Changes in regional cerebral blood flow abnormalities in late-life depression following response to electroconvulsive therapy

Shuichi Awata, Michiko Konno, Ryuta Kawashima, Kazumasa Suzuki, Toshimitsu Sato, Hiro Matsuoka, Hiroshi Fukuda, Mitsumoto Sato

Research output: Contribution to journalArticlepeer-review

41 Citations (Scopus)

Abstract

The impact of electroconvulsive therapy (ECT) on the regional cerebral blood flow (rCBF) abnormalities in late-life depression is still unknown and the clinical significance of these findings in late-life depression has not been fully discussed. Using single photon emission computed tomography (SPECT) with 99mTc-hexamethylpropylene amine oxime (99mTc-HMPAO), we examined the changes of rCBF patterns in nine late-life patients with major depressive episodes before and following response to ECT compared with nine age- and sex-matched healthy volunteers. Statistical comparisons were made on both region-of-interest (ROI) and voxel-by-voxel bases. In ROI-based analyses, a mean rCBF was significantly decreased in the patients before ECT compared with the control, significantly increased (normalized) in the patients 2 weeks after ECT compared with that before ECT, and still increased in the patients 12 weeks after ECT compared with that before ECT. In voxel-by-voxel analyses, a significant rCBF reduction was found in the bilateral pre- and subcallosal anterior cingulate cortex, the bilateral caudal orbitofrontal cortex, the right insular cortex and the right posterior middle frontal gyrus in patients before ECT compared with the control, and similar rCBF patterns were shown at 2 weeks and 12 weeks after ECT. We propose the hypothesis that a mean rCBF reduction may have a state-related property while persistent anterior paralimbic hypoperfusion may have a trait-like property, which relates to the relapse vulnerability as well as a tendency toward medication failure and illness chronicity in late-life depression.

Original languageEnglish
Pages (from-to)31-40
Number of pages10
JournalPsychiatry and Clinical Neurosciences
Volume56
Issue number1
DOIs
Publication statusPublished - 2002

Keywords

  • Anterior paralimbic cortex
  • Electroconvulsive therapy
  • Late-life depression
  • Regional cerebral blood flow
  • Single photon emission computed tomography

ASJC Scopus subject areas

  • Neuroscience(all)
  • Neurology
  • Clinical Neurology
  • Psychiatry and Mental health

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