technetium-tc-99m-bicisate and Depressive-Disorder

The aim of this study was to investigate regional cerebral blood flow (rCBF) changes of end-stage renal disease (ESRD) patients with depressive symptoms during dialysis.. Fourteen patients with ESRD underwent Tc-99m ethylcysteinate dimer (Tc-99m ECD) brain single photon emission computed tomography (SPECT) and were evaluated the severity of depressive mood at pre-dialytic period and at least 6 months after dialysis initiation. rCBF was analyzed using statistical parametric mapping (SPM) in brain SPECT image. The responder was defined as a decrease of ≥25% in Hamilton Depression Rating Scale (HDRS) score from baseline HDRS score.. Pre-dialysis brain SPECT did not show any rCBF differences between responders and non-responders. The follow-up brain SPECT revealed a significant higher perfusion in left middle temporal gyrus of responder group when compared with non-responder (hemisphere coordinate X, Y, Z; -58, -2, -16, peak Z = 3.36, p = 0.046). In responder, a significant increase in rCBF was found in right parahippocampal gyrus (hemisphere coordinate X, Y, Z; 30, -40, -14, peak Z = 3.51, p = 0.043). In non-responder, there were significant decreases in rCBF in left superior frontal gyrus (hemisphere coordinate X, Y, Z; -22, 30, 42, peak Z = 3.86, p = 0.032) and right orbitofrontal cortex (hemisphere coordinate X, Y, Z; 10, 58, -6, peak Z = 3.81, p = 0.046).. The present findings showed the characteristic patterns of rCBF changes in depressive ESRD patients having maintenance dialysis. Further investigations in brain blood flow and glucose metabolism are needed to elucidate the effect of dialysis itself and the difference of according to dialysis modality in patients having depression and ESRD.

Topics: Adult; Aged; Brain; Cerebrovascular Circulation; Cysteine; Depressive Disorder; Dimerization; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Organotechnetium Compounds; Renal Dialysis; Tomography, Emission-Computed, Single-Photon; Treatment Outcome

Transcranial magnetic stimulation (TMS) has been recently suggested for the treatment of patients with major depression. Based on the results of the authors' pilot study showing a possible antidepressive effect of single-pulse TMS, a clinical trial was conducted involving patients with major depression. For the present study single-photon emission computed tomography (SPECT) was recorded for six of the target patients to study the effects of TMS on the local blood flow volume. Twenty-three inpatients meeting the Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) criteria for major depression were invited to participate in the study. Depressive symptoms were rated using the Hamilton Rating Scale for Depression (HAM-D). Patients were given 10 stimuli over the frontal area of both sides for a total of 20 stimuli in a session. The subjects had daily TMS session for 5 days as an add-on therapy. In addition, six patients had their quantitative (99m)Tc-ethyl cysteinate dimer SPECT images measured before and after TMS treatment. Compared with the value 2 days prior to the start of TMS therapy (24.2 +/- 4.9), the average HAM-D scale dropped significantly to 15.3 +/- 6.6 on the day after completion of such therapy. The results of SPECT showed that the regional cerebral blood flow (rCBF) of the bilateral frontal region had increased in four out of six patients when comparing before and after treatment. The present study shows that single-pulse TMS, which is widely used as a neurological test method, possesses a wide range of antidepressive effects without inducing adverse reactions. The results suggest that although repetitive TMS is steadily becoming the mainstay technique today, single-pulse TMS also possesses sufficient antidepressive effects.

Topics: Aged; Cerebrovascular Circulation; Cysteine; Depressive Disorder; Electromagnetic Fields; Female; Humans; Male; Middle Aged; Organotechnetium Compounds; Psychiatric Status Rating Scales; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon

Depression is one of the most common psychiatric illnesses. Its influence on brain perfusion has been demonstrated, but conflicting data exist on follow-up after drug treatment. The aim of our study was to evaluate the effects of antidepressant drugs on regional cerebral blood flow (rCBF) in patients with depression after 3 weeks and 6 months of drug therapy. Clinical criteria for depression without psychosis were met according to psychiatric evaluation. Severity of depression was evaluated with the Hamilton Depression Rating Scale (HAMD) before every scintigraphic study. rCBF was assessed using technetium-99m bicisate (Neurolite) brain single-photon emission tomography in nine patients with severe depression before the beginning of antidepressant drug therapy and 3 weeks and six months after initiation of therapy. Only patients with no change in antidepressant medication during the study were included. No antipsychotic drugs were used. Cerebellum was used as the reference region. rCBF was evaluated for eight regions in each study in three consecutive transversal slices. Follow-up studies were compared with the baseline study. The mean HAMD score was 25.5 points initially, 16 at the second examination and 8.8 after 6 months. Global CBF was decreased compared with the reference region in drug-free patients. Perfusion of left frontal and temporal regions was significantly lower (P < 0.005) in comparison with the contralateral side. After therapy, a moderate decrease in perfusion was seen in the right frontal region (P < 0.05). Perfusion decreased further after 6 months in the right frontal (P < 0.005) and temporal regions (P < 0.01). The highly significant asymmetry in perfusion between the left and right frontal and temporal lobes almost disappeared during treatment. Our findings implicate dysfunction of the frontal and temporal cortex in clinically depressed patients before specific drug treatment. Clinical improvement and decreases in HAMD score after 3 weeks and after 6 months reflect the treatment effect on mood-related rCBF changes.

Topics: Adult; Aged; Antidepressive Agents; Brain; Cerebrovascular Circulation; Cysteine; Depressive Disorder; Female; Humans; Male; Middle Aged; Organotechnetium Compounds; Psychiatric Status Rating Scales; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon

Depressive symptoms are common in patients with Alzheimer's disease (AD) and increase the caregiver burden, although the etiology and pathologic mechanism of depressive symptoms in AD patients remain unclear. In this study, we tried to clarify the cerebral blood flow (CBF) correlates of depressive symptoms in AD, excluding the effect of apathy and anxiety. Seventy-nine consecutive patients with AD were recruited from outpatient units of the Memory Clinic of Okayama University Hospital. The level of depressive symptoms was evaluated using the depression domain of the Neuropsychiatric Inventory (NPI). The patients underwent brain SPECT with 99mTc-ethylcysteinate dimer. After removing the effects of age, anxiety and apathy scores of NPI, and five subscales of Addenbrooke's Cognitive Examination-revised (ACE-R), correlation analysis of NPI depression scores showed a significant cluster of voxels in the left middle frontal gyrus (Brodmann area 9), similar to the areas in the simple correlation analysis. The dorsolateral prefrontal area is significantly involved in the pathogenesis of depressive symptoms in AD, and the area on the left side especially may be closely related to the depressive symptoms revealed by NPI.

Topics: Aged; Aged, 80 and over; Alzheimer Disease; Caregivers; Cerebral Cortex; Cerebrovascular Circulation; Cysteine; Depression; Depressive Disorder; Female; Frontal Lobe; Humans; Male; Middle Aged; Neuropsychological Tests; Organotechnetium Compounds; Psychiatric Status Rating Scales; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon

Depressive symptoms are common in Alzheimer's disease (AD) and contribute to clinical morbidity. Previous studies have suggested that hypoperfusion in the prefrontal cortex and anterior cingulate gyrus are involved in the pathophysiology of depression. Using the easy Z-score imaging system (eZIS), we investigated the relationship between depressive symptoms and prefrontal hypoperfusion in AD. Tc-99m-ethyl cysteinate dimer (Tc-99m-ECD)-single photon emission tomography (SPECT) and Neuropsychiatric Inventory (NPI) were performed in forty-four patients diagnosed as having Dementia of Alzheimer's type (DAT) with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). These patients were divided into the depressive group (D group: n=26) and non-depressive group (ND group: n=18) using NPI depression items. All data from SPECT images were analyzed using eZIS software. Scores in four regions were determined by Z-values; these regions consisted of each side of the prefrontal cortex and anterior cingulate gyrus. The mean scores between the D group and ND group were compared. The mean scores of the left prefrontal cortex in the D group were significantly higher (p<0.0125) than those in the ND group. There were no significant differences in the scores of the right prefrontal cortex and the bilateral anterior cingulate gyrus between these two groups (Mann-Whitney U-test). These findings suggest that hypoperfusion in the left prefrontal area contributes to the expression of depressive symptoms in patients with DAT.

Topics: Aged; Aged, 80 and over; Alzheimer Disease; Brain Mapping; Cerebrovascular Circulation; Cerebrovascular Disorders; Cysteine; Depressive Disorder; Female; Functional Laterality; Gyrus Cinguli; Humans; Male; Organotechnetium Compounds; Predictive Value of Tests; Prefrontal Cortex; Tomography, Emission-Computed, Single-Photon

The aim of this study is to investigate the relationship between regional cerebral blood flow (rCBF) and symptom clusters of depressive mood in pre-dialytic chronic kidney disease (CKD).. Twenty-seven patients with stage 4-5 CKD were subjected to statistical parametric mapping analysis of brain single-photon emission computed tomography. Correlation analyses between separate symptom clusters of depressive mood and rCBF were done.. The first factor (depressive mood) was negatively correlated with rCBF in the right insula, posterior cingulate gyrus, and left superior temporal gyrus, and positively correlated with rCBF in the left fusiform gyrus. The second factor (insomnia) was negatively correlated with rCBF in the right middle frontal gyrus, bilateral cingulate gyri, right insula, right putamen, and right inferior parietal lobule, and positively correlated with rCBF in left fusiform gyrus and bilateral cerebellar tonsils. The third factor (anxiety and psychomotor aspects) was negatively correlated with rCBF in the left inferior frontal gyrus, right superior frontal gyrus, right middle temporal gyrus, right superior temporal gyrus, and left superior frontal gyrus, and positively correlated with rCBF in the right ligual gyrus and right parahippocampal gyrus.. In this study, the separate symptom clusters were correlated with specific rCBF patterns similar to those in major depressive disorder patients without CKD. However, some areas with discordant rCBF patterns were also noted when compared with major depressive disorder patients. Further larger scale investigations are needed.

Topics: Adult; Anxiety; Brain; Case-Control Studies; Cerebrovascular Circulation; Cysteine; Data Interpretation, Statistical; Depressive Disorder; Dominance, Cerebral; Female; Humans; Imaging, Three-Dimensional; Male; Middle Aged; Organotechnetium Compounds; Pattern Recognition, Automated; Radiopharmaceuticals; Reference Standards; Regional Blood Flow; Renal Insufficiency, Chronic; Signal Processing, Computer-Assisted; Sleep Initiation and Maintenance Disorders; Stereotaxic Techniques; Tomography, Emission-Computed, Single-Photon

We report the case of an adult male patient with Tourette syndrome, self-injurious behavior and depression, refractory to conventional treatment, and whose symptoms remitted after electroconvulsive therapy. Serial Technetium 99m-Ethyl-Cysteinate-Dimer single photon emission tomographies were applied, before, during, and after electroconvulsive therapy. The neural substrates of this treatment process were further analyzed by woxel-wise subtracted single photon emission tomography images.

Topics: Adult; Brain; Brain Mapping; Brief Psychiatric Rating Scale; Cerebral Cortex; Combined Modality Therapy; Cysteine; Depressive Disorder; Electroconvulsive Therapy; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Male; Neurologic Examination; Organotechnetium Compounds; Psychotropic Drugs; Regional Blood Flow; Self-Injurious Behavior; Subtraction Technique; Tomography, Emission-Computed, Single-Photon; Tourette Syndrome

The purpose of this study was to correlate the basal cerebral blood flow (CBF) in patients with major depressive disorder (MDD) with the score for each of the 21 questions in the Hamilton Rating Scale for Depression (HRSD), in order to determine the cerebral regions associated with each item.. Fourteen antidepressant-naive patients with unipolar depression (DSM-IV criteria for MDD) participated in this study with a HRSD score of >/=20 points. CBF images obtained by SPECT were analyzed by SPM99 software. The significant correlation threshold for a priori regions (frontocortical and limbic regions) was a Z value of at least 2.25 and clusters formed by more than 10 voxels.. Items 1, 6, 11 and 20 were positively correlated with right medial frontal gyrus; item 7 was negatively correlated with bilateral medial frontal gyrus. Items 2 and 10 were positively correlated with right anterior and medial cingulate, respectively. Item 5 was negatively correlated with the left amygdala. Item 9 was negatively correlated with bilateral insula, and item 16 with right insula. Items 12 and 14 were positively correlated with right and left precentral frontal gyrus, respectively.. The small sample size and only out-patients included in the study.. The frontal cortex plays an important role in the expression of MDD symptoms. Not all the symptoms evaluated correlated with one single structure, which may explain the diverse results reported in the literature. These preliminary results support the necessity of further analyses by symptoms that could provide more specific information on the pathophysiology of MDD.

Topics: Adult; Amygdala; Brain; Cerebral Cortex; Cysteine; Depressive Disorder; Female; Frontal Lobe; Functional Laterality; Gyrus Cinguli; Humans; Limbic System; Male; Organotechnetium Compounds; Psychiatric Status Rating Scales; Regional Blood Flow; Tomography, Emission-Computed, Single-Photon

Topics: Adult; Brain; Cerebrovascular Circulation; Cysteine; Depressive Disorder; Female; Humans; Organotechnetium Compounds; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon