Neuroscientific Investigation of the Pathophysiology of Mood Disorder and Suicide Behavior

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We have investigated disorder-specific pathophysiology of mood disorder, including suicide behavior, by using ^<18>F-FDG-Positron Emission Tomography (PET) and combined endocrinological examination of dexamethasone (DEX) and corticotropin-releasing hormone (CRH). Drug-naive 24 patients with major depression and 10 patients who were investigated by brain imaging analysis and neuroendocrinological examination at pre-treatment and at post-treatment when they were well responded to antidepressant treatment, are included in this study. 75 % of 24 mood disorder patients were non-suppressor in DEX/CRH examination, who have had more frequently the past history of suicide attempt than suppressor. After recovery from depression, most of non-suppressors were changed to suppressors, but 20 % of mood disorders were still non-suppressor, suggesting that some parts of non-suppressor are trait marker of mood disorder or susceptive factor of mood disorder.On the other hand, ^<18>F-FDG-PET study has reveal that left pre-frontal cortex and right superior temporal gyrus of mood disorder patients are significantly decreased to take up ^<18>F-FDG than healthy controls, whereas para-hippocampal gyrus is increased in ^<18>F-FDG intake. These pathological alterations during depressive phase were normalized after recovery from depression, except right superior temporal gyrus. In addition, SPM analysis has clearly demonstrated that ^<18>F-FDG intake into right para-hippocampal gyrus was smaller in non-suppressor than in suppressor. Further studies are needed to clarify the histological alterations in left pre-frontal cortex, right superior temporal gyrus, and right para-hippocampal gyrus from postmortem brain of mood disorder.