Changes in regional cerebral blood flow following antidepressant treatment in late-life depression
Changes in regional cerebral blood flow following antidepressant treatment in late-life depression
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DOI：
10.1002/gps.1980
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发表时间：
2008-08-01
影响因子：
4
通讯作者：
Mimura, Masaru
中科院分区：
文献类型：
--
作者：
Ishizaki, Junko;Yamamoto, Hideki;Mimura, Masaru
目的 抑郁症患者存在可逆/不可逆的局部脑血流 (rCBF) 异常。然而，在晚年抑郁症中，几乎没有证据表明 rCBF 通过缓解而发生纵向变化。我们检查了晚年抑郁症患者的 rCBF 下降是否会在治疗后得到缓解。方法 25 名年龄超过 55 岁的抑郁症患者在平均 13.7 周的药物治疗前后完成了汉密尔顿抑郁量表和单光子发射计算机断层扫描。使用统计参数映射程序进行定量分析。结果与健康对照相比，抑郁症患者的前腹侧和背侧内侧前额叶皮质 (PFC) 的 rCBF 降低，包括前扣带皮层、双侧腹外侧 PFC 至颞叶皮质以及双侧顶枕叶内侧至外侧。没有特定区域显示 rCBF 增加。药物治疗后，左侧背外侧 PFC 至中央前区和右侧顶枕区的 rCBF 显着增加。然而，前腹/背内侧 PFC、双侧腹外侧 PFC、双侧颞叶和双侧顶叶的 rCBF 基线时降低，治疗后并未显示出显着改善。 结论 左背外侧 PFC 至中央前区的 rCBF 显着改善，与包括左额叶皮层在内的神经网络可能在功能上和可逆性地参与晚年单相重性抑郁（状态依赖性）的假设一致。相反，包括双侧内侧、背外侧和顶叶区域的神经回路可能反映了抑郁症潜在的、持续的特征性脑功能障碍（依赖于特质）。版权所有 (C) 2008 约翰·威利父子有限公司
Objective Reversible/irreversible abnormalities of regional cerebral blood flow (rCBF) are seen in patients with depression. However, in late-life depression there is little evidence of a longitudinal change in rCBF through remission. We examined whether the decreased rCBF in individuals with late-life depression resolves following treatment.Methods Twenty-five depressed patients older than 55 years completed the Hamilton Rating Scale for Depression and single photon emission computed tomography before and after a mean of 13.7 weeks of pharmacotherapy. Quantitative analyses were performed using the Statistical Parametric Mapping procedure.Results Patients with depression demonstrated decreased rCBF in the anterior ventral and dorsal medial prefrontal cortex (PFC), including anterior cingulate cortices, bilateral ventrolateral PFC to temporal cortices, and bilateral medial to lateral parieto-occipital lobes relative to healthy controls. No particular areas showed increased rCBF. Following pharmacotherapy, rCBF significantly increased in the left dorsolateral PFC to precentral areas and the right parieto-occipital regions. However, decreased rCBF at baseline in the anterior ventral/dorsal medial PFC, bilateral ventrolateral PFC, bilateral temporal lobes, and bilateral parietal lobes did not show significant improvement after treatment.Conclusions Remarkable improvements in rCBF in the left dorsolateral PFC to precentral regions are consistent with the hypothesis that neuronetworks including the left frontal cortex may be functionally and reversibly involved in late-life unipolar major depression (state-dependent). In contrast, neural circuits including bilateral medial, dorsolateral, and parietal areas may reflect underlying and continuous pathognomonic brain dysfunction of depression (trait-dependent). Copyright (C) 2008 John Wiley & Sons, Ltd.