title: Brain perfusion alterations in depressed patients with Parkinson's disease.
abstract: OBJECTIVE
  Although Parkinson's disease (PD) is frequently accompanied by depression, brain perfusion deficits in PD with depression remain unclear. This study aimed to assess alterations in regional cerebral blood flow (rCBF) in depressed PD patients using99mTc hexamethyl-propylene-amine-oxime single-photon emission computed tomography (SPECT).
  
  
  METHODS
  Among 78 patients with PD, 35 patients were classified into the depressed PD group, while the rest (43 patients) was assigned to the nondepressed PD group based on the scores of the Geriatric Depressive Scale (GDS). All participants underwent brain SPECT imaging. The voxel-wise whole-brain analysis and region-of-interest (ROI) analysis of the limbic areas were conducted to compare rCBF between the depressed and nondepressed PD groups.
  
  
  RESULTS
  The depressed PD patients demonstrated higher GDS scores than nondepressed patients, whereas between-group differences in the PD severity and cognitive function were not significant. Perfusion in the left cuneus was increased, while that in the right superior temporal gyrus and right medial orbitofrontal cortex was reduced in the depressed PD patients as compared with nondepressed PD patients. In addition, the ROI analysis demonstrated rCBF decreases in the amygdala, anterior cingulate cortex, hippocampus, and parahippocampal gyrus in the depressed PD group. A positive correlation was found between the GDS scores and rCBF in the left cuneus cluster in the depressed PD patients.
  
  
  CONCLUSIONS
  This study identified the regional pattern of brain perfusion that distinguished depressed from nondepressed PD patients. Hyperperfusion in the occipital areas and hypoperfusion in the fronto-temporo-limbic regions may be potential imaging biomarkers for depression in PD.
authors: Department of Neurology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, South Korea.
authors: Young-Do
authors: YD
authors: Kim
authors: Department of Radiology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, South Korea.
authors: Hyeonseok S
authors: HS
authors: Jeong
authors: Department of Neurology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, South Korea.
authors: In-Uk
authors: IU
authors: Song
authors: Department of Radiology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, South Korea.
authors: Yong-An
authors: YA
authors: Chung
authors: Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea.
authors: Eun
authors: E
authors: Namgung
authors: Department of Neurology, College of Medicine, Konyang University, Daejeon, South Korea. ohyeap@gmail.com.
authors: Yong-Duk
authors: YD
authors: Kim
mesh_terms: D000368:Aged; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015899:Tomography, Emission-Computed, Single-Photon
keywords: Brain perfusion; Depression; Parkinson’s disease; Regional cerebral blood flow; SPECT