Baseline and cognition activated brain SPECT imaging in depression

Purpose: To evaluate the regional cerebral blood flow (rCBF) abnormalities through the semiquantitative analysis of the baseline and cognition activated rCBF imaging in unmedicated depressed patients. Methods: 27 depressed patients unmedicated by anti-depressants were enrolled. The diagnosis (depression of moderate degree with somatization) was confirmed by the ICD-10 criteria. 15 age matched normal controls were studied under identical conditions. Baseline and cognition activated 99mTc-ECD SPECT were performed on 21 of the 27 patients with depression and 13 of the 15 normal controls. Baseline 99mTc-ECD SPECT alone were performed on the rest 6 patients with depression and 2 normal controls. The cognitive activation is achieved by Wisconsin Card Sorting Test (WCST). 1110 MBq of 99mTc-ECD was administered by intravenous bolus injection 5 minutes after the onset of the WCST. Semi-quantitative analysis was conducted with the 7th, 8th, 9th, 10th, 11th slices of the transaxial imaging. rCBF ratios of every ROI were calculated using the average tissue activity in the region divided by the maximum activity in the cerebellum. Results: 1) The baseline rCBF of left frontal (0.720) and left temporal lobe (0.720) were decreased significantly in depressed patients comparing with those of the control subjects. 2) The activated rCBF of left frontal lobe (0.719) and left temporal lobe (0.690), left parietal lobe (0.701) were decreased evidently than those of the controls. Conclusions: 1) Hypoperfusions of left frontal and left temporal cortexes were identified in patients with depression. 2) The hypoperfusion of left frontal and left temporal cortexes may be the cause of cognition disorder and depressed mood in patients with depression. 3) Cognition activated brain perfusion imaging is helpful for making a more accurate diagnosis of depression