cuneus, right inferior parietal lobule, and right putamen. However, there were no specific hypoperfusion areas in CKD patients with depression compared with CKD patients without depression. Interestingly, several hypoperfusion areas in CKD patients (inferior frontal gyrus [BA46], superior temporal gyrus [BA42], anterior cingulate gyrus [BA24]) were concordant with hypoperfusion areas found in patients with major depression who were free of kidney disease. In conclusion, this study did not demonstrate specific depression-related cerebral hypoperfusion areas. However, the cerebral blood flow pattern in CKD patients was similar to that of patients with major depression in some areas. Although further investigations are needed in the future, we suggest that the causes of the higher prevalence of depression in CKD might be associated with this finding.
Song
Sang Heon
SH
Department of Internal Medicine, Pusan National University Hospital 1-10, Ami-dong, Seo-gu, Busan 602-739, Republic of Korea.
Kwak
Ihm Soo
IS
Kim
Seong-Jang
SJ
Kim
Yong-Ki
YK
Kim
In Joo
IJ
D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology*; D001931:Brain Mapping; D002908:Chronic Disease; D003545:Cysteine / Q000031:analogs & derivatives; D003863:Depression / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011569:Psychiatric Status Rating Scales; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C059659:technetium Tc 99m bicisate; D003545:Cysteine