Changes in regional brain activity in major depression after successful treatment with antidepressant drugs

Abstract

Relative regional cerebral blood flow was measured with single photon emission computed tomography (SPECT) using 99mTc-hexamethylpropyleneamine oxime (99mTc-HMPAO) in 16 patients with major depression while they were in the depressed state as well as in remission. All patients were closely matched with regard to medication status. In the depressed state, significant reductions in tracer uptake were found in the left superior frontal, bilateral parietal and right lateral temporal cortex. During remission, significant increases in uptake were found in the left superior frontal, right parietal and right lateral temporal cortex. There were no significant differences in tracer uptake between patients in remission and controls. These findings suggest that the regional decreases in tracer uptake observed in the depressed state might be a state-related abnormality.

ATF2, A Member of the CREB/ATF Family of Transcription Factors, in Chronic Stress and Consequent to Antidepressant Treatment: Animal Models and Human Post-Mortem Brains

“…In order to assess the relevance of our findings in animal models to depression in humans, we examined the ATF2 expression in human post-mortem brains of depressed, bipolar, and schizophrenic patients, and normal controls. This was assessed in the ventral parieto-occipital cortex, alterations in which have been observed in depression (Ogura et al, 1998;Drevets et al, 2000;Brody et al, 2001). In the present study, no differences were observed in the levels of ATF2 and its phosphorylation between any of the patients groups.…”

“…Notably, the lack of differences in ATF2 levels could also be a result of the specificity of the region examined. Thus, while, as mentioned, alterations in the parietal cortex in general have been reported in depression (Ogura et al, 1998;Drevets et al, 2000;Brody et al, 2001), the select nature of the area we obtained (ie the ventral parietooccipital cortex) may have resulted in an attenuated effect. Conceivably, alterations in ATF2 would have been more prominent in regions more fundamental to the pathophysiology of the disorder.…”

Attenuated Left Prefrontal Activation during a Verbal Fluency Task in Patients with Depression

“…Finally, our preliminary findings are limited by the relatively small group size and potential medication effects. However, Okada/Okamoto/Morinobu/Yamawaki/ Yokota there has been no established study that reports a negative influence of antidepressant medications on brain activity during verbal fluency tasks, and numerous studies have demonstrated that administration of antidepressants did not decrease cerebral blood flow [26,27]. Nevertheless, further studies using larger numbers of unmedicated subjects are required to elucidate the pathophysiological changes in depression.…”

“…All depressed subjects were inpatients at Hiroshima University Medical Hospital, diagnosed by three experienced clinicians as having major depressive disorder but no other major disorders according to DSM-IV criteria [21]. Their mean score on the 17-item Hamilton Rating Scale for Depression (HRSD) [22] was 19 (range [14][15][16][17][18][19][20][21][22][23][24][25][26][27]. All were medicated as follows: 4 patients were taking 150 mg fluvoxamine, while the others were taking either 200 mg fluvoxamine, 200 mg imipramine, 150 mg clomipramine, 150 mg amoxapine, 20 mg paroxetine, or 30 mg mianserin.…”

Brain Imaging in Mood Disorders

“…Pharmacotherapy Ogura et al (1998) found in an HMPAO-SPECT study of patients with major depression that the severity of depression was correlated negatively with perfusion in the left superior frontal, right lateral temporal and right parietal cortex. After treatment with tricyclic antidepressants (clomipramine and amoxapine), remitted patients' perfusion did not differ significantly from that of controls.…”