Cerebral blood flow in depressed patients with systemic lupus erythematosus.
OBJECTIVE
To characterize the neural circuitry involved in depression associated with systemic lupus erythematosus (SLE), we used single photon emission computed tomography (SPECT) to study regional cerebral blood flow (CBF) in patients with SLE.


METHODS
SPECT with (99m)Tc-ethylcysteinate dimer was performed in 30 depressed women patients with SLE, in 14 women patients with SLE and without history of neuropsychiatric disorders, and in 25 healthy women controls. Magnetic resonance imaging was done for all subjects for diagnostic purposes. Analysis of CBF patterns was performed using statistical parametric mapping. Statistical significance was taken at uncorrected p < 0.001 at cluster level.


RESULTS
There were no significant differences between depressed and nondepressed patients with SLE for any rheumatologic variable. In comparison to healthy controls, depressed patients with SLE had significantly reduced CBF in bilateral frontal and temporal cortex; global maximum was located in the left precentral gyrus. There were no significant CBF differences between nondepressed patients with SLE and controls. Compared to nondepressed patients with SLE, depressed patients with SLE had significantly lower CBF in 2 clusters that had their local maxima in the right precentral gyrus and in the left superior temporal gyrus. The duration of SLE correlated with decreased perfusion in the left middle and superior frontal gyrus.


CONCLUSIONS
Depressed patients with SLE have CBF reductions in discrete temporal and frontal regions that may account for depressive symptoms.
Giovacchini
Giampiero
G
Regional Center of Nuclear Medicine, University of Pisa Medical School, Pisa, Italy. giovacchinig@uhbs.ch
Mosca
Marta
M
Manca
Gianpiero
G
Della Porta
Mauro
M
Neri
Claudia
C
Bombardieri
Stefano
S
Ciarmiello
Andrea
A
Strauss
H William
HW
Mariani
Giuliano
G
Volterrani
Duccio
D
D000328:Adult; D001921:Brain / Q000033:anatomy & histology / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003866:Depressive Disorder / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D008875:Middle Aged; D015609:Organotechnetium Compounds / Q000378:metabolism; D012039:Regional Blood Flow / Q000502:physiology*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
D015609:Organotechnetium Compounds