title: The value of ethyl cysteinate dimer single photon emission computed tomography in predicting antidepressant treatment response in patients with major depression.
abstract: OBJECTIVE
  The purpose of this study is to examine whether the reversal of compromised regional cerebral blood flow (rCBF) in older patients with major depressive disorder (MDD) is dependent on specific parameters of selective serotonin reuptake inhibitor (SSRI) treatment and to examine the efficacy of such treatment.
  
  
  METHODS
  Forty-five patients with moderate MDD were studied following 8 weeks of treatment with SSRIs. Twelve patients displayed a positive response to SSRIs, whereas 33 patients did not respond to SSRI treatment. A comparison group of 30 healthy volunteers was also studied. The age of all participants was greater than 50 years. Age, gender, and the Hamilton Rating Scale for Depression scores were examined. The rCBF was assessed using 99mTc-ethyl cysteinate dimer single photon emission computed tomography after SSRI treatment.
  
  
  RESULTS
  The rCBF levels in the right middle frontal cortex in non-responsive MDD patients were lower compared with responsive MDD patients. Compared with healthy controls, non-responders had significantly lower rCBF levels in the bilateral middle frontal cortex and insula and had significantly higher rCBF levels in the bilateral inferior frontal cortex and left middle temporal cortex. Compared with healthy controls, responders had significantly higher rCBF levels in the left inferior frontal, middle temporal, precentral, and fusiform gyrus. We found no changes in single photon emission computed tomography between pre-treatment and post-treatment stages for the responders to SSRI treatment.
  
  
  CONCLUSIONS
  Hypoperfusion in older, non-responsive MDD patients was primarily localized in the middle frontal cortex. It is possible that the responders to SSRI treatment at baseline already displayed higher rCBF values in the frontal regions.
authors.affiliation: Department of Neuropsychiatry, Oita University Faculty of Medicine, Oita, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Hanada
authors.forename: Junko
authors.initials: J
authors.lastname: Imanaga
authors.forename: Aoi
authors.initials: A
authors.lastname: Yoshiiwa
authors.forename: Tomoya
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Jusen
authors.initials: J
authors.lastname: Tsuru
authors.forename: Ayako
authors.initials: A
authors.lastname: Inoue
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Ishitobi
authors.forename: Shizuko
authors.initials: S
authors.lastname: Okamoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kanehisa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Maruyama
authors.forename: Taiga
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Haruka
authors.initials: H
authors.lastname: Higuma
authors.forename: Koichi
authors.initials: K
authors.lastname: Isogawa
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kawasaki
authors.forename: Toshio
authors.initials: T
authors.lastname: Fujioka
authors.forename: Jotaro
authors.initials: J
authors.lastname: Akiyoshi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation / Q000187:drug effects* / Q000502:physiology; D003545:Cysteine / Q000031:analogs & derivatives*; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D000928:Antidepressive Agents; D003545:Cysteine; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D017367:Selective Serotonin Reuptake Inhibitors; C059659:technetium Tc 99m bicisate