Regional Cerebral Blood Flow in Depression and Mania

Assessment of changes in regional cerebral blood flow in patients with major depression using the 99mTc-HMPAO single photon emission tomography method

“…In a recent study, the same group (Devous et al 1991), using xenon-133/SPET, found a decreased CBF in the frontal and both temporal lobes and a lowered left/right gradient in patients with endogenous depression, which is similar to our findings. However, our results are not in agreement with some authors who reported unchanged rCBF in depression (Gur et al 1984;Goldstein et al 1985;Silfverski61d et al 1989). …”

“…Besides the PET studies, there have been an increasing number of single photon emission tomography (SPET) studies in patients with affective disorders because of the greater availability and lower expense of the technique. In regional cerebral blood flow (rCBF) studies of patients in episodes of major depressive disorder, there are reports of global reduction (Mathew et al 1980;Warren et al 1984;Schlegel et al 1989;Sackeim et al 1987Sackeim et al , 1990Delvenne et al 1990) and, in contrast, reports of no difference from controls (Gur et al 1984;Goldstein et al 1985;Silfverski61d and Risberg 1989). The original xenon method and dynamic SPET are inadequate in evaluating the deeper structures of the brain and the images obtained contain artefacts.…”

Cerebral blood flow and metabolism in affective disorders

“…Silfverskiold and Risberg (1989) also found unaltered blood flow in depression and moreover, in an earlier study with fewer patients, the same group actually reported increased cortical flow (Silfverskiold et al, 1986). In support of this latter finding, Rosenberg et al (1988) found increased hemispheric blood flow in depressed subjects using CBF SPECT.…”

Structural and functional neuroimaging of electroconvulsive therapy and transcranial magnetic stimulation

“…Moreover, not all techniques, including recent tomographic methods, provide fully quantitative measures of CBF or CMR. As global shifts in CBF and CMR are known to occur with ECT [Volkow et al, 1988;Silfverskiöld and Risberg, 1989;Nobler et al, 1994], such lack of full quantification introduces potential errors. Aside from imaging technique, the method of ECT administration has also varied from study to study.…”

“…Rosenberg et al [1988], utilizing 133 Xe dynamic SPECT, found reductions in global CBF 24 hr following a course of ECT, that was largely due to frontal decreases. Using the 133 Xe inhalation technique, Silfverskiöld and Risberg [1989] studied 32 patients at baseline, 1-2 hr after individual right unilateral (RUL) or bilateral (BL) ECT treatments, and at long-term follow-up. They reported decreased cortical CBF immediately after ECT, with RUL resulting in predominately right frontal reductions and BL ECT leading to symmetric frontal CBF decreases.…”