Regional cerebral blood flow in depression: associations with psychopathology

Schlegel, S.; Aldenhoff, Josef B.; Eißner, D; Lindner, Peter; Nickel, O.

doi:10.1016/0165-0327(89)90002-5

Cited by 63 publications

(14 citation statements)

References 21 publications

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“…In demented patients depression scales often also reflect dementia [81] and therefore reduced responsiveness correlates with higher (pseudo)depression. In the controls, though they were not significantly depressed, results of previous stud ies could be applicable, which showed a reduced CBF in depression normalizing under stimulation [82,83], Thus there appeared to be a trend for a higher responsiveness with increasing depressivity in nondemented persons. Our results support the assumption that CBF investiga tions using acetazolamide and 99mTc-HMPAO and SPET could help differentiating primary depressive syndromes with cognitive impairment from demented patients ex hibiting depressive symptoms [81] and encourage further studies in this direction.…”

mentioning

confidence: 77%

Cerebrovascular Reactivity to Acetazolamide in (Senile) Dementia of Alzheimer’s Type: Relationship to Disease Severity

Stoppe¹,

Schütze²,

Kögler

et al. 1995

Dement Geriatr Cogn Disord

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Neuropathological reports about denervation and amyloid angiopathy in dementia of Alzheimer''s type (DAT) as well as signs of selective incomplete white matter infarctions point to a vascular involvement within the degenerative process. In order to investigate potential alterations of cerebrovascular function we performed cerebral blood flow measurements before and after intravenous injection of 1 g acetazolamide using technetium-99m hexamethylpropyleneamine oxime and single photon emission tomography in 12 patients (6 female, 6 male; mean age 70.8 ± 9.6 years) with probable (senile) dementia of Alzheimer''s type (SDAT) and 9 controls (7 female, 2 male; mean age 71.2 ± 8.6 years). SDAT patients revealed significantly reduced cerebrovascular reactivity with lower values with increasing cognitive impairment. We discuss possible underlying mechanisms.

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mentioning

confidence: 77%

Cerebrovascular Reactivity to Acetazolamide in (Senile) Dementia of Alzheimer’s Type: Relationship to Disease Severity

Stoppe¹,

Schütze²,

Kögler

et al. 1995

Dement Geriatr Cogn Disord

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“…In single-photon emission-computed tomography studies, null findings 57,58 or higher pretreatment rostral ACC activity in melancholic subjects who responded to sleep deprivation than nonresponders 59 have been reported. In PET studies, decreased glucose metabolism in the left dorsolateral PFC 60 and increased blood flow in the left ventrolateral PFC 61 has been observed in melancholic patients.…”

mentioning

confidence: 99%

Functional but not structural subgenual prefrontal cortex abnormalities in melancholia

et al. 2003

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Major depression is a heterogeneous condition, and the search for neural correlates specific to clinically defined subtypes has been inconclusive. Theoretical considerations implicate frontostriatal, particularly subgenual prefrontal cortex (PFC), dysfunction in the pathophysiology of melancholia-a subtype of depression characterized by anhedonia-but no empirical evidence has been found yet for such a link. To test the hypothesis that melancholic, but not nonmelancholic depression, is associated with the subgenual PFC impairment, concurrent measurement of brain electrical (electroencephalogram, EEG) and metabolic (positron emission tomography, PET) activity were obtained in 38 unmedicated subjects with DSM-IV major depressive disorder (20 melancholic, 18 nonmelancholic subjects), and 18 comparison subjects. EEG data were analyzed with a tomographic source localization method that computed the cortical three-dimensional distribution of current density for standard frequency bands, allowing voxelwise correlations between the EEG and PET data. Voxel-based morphometry analyses of structural magnetic resonance imaging (MRI) data were performed to assess potential structural abnormalities in melancholia. Melancholia was associated with reduced activity in the subgenual PFC (Brodmann area 25), manifested by increased inhibitory delta activity (1.5-6.0 Hz) and decreased glucose metabolism, which themselves were inversely correlated. Following antidepressant treatment, depressed subjects with the largest reductions in depression severity showed the lowest post-treatment subgenual PFC delta activity. Analyses of structural MRI revealed no group differences in the subgenual PFC, but in melancholic subjects, a negative correlation between gray matter density and age emerged. Based on preclinical evidence, we suggest that subgenual PFC dysfunction in melancholia may be associated with blunted hedonic response and exaggerated stress responsiveness.

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“…Two other CBF-studies on this topic revealed comparable results (Curran etal., 1993;Upadhaya etal., 1990). Reduced global CBF values were also described in younger depressives by other authors (Mathew et al, 1980;Warren et al, 1984;Schlegel et al, 1989). Overall, the data concerning the influence of depression of CBF are conflicting up to now.…”

Section: Discussionmentioning

confidence: 73%

“…For the depression group these results should be interpreted carefully, since decreasing flow with better cognition (and less depressivity?) would be the opposite trend to the above mentioned 'decreasing flow with increasing depression severity', which however has been demonstrated as significant correlation in only one study (Schlegel et al, 1989). There was also no correlation between MMSE and depression scores.…”

Section: Discussionmentioning

confidence: 76%

99mTc-HMPAO-SPECT in the diagnosis of senile dementia of Alzheimer's type ? a study under clinical routine conditions

Stoppe

Staedt

Kögler

et al. 1995

J. Neural Transmission

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This study was designed to evaluate, whether investigations of cerebral blood flow can be a helpful diagnostic tool in the differential diagnosis between (senile) dementia of Alzheimer's type [(S)DAT] and geriatric depression with cognitive impairment. Under clinical routine conditions we performed Single Photon Emission Computed Tomography (SPECT) using 99mTc-Hexamethylpropyleneamine Oxime (HMPAO) in 23 patients with (S)DAT (14f, 9m; mean age 68.9 y), 17 patients with geriatric depression (9 f, 8 m; mean age 66.4 y) and 12 age-matched controls (9 f, 3 m; mean age 69.2 y). Semiquantitative analysis (corticocerebellar ratios) of eight different regions of interest (ROI) revealed a significantly (p < 0.05) reduced perfusion in the (S)DAT patients compared to the control group. The depression group exhibited perfusion values between the (S)DAT and control group. The difference between the depression and (S)DAT group was most prominent in the left parieto-occipital ROI (p = 0.008). We discuss the data with extensive regard to the literature and conclude that 99mTc-HMPAO SPECT is a valuable additional tool in the differential diagnosis of depression and dementia in the elderly.

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Regional cerebral blood flow in depression: associations with psychopathology

Cited by 63 publications

References 21 publications

Cerebrovascular Reactivity to Acetazolamide in (Senile) Dementia of Alzheimer’s Type: Relationship to Disease Severity

Cerebrovascular Reactivity to Acetazolamide in (Senile) Dementia of Alzheimer’s Type: Relationship to Disease Severity

Functional but not structural subgenual prefrontal cortex abnormalities in melancholia

99mTc-HMPAO-SPECT in the diagnosis of senile dementia of Alzheimer's type ? a study under clinical routine conditions

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